Inquiry & Craft of Argument
March 29, 2016
Aging and Abjection
All humans face aging at every stepping stone of life; from being a child, to becoming an adult, and so on. However, there is something unique in the last stretch of life that makes seniors mysteriously prone to depression. As people inevitably age, their functionality in society deteriorates, much like their social presence, physical ability, cognitive ability, and psychological stance. Suddenly, the elderly find themselves in depressive states as they struggle to fight off the burden of old age. Older generations acquire their depression by many different factors and its appearance cannot be narrowed down to a single specific cause. However, it is debated whether they are more prone to develop depression due to the factors listed above. Numerous researchers acknowledge depression is prominent in the elderly, but all debate on what the main factor for developing it is. A number of sources used will discuss possible causes and cures of elderly depression.
The ability to function physically is so essential to everyday life that most take it for granted. As time goes by and people age, they find themselves unable to perform mundane tasks like bend, reach, or lift. To think that the inability to perform these small tasks could determine whether or not someone older could develop severe depression seems challenging. Brenda Penninx’s team of researchers from Vrije University (VU) in Amsterdam conducted a study that examined how depression can affect physical ability in the elderly and how in turn, declining physical ability could also lead to depression. In this study, the researchers determined that “Depression has been found to result in improper functioning of the immune, nervous and endocrine systems” (Penninx et al. 9). This exemplifies direct effects of the physical abilities of not only the elderly, but of anyone suffering from depression. Without these necessary systems working for the elderly, they face many more risks in everyday life than they would if they only suffered from depression without its physical repercussions. The research team also concluded that..”[D]epression and poor physical function are mutually reinforcing, causing a progressive downward spiral in older persons’ physical and psychological health” (10). As both enable the other to reach new heights, depression and physical disability take a toll on the elderly ultimately leading them to give up emotionally and physically, leading them to the depths of despair and finally a depressive state.
The VU team isn’t the only group of researchers that have determined that there is a link between loss of physical ability and increase in depression amongst older generations. Dan Blazer, an Associate Professor of Surgery at Duke University School of Medicine, Maryland and Candyce Williams, a medical psychiatrist at the University of Phoenix conducted a study around the effects of depression on the cognitive and physical abilities of the elderly. The study concluded that depression makes older people more susceptible to other mental illnesses and physical illnesses. “The depressed elderly could suffer from qualitatively different disease entities” (Williams, Blazer, 443). Professor of the Department of Medicine at McGill University, Dr. Nandini Dendukuri and Psychiatrist Dr.Martin G. Cole also found that “studies of depressed adults indicate that those with depressive symptoms, with or without depressive disorder, have poorer functioning, comparable to or worse than that of people with chronic medical conditions such as heart and lung disease, arthritis, hypertension, and diabetes” (1147). According to this, due to the depression, their physical health is worse off than the health of happy elders with less functional ability. All these studies establish an obvious connection between physical decline depressions in the elderly and that as a result, action should be taken. If we can learn to determine reoccurring physical symptoms in the elderly than perhaps we can narrow down symptoms that lead to depression. This proof that deteriorating physical ability can lead to a depressive state in the elderly and can be used as a predictor. This evidence can help future generations prioritize physical healthcare throughout the years.
Cognitive ability is just as, if not more important than physical ability in respect to how people function on a day-to-day basis. From being decisive, to speaking, to interacting, cognition is the main function of the human brain. If one’s cognitive ability is jeopardized, it could affect every aspect of their life, such as self-care, social interaction, and general functionality. However, as cognition unavoidably decreases in the elderly, depression starts to set in. A group of professors, students, and researchers from the Aging Research Center (ARC) in Sweden, lead by medical doctor and director of the ARC, Dr.Laura Fratiglioni, dedicated themselves to an observational study focusing on the relationship between deteriorating cognitive ability and depression in the elderly. The study also tuned in to whether factors like age range, as well as sex could effect depression in the elderly. What they found was that “Moderate/severe unipolar depression [is] associated with poorer performance in processing speed, attention, executive functions, verbal fluency, episodic memory and vocabulary” (Pantzar et al. 944). The elderly already have deteriorating cognitive ability as the brain ages with the body. Depression accelerates loss of processing abilities like these due to the lack of alertness and attention that comes with depression. Not only that, but they also uncovered that “ cognitive deficits in depression follow a continuum, where the more severe the depression is, the more severe are the cognitive deficits” (943). Depression is accelerated and so is the loss of cognitive ability with age.
Like physical disability, depression only promotes cognitive deterioration, and sadly, determining depression in the elderly is difficult and just as difficult to treat before taking full effect. Blazer and Willams’ research also concluded, “Many researchers and clinicians are likely to overlook mild depression or even severe depressive illness that involves a predominance of somatic complaints or even cognitive impairment.” (439). This is disappointing especially since determining the cognitive stance of an elder can help determine their susceptibility to depression. Much of the time health care professionals may overlook and neglect the symptoms that the elderly show, leading the recognition of elderly depression to go overlooked itself as a whole topic in the medical field. This proves to be another sad truth to the way the elderly are treated and how this low level of concern could have made them depressed in the first place.
Many studies have found that other sociological factors affect depression besides physical and cognitive deterioration; such as education level, living arrangements, marriage, and wealth. It can be assumed that social factors take a toll on the elderly as they slowly find themselves needing money for good healthcare, companionship to avoid loneliness, and good living arrangements to feel relevant in everyday life. However, this theory faces much more speculation and counter arguments in comparison to how cognitive and physical ability cause depression. Dr. Martin G. Cole (MD) a psychiatrist, and Dr. Nandini Dendukuri, an associate professor for the Department of Medicine, Division of Clinical Epidemiology, Faculty of Medicine, at McGill University collaborated to explore different factors that the elderly face that can make them more susceptible to depression as they grow older. The duo stated that less than 20% of major depression in the elderly is detected or treated and that1-3% of the general elder population suffers from major depression. What is more is their finding that “five risk factors for depression among elderly community subjects include bereavement, sleep disturbance, disability, prior depression, and female gender” (1154). Females are repeatedly proven to be more effected by depression elder or not. Lack of sleep (which is prominent in the elderly as well as bereavement are listed and can be seen as a type of grief towards a lost loved one, and can turn into a state of despair and loneliness, which has also been listed as a risk factor for depression.
Another pair of experts, Professor of Psychology at the University of Toronto Dr.Esther Greenglass, and Dr.Lisa Fiksenbaum, a professor at York University in Toronto investigate as to whether an elder’s ability to cope with either a change in their life, losses they may have faced, or accepting the mere fact that they are growing old may also prevent them from becoming depressed as well as maintaining their cognitive health and thus their ability to become depressed. “[O]lder individuals report higher levels of depressive symptoms than their younger counterparts. Possible explanations for this include losses arising from the aging process, including social losses, and life transitions” (Greenglass, Fiksenbaum 25). Life changes that the elderly are not prepared to deal with can lead them to feel helpless and therefore might drag them into depressive states. Losing people who have been in their lives whether dead or neglectful can lead the elderly to feel grief, despair, isolation. Those feelings might lead them to a depressive state in the future as they build. However, they also state how these feelings can be countered. “To the extent that the elderly employ coping techniques based on proactivity, they experience greater physical and psychological well-being” (Greenglass, Fiksenbaum 27). If the elderly are willing to accept that their lives are changing and adjust to the losses they face than they are more likely to move forward and avoid illness, mental or physical. A group of professors (Add their names) from the University College London lead an experiment concentrated