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

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Depression in Older Adults

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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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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: Fiske, Amy
Wetherell, Julie Loebach
Gatz, Margaret
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: green
www.ncbi.nlm.nih.gov
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 › Developmental and Educational 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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