Risk factors of depression
The result is that one in four older people suffer from symptoms of depression, according to the Royal College of General Practitioners. There are a variety of social, psychological and physical factors which increase the likelihood of developing depression in old age. Poor health is considered to be a main stressor, often resulting in a loss of independence, loneliness and psychological distress. Depression can often cause confusion and anxiety, so it’s sometimes mistaken as a symptom of dementia. Other individuals might not consider depression a real illness, but mental health and physical illness are comorbid, so it is equally as important to look after one as well as the other.
Other risk factors might include a loss of contact with friends and family, sensory impairments, individual circumstances (race, financial status), abuse and neglect. The WHO contends that 1 in 10 people suffer a form of physical, sexual, psychological, material or financial abuse. There are a variety of medical and psychological treatments for depression, including antidepressants, Cognitive Behavioural Therapy and Psychotherapy. However, there are studies which suggest that depression in older people can be prevented by maintaining a busy schedule, which promotes aspects of social interaction, physical activity, volunteering and continued learning.
According to Age UK, 3.9 million older people agree that television is their only form of company. A further 200 000 have not had any contact with friends or family for over a month. Therefore, loneliness can be reduced dramatically by creating social outlets where older people can discuss their concerns. However, traditional face to face contact isn’t the only way of reconnecting with friends or family. Initiatives such as Digital Communities Wales help older people to get online and up to date with sending emails, booking travel, managing finance, using social media and Skype.
Volunteering can also act a social networking platform for older people. Lum and Lightfoot (2005) describe volunteering as “the cornerstone to productive ageing”. Those who volunteered at least 100 hours per year had lower depression levels than those who did not, and they had better self-reported health. Participants also reported feelings of self-gratification and a sense of purpose.
Physical activity is also considered to be hugely beneficial as it can improve an individual’s morbidity as well as mortality. In other words, a person’s life can be enriched as well as lengthened by exercise. Expending large amounts of energy on a daily basis can delay disability, and make you more likely to have optimal function in your activities of daily living.
It is widely recommended that older adults take part in thirty minutes of physical activity each day. Studies from The National Heart Foundation of Australia have concluded that the length of exercise is more important than the intensity. Walking, strength and flexibility training are among the recommended activities for older people. Organisations in Wales, such as Age Connects Torfaen offer extend exercise and Nordic walking to their clients. Both are ideal for individuals with limited mobility, or those who might be recovering from knee or hip replacements as they relieve pressure on the joints.
So can physical activity really affect mood in older adults? Studies suggest that this is the case, showing a significant reduction of depressive symptoms in older adults over several months (Penninx et al). Other studies suggest that an individual is less likely to relapse over ten months if they partake in physical activity on a regular basis (Babyak et al). But how does it all work? Some theorists suggest that exercise enhances mood by increasing feel-good serotonin and encouraging the growth of neurons in the brain. Individuals with depression often complain that they are unable to sleep, but theories suggest that exercise can actually improve the quality of sleep, which has protective effects on the brain.
Maintaining cognitive ability
It’s not just exercise that can have a positive effect on your mental health. Other studies suggest that brain training activities can improve cognitive function and lower the risk of dementia. The media is saturated with brain training technology, but many agree that the best type of training keeps the brain engaged for a long period of time. Brain training should be varied and not replace aspects of real life such as social interaction. So although crosswords and Sudoku can be great individual training exercises, board games such as Monopoly or Pictionary do well to combine both.
Social networking, brain training or physical activity? The NHS advises that keeping active in old age can prevent stroke, type two diabetes, heart disease as well as depression and dementia. There are a variety of organisations in Wales which help older people to maintain a busy schedule and reduce the effects of loneliness.
Age Connects Torfaen is one of six independently constituted organisations which form Age Connects Wales. They aim to combine all aspects of social interaction, brain and physical activity through the provision of weekly classes for people aged 50 plus. Activities range from lunch clubs to Nordic walking, arts and crafts, as well as IT classes. Older adults also have access to financial advice and advocacy services, so that they can remain independent and continue to make their own decisions. Many of its volunteers are over fifty, and report that volunteering enriches their lives by giving them a sense of purpose and satisfaction in their retirement.
More information on Age Connects Wales can be found on their website: http://www.ageconnectswales.org.uk/
For more information on depression and loneliness in older people:
Royal College of Psychiatrists: http://www.rcpsych.ac.uk/healthadvice/problemsdisorders/depressioninolderadults.aspx