Suicide rates do not increase with age among women. The elderly are less likely than younger patients to seek or respond to offers of help designed to prevent suicide. The elderly make fewer suicide gestures but more often succeed at suicide attempts. The etiology of depression in the elderly, as in younger persons, is biopsychosocial. Psychologic risk factors are similar across age groups and include guilt and negative thought patterns.
Cognitive dysfunction is another major risk factor.
Persons with lower incomes are at greater risk for depression. Heredity plays less of a role in depression with first onset in late life than in that with first onset in midlife. However, persons who first experience depression in early or midlife and have a recurrence in late life are just as likely to report a family history as are persons who experience depression in midlife. Structural brain changes, seen on MRI and thought to be secondary to vascular insufficiency, are associated with depression in late life. Such cases are referred to as vascular depression.