1) My sponsorship by a Chinese hospital to speak to local and international physicians at a Geriatric conference
2) Recent commitment between Canadian Prime Minister Trudeau and Chinese upper officials to conduct joint research on China’s growing elderly population
3) Successful Befriending phone service in the United Kingdom to counteract isolation in the elderly population in England and Wales
I recently traveled to Beijing to speak on risks, diagnostics, and treatment of depression in the expanding Chinese elderly population. Depression in the elderly in Western Countries is related to low socioeconomic status and low social support (Chen et al., 2005). It has been found in China that a protector against depression, even for people in poorer, rural communities, is maintaining social support (Chen et al., 2005). This particular study also identified the following factors to increase risk for depression: eating meat less than once a week increased risk over 2 fold, not watching television, and having undetected hypertension.
In my talk, I discussed that people potentially not seeking mental health treatment drives the need for physicians to assess for depression even when a patient comes in with somatic concerns. The Geriatric Depression Scale (Yesavage et al., 1983) is a recommended tool. Depression in the elderly can present similarly to dementia: confusion, reduced concentration, personality and behavioral changes, apathy and withdrawal. Brain scans and tracking memory across time are key methods to improve the differential diagnosis. In terms of treatment, a gold standard is cognitive behavioral therapy with a focus on restructuring negative patterns of thought, improving coping skills, and increasing social support through activities such as Mahjong and Tai Chi.
This is a pertinent issue with Canada and China also linking resources to research how best to manage the growing elderly population. Additionally, I was impressed to read up on a successful phone service being offered in England and Wales (http://www.fote.org.uk/?service-post=phoning-friends). This is a relatively cost effective community tool to increase social connectedness.
What can you do?
Monitor the following four factors in yourself as you age. Most important, be mindful of the following in those you love as they age:
1) Sadness and/or anhedonia (lack of pleasure/interest in things ordinarily enjoyed)
3) Reduced perception of purpose, often concurrent to retirement
4) Reduced independence, especially in terms of transport, that can further drive isolation
-Chen, R. et al. (2005). Depression in older people in rural China. Arch Intern Med. 165: 2019-2025.
-Yesavage, JA. et al. (1983). Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatry Res. 17: 37-49.