NEWS: Elderly depression 'ignored'

[janet paterson <janet313@xxxxxxxxxxx>]

Elderly depression 'ignored'

Friday, July 23, 1999 Published at 12:35 GMT 13:35 UK - Move over Victor 
Meldrew. Doctors say the typical image of the moaning old git could be 
hindering attempts to deal with one of the most common ailments of old age, 
depression.

The elderly are the highest risk group for suicide, while health experts warn 
of the impact of mental ill health on physical well-being.

It is estimated that up to 17% of elderly people living in the community suffer 
from depression - twice the number who have dementia, yet it mostly goes 
undetected and untreated.

Part of the reason is ageism: people, including doctors and old people 
themselves, expect the elderly to feel down and do not consider this as a 
treatable illness.

Other likely reasons are that the elderly do not like to bother their doctors 
or that they fear the stigma of mental illness or that admitting a problem 
could lead to them losing their independence.

Assessment

Researchers in Sheffield believe a new way of assessing depression in elderly 
people could tackle the problem and improve mental health and its knock-on 
effects on physical well-being.

The Institute for Ageing Research and the Institute for General Practice in 
Sheffield have been evaluating the use of the Elderly Assessment System (EASY) 
by community health workers.

The system contains 25 questions on physical, mental and social well-being.

It is being piloted in 18 countries around Europe, including Wales, Scotland 
and Northern Ireland.

Professor Ian Philp, who leads the programme at the University of Sheffield, 
says that, after three years of pilots, the system has proved effective.

He is in discussions with social and health services to get it to be taken up 
as standard practice for community workers.

"The aim is to detect depression among people living in their homes before they 
have to see their GP," he said.

"EASY is a very brief screening questionnaire and we have found it works very 
well and helps health workers to understand older people better."

He said other scales for assessing depression tended to have been developed 
with young people in mind.

They concentrated more on physical indicators of depression, such as poor 
appetite.

In older people, these symptoms might indicate other problems since the elderly 
were likely to have multiple medical problems, said Professor Philp.

"EASY relies more on people's perceptions of their own well-being."

Follow-up

Other assessment systems which fulfill similar functions include the Geriatric 
Depression Scale which has four basic questions which require a yes/no answer.

They include:

   * Are you basically satisfied with your life?
   * Do you feel your life is empty?
   * Are you afraid something bad is going to happen to you?
   * Do you feel happy most of the time?

Answers to the questions may prompt further more detailed questions or may 
require a trip to the GP.

The Sheffield pilot also looked at how health workers manage suspected 
depression among the elderly.

This involved primary care workers, social services and the voluntary sector.

Research shows screening can double GP recognition of depression, but this has 
little impact on treatment offered and follow-up.

Professor Philp says the people targeted are not severely mentally ill in which 
case they would need specialist services.

However, they may require a range of treatments, including social 
interventions, counselling or drugs.


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BBC News Online: Health

janet paterson
52 now / 41 dx / 37 onset
snail-mail: PO Box 171  Almonte  Ontario  K0A 1A0  Canada
website: a new voice <>
e-mail: <janet313@xxxxxxxxxxx>