Mood in later life

Depression in later life is common, and it is frequently missed. Partly because low mood in an older person gets put down to circumstance, to bereavement, to ill health, to age itself. Partly because it does not always look like sadness. It can show up as poor sleep, loss of appetite and weight, tiredness, pain, withdrawal from things once enjoyed, or difficulty with memory and concentration that is mistaken for the beginnings of dementia.

​Depression can impair thinking to a degree that genuinely resembles dementia, and importantly improves with treatment.  Anxiety and worry are common too, particularly after a fall or an illness, and particularly when it becomes a fear of going out, of falling again, of being alone. That fear tends to shrink life and is rarely mentioned. ​

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Mood is also closely bound up with physical health. Thyroid problems, vitamin deficiency, pain, poor sleep, hearing loss and a number of common medications all affect it. Parkinson's disease affects mood directly, through the changes in the brain itself, not only as a reaction to the diagnosis.

 

None of this is an inevitable part of growing older, and it responds to treatment.

How Professor Henderson can help ​

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• A careful assessment of mood, sleep, appetite and motivation, and of how much they are affecting daily life.

• Distinguishing depression from cognitive impairment, and recognising where both are present.

• Looking for physical contributors, including thyroid function, vitamin deficiency, anaemia, pain and undertreated conditions.

• Reviewing medications, some of which affect mood and some of which interact badly with antidepressants.

• Discussing treatment, including medication chosen with care for older people, where the right drug and the right dose differ from those used in younger adults.

• Coordinating a bespoke and individualised treatment schedule for repetitive transcranial magnetic stimulation (rTMS) where that is appropriate. rTMS is a non-invasive treatment for depression, recognised by NICE, and may be an option where medication has not worked or is not tolerated.

• Referral for talking therapies, which work as well in later life as at any other age.