Mental
Health Experts discuss Topic as it Relates To the Graying of America
WASHINGTON, D.C., May 18 /PRNewswire/ -- The rate of depression
in people with other medical illnesses, such as arthritis, heart
disease, chronic lung disease, and stroke, is alarmingly higher
than in that of otherwise healthy adults. Unfortunately, many
of those who suffer do so needlessly, according to physician researchers
from the American Association for Geriatric Psychiatry (AAGP)
presenting data here today at the 152nd annual meeting of the
American Psychiatric Association.
In
fact, medical illness is the single greatest risk factor in late-life
depression. With the rapid growth in the number of older adults
-- the fastest growing segment of the U.S. population -- the link
between depression and medical morbidity has been gaining attention.
"Many
people think that depression is a normal part of aging. It's not.
It's not normal to be old and sad," said Barry Lebowitz, PhD,
chief, Adult and Geriatric Treatment and Prevention Interventions
Research Branch, National Institute of Mental Health. "Depression
is an illness and needs to be properly diagnosed and treated.
It is a known fact that when you treat the depression, symptoms
of other medical illnesses improve."
"Aging
brings with it increased risks for chronic medical disease. While
chronic illness is stressful, depression is not an inevitable
consequence and should be treated. Depression complicating medical
disorders in older adults responds well to treatment," added Soo
Borson, MD, AAGP president, and associate professor of Psychiatry
and Behavioral Sciences and director of Geriatric Psychiatry Services
at the University of Washington Medical Center.
"We
now have data from research that provide us with an understanding
of the issues surrounding depression and co-morbid illness, so
as we move into the future, we are better equipped to identify,
treat, and someday prevent, this complication."
Lebowitz
and Borson were two of four thought leaders who took part in an
AAGP-sponsored briefing here today on depression and co-morbid
illness, called "Is It All In Your Head? The Relationship Between
Depression, Other Medical Illnesses, and the Graying of America."
They
discussed the public health implications of depression in the
growing population of older Americans, as well as the newly presented
research they feel will better our ability to identify, treat,
and ultimately prevent, depression in people with other chronic
medical illnesses. The AAGP is the leading organization dedicated
to promoting the mental health and well being of older people,
and improving the care of those with late-life mental disorders.
In
addition to the topics presented by Lebowitz and Borson, P. Murali
Doraiswamy, MD, Duke University Medical Center, discussed "Heart
and Soul: the relationship between stroke, heart disease, and
depression," and Gary Small, MD, University of California at Los
Angeles, presented "The Brain and Body Connection: the relationship
between depression and other medical illnesses."
"We
are here today to answer the question on everyone's mind, 'What
can we in the United States, with our aging population, expect
in the 21st century, and what are our risks for physical and mental
diseases?'" said Borson. The answer is that the future looks very
good for both baby boomers and their graying family members.
"Older
adults are getting healthier, and overall rates of disability
are declining," said Borson. "And, in fact, 70 percent of those
over 65 years of age have no mental disorder." Borson added, however,
that of those who do, the two main sources of mental impairment
in the elderly are depression and dementia.
Although
the future is bright, Borson pointed out the challenges that still
exist. "The challenge for baby boomers who may care for an older
adult is to gain an understanding of the issue, identify disorders
early, and help him or her get appropriate treatment," said Borson.
"The
success rates of drug treatment therapies, for instance, have
never been better," said Borson. "Medications are now available
to treat depression with little risk of negative interactions
with other drugs a person might be taking for another medical
illness. In addition, unwanted effects of these drugs are generally
uncommon."
The
availability of one such medicine, citalopram, has allowed 10
leading academic institutions nationwide to conduct the first-ever
clinical trial evaluating depression treatment in people age 75
and older. The results of this study will further elucidate the
role of antidepressant therapy in the treatment of late-life depression.
Until now, a paucity of data exists regarding antidepressant treatment
in the oldest-old.
In
addition, older adults typically are a tougher audience for treatment
-- they're typically more sensitive to medications and drug interactions,
are often on more medications for a variety of ailments, and are
more likely to be suffering from chronic illness, than their younger
and healthier counterparts. As such, researchers believe that
what is learned in this study ultimately may improve depression
treatment in all patients whatever their age.
Borson
added that prevention is another important key to keeping depression
at bay in older adults, or in those people who have other medical
illnesses. "Preventive interventions are necessary to control
lifestyle risk factors, such as smoking, alcohol, head injury,
hormone deficiencies, and poor diet, all of which may make people
more susceptible to medical illness, and subsequently, depression,"
said Borson. "We must identify -- and identify early -- those
people who are at risk, and get them help."
This
briefing was supported by an unrestricted grant from Forest Laboratories,
Inc., and the Parke-Davis division of Warner-Lambert Company.
SOURCE American Association of Geriatric Psychiatry
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