Harry lost his wife. Then his hearing. Now 76, he struggles to pay his bills for food, rent and medicine.

Aging can take a heavy emotional toll. Loss, disability, isolation and anxiety are all risks for depression. Studies show that 15 percent of Americans over age 65 are depressed. The rates are much higher among those in hospitals and nursing homes.

Depression in seniors often goes unrecognized and untreated, though. This may be due to:

• Lesser known symptoms. The person may not appear to be sad. Memory loss and insomnia are common signs of depression in the elderly.
• Misdiagnosis. Symptoms like fatigue or weight loss may be blamed on another illness. Low motivation or slow reaction times may be attributed to dementia when it's really depression.
• Stigma. Older people grew up in a time when mental illness was seen as a character flaw. They may be ashamed to admit to feeling depressed.
• Lack of knowledge. Some believe wrongly that depression is a normal part of aging or that seniors don't respond as well to treatment.

Knowing when an older person is depressed can be challenging. But it's important not to overlook or dismiss possible symptoms. Depression can rob a person of happiness, make existing health problems worse or even lead to suicide.

Causes of late-life depression

Depression in late life can be a relapse of an earlier episode. Or it could stem from a family history of the disorder or biological change in the brain. Life events that often accompany aging are more likely triggers of depression in seniors. These might include:

Chronic or serious illness. When depression occurs for the first time in seniors, a common cause is an illness, such as:

• Cancer
• Alzheimer's disease
• Parkinson's disease
• Heart disease
• Stroke

You can suspect depression if recovery is delayed or treatments are refused.

Pain and disability. Pain or other impairments can make it hard to carry out routine activities. This can lead to feelings of helplessness and low self-esteem.

Hospital patients and nursing home residents. Depression rates rise markedly among elders in facilities.

Loss. The death of a spouse, sibling or friend can cause loneliness and isolation. So can moving out of a longtime home and neighborhood. Other seniors suffer a loss of identity or purpose after they retire.

Medications. Medications may have side effects that cause depression.

Anxiety. Those who dwell on death or dying, or worries about money and health, are prone to depression.

Recognizing depression

Older adults may feel sad, but not show it or acknowledge it. Instead, they may reveal their depression in these ways:

• Withdrawal. Lack of social activity is blamed on not feeling well, not having energy or being too much trouble.
• Persistent, unexplained physical complaints. It might be joint pain, stomach upset, backache or headaches.
• Change in habits. They may neglect personal grooming, start skipping meals or forget to take medicine.
• Anxious behavior. Restlessness, panic, worry and being irritable or demanding can all be signs.
• Mental changes. Confusion, memory loss or not being able to concentrate can signal depression.

Someone who is depressed does not just get over it. Depression is a medical disorder that requires a doctor's care. Treatment for depression has been shown to work just as well for the elderly as for young people. Most older adults can be helped with medication, counseling or both.

To find services for an older person in his or her locality call the Eldercare Locator at 800-677-1116 or go to www.aoa.gov for more resources for seniors.

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