Older women are at the greatest risk because women in general are twice as likely as men to become seriously depressed. Biological factors, like hormonal changes, may make women more vulnerable. The stresses of maintaining relationships or caring for an ill loved one and children also fall more heavily on women, which could contribute to higher rates of depression. Unmarried and widowed individuals as well as those who lack a supportive social network also have elevated rates of depression. Fortunately, the prognosis is good.
Medication compliance is especially important, but can be a problem among older patients.
It has been estimated that 70 percent of these patients fail to take 25 to 50 percent of their medication. For this reason, ECT has had an important role in the treatment of depression in older adults. Unfortunately, ECT is generally underused, unavailable, or burdened with myth and misinformation about its safety and efficacy. Psychosocial treatment can also play an essential role in the care of older persons who have significant life crises, lack social support, or lack coping skills to deal with their life situations. Because large numbers of older persons live alone, have inadequate support systems, or do not have contact with a primary care physician, special efforts are needed to locate and identify these people to provide them with needed care.