At this age, people are least depressed
While depression has increased among the youngest in the Norwegian population, the incidence of depression among the elderly has fallen sharply over the past 20 years. The incidence has actually halved among 70-year-olds.
Published
‘After seventy all is trouble and sorrow’, the British author Robert Burton wrote in the classic book The anatomy of melancholy in 1621.
“Today we laugh a little at this, because it is no longer true at all,” said Eivind Aakhus said at an event at Arendalsuka recently. Arendalsuka is the largest political gathering in Norway and is held every August in Arendal. Aakhus is head of mental health at the National Centre for Ageing and Health.
Marked decline
Many young and middle-aged people dread getting older, convinced that life will get sadder.
But data from the Trøndelag Health Study (HUNT) show that the risk of depression actually decreases with age.
The data from 1995 to 2019 show a marked decrease in depression among 70-year-olds.
Incidence of depression among women and men in Norway, 1997-2008-2019
The incidence of depression has fallen sharply for both women and men in their 70s over the past 20 years. When people pass the age of 80, the incidence increases significantly. The table also shows that the incidence of depression during the same time period has increased sharply among the youngest age groups. (Illustration: HUNT/Ageing and health)
Dramatic increase after the age of 80
This is not the only study that shows that the elderly are doing well in Norway.
Recently, the UN's World Happiness Report showed that while young people seem to be getting worse and worse, the elderly are getting better.
“Especially in the first decade after we retire, many of us are doing very well,” says Aakhus.
But there will be a turning point.
Things change when we turn 80. At this age, the incidence of depression increases dramatically, although it has also fallen sharply in this group over the past 20 years.
Seeing friends in the obituaries
Aakhus believes the reason for this trend is complex.
This can be due to major social changes in life, such as losing friends and family.
During this period of life, people really start to seeing their friends’ names in the obituaries.
The very thought that life will soon end is in itself a risk factor for depression, the researcher said.
“But the fact that there is less happiness around you socially increases the risk of depression and the experience of loneliness,” he said.
More than half lonely
Depression is often associated with loneliness.
Those at greatest risk are men older than 85.
“More than 53 per cent in this age group report such high scores on loneliness that it equates to depression,” said Maria Lage Barca during the event in Arendal. She is a senior researcher at Ageing and Health and studies depression as the main focus of her research.
She points out that loneliness is a subjective experience and something different from living alone.
“Some people who live alone are lonely, but not all are,” she said.
Getting sicker
At the age of 80, people develop more illnesses. This is probably also among the explanations for the increased incidence of depression, the researchers believe.
“People who have several illnesses at the same time have an increased risk of mental illness, and the more illnesses, the greater the risk,” said Aakhus.
With diseases comes a greater use of medication, which in itself is a risk factor for mental disorders.
Many do not ask for help
Most young people today are used to talking about mental health problems.
Older people are less used to talking about these issues. As a result, they are much less likely to go to the doctor to say that they are depressed and ask for help.
A Norwegian study among GPs shows that almost one in three elderly people with moderate depression flies under the radar of their GP.
If depression is not detected or not treated, or if an individual thinks that depression is part of ageing itself, that individual is at risk of prolonged suffering.
“Untreated anxiety and depression significantly increase the risk of early death, suicide and hospitalization. It also means increased health costs for society,” says Aakhus.
Not part of getting old
The researchers believe that health personnel must make an extra effort to detect and treat mental illness among the oldest in the population.
Depression is not part of becoming old, they said.
“We can do something about loneliness and the feeling of being abandoned. We can reduce chronic pain. And we can treat people who have been diagnosed with dementia to reduce the risk of suicide,” Aakhus said.
Treating mental health problems among the elderly is actually a rewarding task, he believes.
“We see many good results from treatment. Elderly people with depression have a good results from conversations, medicines and even electric shock therapy,” Aakhus said.
Social contact should be built into the system
The researchers know that physical activity and a social life are also protective and improve many conditions.
In a recently published article on forskning.no (in Norwegian), a senior counsellor described a project in Sandefjord that tries to prevent loneliness from developing into depression and possibly suicide.
Lars Mehlum, professor of psychiatry, wrote in the article that systematic follow-up of lonely elderly people should be standard in all Norwegian municipalities.
A powerful warning
Undiagnosed and untreated depression is one of the biggest risk factors for suicide, said researcher Fredrik Walby at the National Centre for Suicide Research and Prevention in a Norwegian podcast on ageing and health.
A completed suicide attempt among the elderly is a much more powerful warning sign of future suicide than a suicide attempt among younger people. There are, on average, four attempts behind every completed suicide in the elderly, compared to 25 attempts in younger people.
“We must take all suicide attempts seriously. But if we learn that an old person has attempted suicide, we have to take it extra seriously,” says Aakhus.
Not just sadness
Walby is concerned that we not dilute the concept of depression.
The easiest way to distinguish between a difficult period in a person’s life and depression is to look at duration, he believes.
“If something sad happens in your life, and you are sad that day and maybe a few days afterwards, that’s completely normal. But if you are sad most of the time and for more than two weeks, it could be depression,” he said.
Other signs are that you sleep less. You lose your appetite. You are unable to concentrate or feel joy. Getting into the shower or doing the most common things at home can also be difficult or impossible, Walby says in the podcast.
“This is something other than ordinary sadness,” he said.
Referance:
Krokstad et.al.: Divergent decennial trends in mental health according to age reveal poorer mental health for young people: repeated cross-sectional population-based surveys from the HUNT Study, Norway. BMJ Open, 2022. Doi.org/10.1136/bmjopen-2021-057654
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Translated by Nancy Bazilchuk
Read the Norwegian version of this article at forskning.no
