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Cited by 2,353Aging, Health, and DisabilityAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesAging and Gerontology Research

Depression in Older Adults

Open access
Fiske, Amy, Wetherell, Julie Loebach, Gatz, Margaret·2009·Annual Review of Clinical Psychology
DOI 10.1146/annurev.clinpsy.032408.153621PMC PMC2852580
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Abstract

Depression is less prevalent among older adults than among younger adults, but it can have serious consequences. More than half of cases represent a first onset in later life. Although suicide rates in the elderly are declining, they are still higher than in younger adults and are more closely associated with depression. Depressed older adults are less likely to endorse affective symptoms and more likely to display cognitive changes, somatic symptoms, and loss of interest than are depressed younger adults. Risk factors leading to the development of late-life depression likely comprise complex interactions among genetic vulnerabilities, cognitive diathesis, age-associated neurobiological changes, and stressful events. Insomnia is an often overlooked risk factor for late-life depression. We suggest that a common pathway to depression in older adults, regardless of which predisposing risks are most prominent, may be curtailment of daily activities. Accompanying self-critical thinking may exacerbate and maintain a depressed state. Offsetting the increasing prevalence of certain risk factors in late life are age-related increases in psychological resilience. Other protective factors include higher education and socioeconomic status, engagement in valued activities, and religious or spiritual involvement. Treatments including behavioral therapy, cognitive-behavioral therapy, cognitive bibliotherapy, problem-solving therapy, brief psychodynamic therapy, and life review/reminiscence therapy are effective but are too infrequently used with older adults. Preventive interventions including education for individuals with chronic illness, behavioral activation, cognitive restructuring, problem-solving skills training, group support, and life review have also received support.

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Crossref · 10.1146/annurev.clinpsy.032408.153621

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  • Bibliotherapy has been found to be efficacious by several systematic reviews or meta-analyses in the treatment of emotional, physical, and mental health problems among adults.

    “Bibliotherapy has been found to be efficacious by several systematic reviews or meta-analyses in the treatment of emotional, physical, and mental health problems among adults.22,28–32”

    From Comparative efficacy and acceptability of bibliotherapy for depression and anxiety disorders in children and adolescents: a meta-analysis of randomized clinical trials (2018) · cites this paper as [29]

    The Abstract and ‘Evidence Based Treatments’ section identify cognitive bibliotherapy as effective for depression in older adults. They do not establish efficacy for emotional, physical, and mental health problems broadly among adults, or say that several systematic reviews or meta-analyses reached that conclusion. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • Although aging itself is not associated with decline in affective functioning, aged individuals, compared with the young, are more vulnerable to depressive symptoms associated with physical illnesses and life events.

    “Although aging itself is not associated with decline in affective functioning, aged individuals, compared with the young, are more vulnerable to depressive symptoms associated with physical illnesses, and life events (English and Carstensen, 2015;Fiske et al, 2009Fiske et al, , 2013)).”

    From Microglia Priming with Aging and Stress (2017) · cites this paper as Fiske et al, 2009

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Research works printed but not linked: 1

  1. American Psychiatric Association (APA) Practice guideline for the treatment of patients with Alzheimer's disease and other dementias 2007 American Psychiatric Association Arlington (VA) Accessed at http://www.guideline.gov/summary/summary.aspx?doc_id=11533 18340692

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Authors
Fiske, A., Wetherell, J. L., & Gatz, M.
Affiliations
  • West Virginia University (US)
  • University of California San Diego (US)
  • University of Southern California (US)
ORCID
Venue
Annual Review of Clinical Psychology
Publisher
Annual Reviews
Published
2009-04-01
Volume
5
Issue
1
Pages
363-389
ISSN
  • 1548-5943 (ISSN-L)
  • 1548-5951
DOI
10.1146/annurev.clinpsy.032408.153621
PMC
PMC2852580
OpenAlex
W3026624461
Cited by
2,353
References
151
Citations by year
2026: 123 · 2025: 159 · 2024: 171 · 2023: 190 · 2022: 203 · 2021: 266 · 2020: 219 · 2019: 157 · 2018: 152 · 2017: 132 · 2016: 137 · 2015: 106 · 2014: 97 · 2013: 84 · 2012: 65
FWCI
6.94
Type
journal article
Language
en
Open access
Locations
  • Annual Review of Clinical Psychology (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institute on Aging (R01 AG 10175, P50-AG05142, R01AG010175, P50AG005142)
  • National Institute of Mental Health (R34MH080151, R15MH080399, R15 MH 80399)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Aging, Health, and Disability
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Social Sciences › Psychology › Neuropsychology and Physiological Psychology › Aging and Gerontology Research
Keywords
geriatric depression, older adults, suicide risk, somatic symptoms, risk factors, genetic susceptibility, life events, insomnia, self-criticism, psychological resilience, protective factors, depression treatment, cognitive behavioral therapy, bibliotherapy, problem-solving therapy, psychodynamic psychotherapy, life review, reminiscence therapy, behavioral activation, depression prevention, chronic disease
MeSH terms
Aged, Chronic Disease, Cognition Disorders, Depression, Humans, Risk Factors, Self Concept, Social Behavior, Social Environment, Social Support, Socioeconomic Factors, Prevalence, Age of Onset

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