DEPRESSION IN THE ELDERLY IN THE COMMUNITY - EFFECT OF PHYSICAL ILLNESS AND SELECTED SOCIAL-FACTORS

Depressive illness in the elderly may be the result of a physical illness, the cause of secondary physical problems, coincidental tophysical illness or the result of an aetiological factor common to both conditions. Analysis of a cross‐sectional community sample of 396 elderly people showed depression to be significantly linked to presence of headaches, dyspnoea, and malignant disease known to the patient. It was not linked with heart disease nor arthritis per se, although those on anti‐arthritic or analgesic medication were significantly more depressed. The subjective description of physical health given by the patient also correlated strongly with depression. Depressive illness is sometimes unrecognized and frequently untreated with a consequent reduction in quality of life for many patients. Clinicians must be aware of the possibility that depression may coexist with physical illness, and that both conditions may need appropriate treatment. Further analysis of the above sample, controlling for physical illness and the additive effect of the variables concerned, showed depression to be positively correlated with adverse social factors such as not going out because of physical disability, feeling lonely, having a shopper and having hearing difficulties. The home help service was identified as a probable protective factor, implying the importance of this service in supporting the emotional as well as the physical needs of its clients. Copyright © 1991 John Wiley & Sons, Ltd.