Policy Brief Presentation on Selected Health Issue

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Depression with elderly in the United States of America

Introduction

Healthcare is a critical issue that concerns every person in public health across the globe. Healthcare is a social factor that involves identifying diseases and research and developments to establish a framework to cure the disease and improve people's living standards. Depression among the elderly in the United States is a common healthcare challenge that lasts longer among adults above the age of sixty-five (Fekadu, Shibeshi & Engidawork, 2017). Depression is a serious psychological health challenge. It is more common among the elderly due to under-treatment. The paper will concentrate on the epidemiology of depression among the elderly in the United States. Through epidemiology, I will also conduct peer-reviewed articles to determine the pathogenesis, assessments, diagnosis, and treatments of depression among the elderly in the United States.

Epidemiology

Epidemiology is the process and study of determining the determinants and occurrence of a disease affecting specific pollution. In my case, I will focus on depression among the elderly based on the causes, diagnosis, and application of technology and knowledge to control the disease. Therefore, epidemiology is a branch of medicine that deals with studying a disease that is more vulnerable to a specific population than the others. Therefore, epidemiology investigates the causes of disease while providing medical measures to mitigate or eradicate the disease. Epidemiology requires evidence-based information that healthcare professionals can utilize to enhance quality care among the vulnerable population. Epidemiology is considered complete after the investigation has been done and the professionals have ascertained the cause and the medical intervention to mitigate or eradicate the negative impact of the disease. Healthcare professionals conduct epidemiology to improve health outcomes by reducing mortality and morbidity rates.

Literature review

Pathogenesis

Based on the article titled “Major depressive disorder: pathophysiology and clinical management” and written by (Fekadu, Shibeshi & Engidawork, 2017) is that depression will at least affect one out of every elderly in the course of their life. The article indicates that most depression cases among the elderly are poorly diagnosed and treated among the elderly. The article also states that there are numerous to describe the pathogenesis of depression among the elderly. The main pathogenesis of depression focuses on the three main theories, including neuro-imaging techniques, post-mortem studies, and indirect markers, which have focused on many healthcare professionals.

Based on the neural circuitry of depression, most of the elderly functionality and structure of the elderly brains are severely damaged because of mood. Neuro-imaging and post-mortem have indicated morphological changes in the glial density and the grey-matter volume in the hippocampus and prefrontal cortex. HPA axis, hyperactivity, and chronic stress play a critical role in depression among the elderly. Additionally, according to the article is that the gene environment can contribute to depression. Thus, the elderly must be exposed to a stress-free environment, particularly after retirement.

Assessment of depression among the elderly

Based on the article titled “Measuring depression in the Elderly” and written by (Holyrod & Clayton, 2000) is that depression assessment in the elderly is a tedious healthcare activity since the disorder presents itself in different ways to the elderly. In the United States, the elderlies must undergo various assessments before doctors ascertain that a patient suffers from depression. Depression among the elderly in the United States is common among people above the age of six-five. Most of the elderly cannot access healthcare interventions since most of them are dependent and within the retired bracket. Therefore, the elderlies are most vulnerable to the disorder since they are more likely to be alone when productive people go to work. They are also not likely to engage in practices that enhance their mental and physical health.

Based on the articles, various emerging tools are used to detect whether the elderly are suffering from depression. Most common tools include Cornell Scale for Depression in Dementia, Montgomery-Asberg Depression Rating Scale, Geriatric Depression Scale, Zung Selt-Rating Depression Scale, and the Hamilton Rating Scale for Depression. Among all the assessment tools, the most common one used in the United Stated is Geriatric Depression Scale. It is the most common since it is user-friendly and applicable to any nature of the hospital. It is also effective in detecting severe to complex depression among the elderly. It is also the best validated among the other tools.

Diagnosis

The diagnosis of depression among the elderly is a critical process that should consider confounding co-morbidities and variations in the presentation. Healthcare professionals should diagnose depression among the elderly by considering the patients' lifestyles to ascertain whether they live a stressful life. The elderly in the United States should be assigned a regular doctor or a care worker who can proactively identify any symptoms and signs related to depressive disorder. The most common activities to be monitored among the elderly include day-to-day activities, behavior, moods, and symptoms. The evaluation of the activities among the elderly should be between two to three weeks before they are diagnosed. Most depression cases are associated with excessive stress that occurs due to social and political challenges.

Treatment

There are various treatments for depression among the elderly. The most common form of treatment, particularly among the elderly in the United States, is psychotherapy. The most common method of psychotherapy includes interpersonal therapy and cognitive behavior therapy. The other method is CBT which involves teaching the elderly how to cope with adverse behavior, feelings, and thoughts. The method is more effective since it can reduce depression from fewer complexes to severe illnesses. The other common type of treating depression is the IPT method that requires the patient to attend therapist sections. The patients feel relief and are educated about the depression, its causes, and how it can be prevented. The other most common method of treating depression is pharmacotherapy, which includes administering antidepressant drugs prescribed by a professional doctor. The most common drugs used to treat depression among the elderly include Monoamine oxidase, tricyclic antidepressants, and selective serotonin reuptake inhibitors.

Conclusion

Depression is a disorder that affects millions of elderlies in the United States. There are approximately thirty-nine million people above the age of sixty-five years in the United States. Based on the recent statistics, roughly more than seven elderlies are depressed. The healthcare professionals must intervene since the elderly can never eradicate depression on their own. Although there are various medications, the elderly can reduce depression by adjusting their lives and staying a free stress life. The families have a critical role to play by creating a conducive environment for the elderly. Individuals above the age of sixty-five must be supported both socially and financially.

References

Fekadu, N., Shibeshi, W., & Engidawork, E. (2017). Major depressive disorder: pathophysiology and clinical management. J Depress Anxiety, 6(1), 255-257.

Frank, C. R., Xiang, X., Stagg, B. C., & Ehrlich, J. R. (2019). Longitudinal associations of self-reported vision impairment with symptoms of anxiety and depression among older adults in the United States. JAMA ophthalmology, 137(7), 793-800.

Holyrod, M.D. & A. H. Clayton, M.D. (2000). Measuring depression in the Elderly: Which scale is best? Medscape General Medicine. 2(4).