Many elderly people who are depressed may focus on their physical symptoms rather than emotional ones, often because they are unable or unwilling to express their feelings or are even aware that they are depressed. Others may be aware of their depression but believe that nothing can be done about it. Symptoms of late-life depressionaches and pain, confusion, agitation, anxiety, and irritabilitymay differ from depressive symptoms in younger people. They are often ignored or confused with other ailments common in the elderly, including Parkinson's or Alzheimer's disease, dementia, thyroid disorders, arthritis, stroke, cancer, heart disease, and other chronic conditions. Depression may even be a predictor of Alzheimer's disease or an impending physical illness before the symptoms of the disease itself become evident.
Depression is also a side effect of many drugs that are commonly prescribed for the elderly.
It is often very difficult, then, to determine if the patient's depression is a psychologic reaction to the illness, caused by the disease itself, or completely independent from the medical condition. Social and Economic Considerations Being in a low socioeconomic group is a major risk factor for depression. However, people of all income levels are likely to be depressed if they have poor health and are socially isolated. Money, of course, allows greater access to good health care, but this factor does not explain all cases of depression in impoverished people. Western cultural attitudes that hinge income to social status may play a significant role in the connection between poverty and depression.