Page 152 - Encyclopedia of Nursing Research

DEPRESSion in WoMEn n 119

and quality of life. indeed, the symptoms of however, its symptoms may not be consis-
depression can lead to total inability of the tent across racial/ethnic groups, making
older individual to care for self and to relate early diagnosis and treatment challenging. D
to others. There is also a potential for persons Research on depression among older
with depression to negatively affect family adults was ignored in the past and is still a
members and others around them. neglected area. Clearly, much more nursing
not surprisingly, few elders in the com- research is needed. it is critical that nurses
munity seek mental health services. Most assume leadership in disseminating infor-
depressed elders are seen by general prac- mation about the outcomes of a variety of
titioners for psychosomatic complaints. treatments that can be used for depression in
Part of the symptomatology of depression later life. There is a particular need to exam-
is a focus on physical problems, and this ine suicide in late life and to develop better
requires practitioners to carefully assess for assessment instruments for detecting sui-
depressive symptoms. Suicide is a risk factor cidal ideation in elders.
for depressed older adults. The suicide rate
for individuals 80 years and older is twice as Jaclene A. Zauszniewski
that of the general population and is particu- Abir K. Bekhet
larly high in older White males. interestingly, May L. Wykle
most suicidal elders recently visited a general
practitioner before their suicidal act.
Studies of risk factors for late-life depres-
sion have examined the effects of gender, Depression in woMen
age, and race/ethnicity. Like earlier depres-
sion, late-life depression more commonly
strikes women than men (Chen, Chong, & Depressive disorders (DDs) are widely occur-
Tsang, 2007) at an approximately 2:1 ratio ring psychiatric illnesses that account for
(Kockler & heun, 2002). Recent population- significant suffering and disability world-
based studies have estimated the prevalence wide. Women have significantly higher rates
of geriatric depression at 4.4% for women of DD than do men, and the illness course
and at 2.7% for men, whereas the estimated is longer and more debilitating for most
lifetime prevalence for clinical depression women. Well-established gender differences
is approximately 20% in women and 10% in the precipitants and outcomes of DDs fur-
in men (Kockler & heun, 2002; Sable et al., ther underscore the need to address DDs
2002). Although female gender is a risk fac- as a specific health problem for women. As
tor for depression throughout the life span, these disorders first emerge in adolescent
gender differences decrease with increasing girls, commonly occur pre- and postpartum,
age (Sable et al., 2002), and White men ages and in menopause, and co-occur with a host
80 to 84 years are at greatest risk for suicide of chronic illnesses, nurses in most practice
(Kockler & heun, 2002). settings will encounter women with DD and
Cohort studies have shown that the may be the sole available treatment provider.
oldest-old, those older than 85 years, are Gender disparities in the rates of DD are
more likely than the younger-old, those most pronounced for major DD (MDD) and
between 65 and 74 years, to experience dysthymia (DYS) so these psychiatric ill-
depressive symptoms (Blazer, 2003; Mehta nesses are discussed here. note that gender
et al., 2008; van’t Veer-Tazelaar et al., 2008). does play a role in the manifestations and
Depression is thought to afflict older adults outcomes of other kinds of DDs (e.g., bipo-
of all racial and ethnic backgrounds simi- lar disorder), but the overall incidence and
larly (Alexopoulos, 2005; Bruce et al., 2002); presentation is similar for women and men