Depression common in the elderly but underdiagnosed, undertreated

A recent study by the National Statistics Bureau (NSB) revealed a high prevalence of depression among the elderly Bhutanese.  

The study- Understanding the Situation of Elderly Citizens- named depression as the most common health condition affecting them.  Also, it has been found to occur more commonly in women than men.

The study also found out that depression in the elderly often goes under-diagnosed and under-treated.

Dr. Ugyen Dema, a psychiatrist with the Jigme Dorji Wangchuck National Referral Hospital says people often assume the symptoms of depression to be part of the normal process of ageing. Therefore, depression in older people goes unreported.

She added the symptoms of depression with the old are also often unusual, making it hard to recognize the disease. “They have this atypical presentation,” said Dr. Ugyen Dema.

“They do not come with typical depressive symptoms and signs. They mainly come with stomachic complaints.  They will talk about the history of physical aches and pains instead of bringing up mood related problems or loss of energy.”

When it comes to treating the disease, Dr. Ugyen shared that in most cases, treatment cannot be done adequately. “Even if we diagnose them, we cannot give them the dose we want, for example anti-depressants,” she said.

“It’s again an ageing process. They have compromised liver, renal and cardiac functions, so we cannot give them adequate doses. We have to start with a very minimal dose and then try to take it very slowly.”

Dr. Ugyen Dema adds that age is not a risk factor for depression. But factors associated with ageing, such as financial status, social isolation, loss of partner and even certain medications, contribute to depression in older people.

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