In a recent issue of USA Today, Philip Gold, chief of clinical neuroendocrinology at the National Institute of Mental Health, stated that depression shortens life by unleashing a cascade of harmful effects on the body. What Gold failed to mention was the overwhelming size of this issue. According to the World Health Organization, depression will become the second leading cause of premature death by the year 2020.

This monumental shift is largely due to the aging of the world's population. Yet, in the United States, primary care physicians often fail to diagnose depression in older adults. Research shows that about 83 percent of older adults would like to be treated for their depression; however, as many as 75 percent are not receiving the necessary treatment. With treatment, older adults can recover from mental illness at the same rate as younger people.

Depression is NOT a normal part of aging, and the effect that it can have on those over the age of 50 is significant, according to the American Psychological Association. The following list offers just a few examples of how this mental health issue can affect the lives of older adults:

• Depression in older adults not only causes distress and suffering but also leads to impairments in physical, mental and social functioning.

• Because depression tends to be a recurrent disorder, many older adults will have previously experienced depression and will be at increased risk for future bouts.

• Risk factors for late-onset depression include: widowhood, physical problems, educational attainment less than high school, impaired functional status and heavy alcohol consumption.

• Depressed older adults tend to use health services at high rates, engage in poorer health behaviors and experience “excess disability” (Functional impairments that are out of proportion to the degree of cognitive impairment).

• Older Americans have the highest suicide rate of any age group, and depression is its foremost risk factor.

Depression's effect on society is immense; however, its impact on your bottom line could be just as significant, according to research from the University of Alberta. The study's researchers looked at depression as a barrier to exercise in older adults and found that symptoms from the study's participants were so debilitating during times of pronounced depression that it affected not only their participation in physical activity but participation in life itself.

According to the researchers, the study yielded four main themes. The first three clearly showed that depression is a barrier to older adults' participation in regular physical activity. However, the fourth theme shared participants' thoughts about how to break the cycle of inactivity.

The following list includes a representative quotation from each of the four themes.

1. No energy: “It just flattens you…I would have to drag myself out of bed …I didn't go for walks with my husband because I just couldn't get my rear off the couch. I used to be a very active person, but I sure went from highly active to nothing because of that.”

2. Consumed by depression: “Nothing's gonna work because nothing is working. You're being tossed around by depression. You're consumed by depression.”

3. Kind of a conundrum: “To do exercise, it's not like, ‘I have to be’…it's something you would have to talk yourself into being a ‘have to be,’ so the self-talk would have to be very, very positive…it's hard to get positive self-talk when you're already depressed anyhow. There's kind of a conundrum there.”

4. Moving “out of a depressed state:” “I do believe that I need some physical exercise, maybe if it's in…little increments…I was pretty depressed when I started taking yoga — but I went anyway — because I paid for it…”

What the researchers found was that depression is insufficiently recognized as a key barrier to seniors participating in regular physical activity. And they recognized the need to create a collaborative process to help older adults address their depression and help them become more active. According to The Physician and Sports Medicine, 1998:26; 10, several studies have documented the benefits of exercise on mood in healthy and clinically depressed individuals in recent decades.

By offering and promoting programs that will address this medical and societal issue, you'll find that your members, their families, your staff and your organization will have a brighter future.

Colin Milner is chief executive officer of the International Council on Active Aging^™. An award-winning writer, Milner has authored more than 100 articles on aging-related issues. He can be reached at colinmilner@icaa.cc.

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