The role of stress and life events in the onset of depression in the elderly

Abstract

The prevalence of major depressive episode in the elderly leads to impairment on several aspects of daily life, including life quality, morbid - mortality and increases rates of suicide risks. Stress and life events are frequent triggers of depressive episode in elderly. The present review aimed to explore the aspects related to the onset of depression in old age, focusing on psychosocial and stress. In order to achieve that, we systematically reviewed papers published in the Medline database from 2003-2013. From this study, we verify that depression in the elderly is a complex disorder, more often associated to psychosocial aspects and chronic stress than to genetic and biomarkers. Loneliness, daily and chronic stress, lack of social support, mourning and economical aspects such as retirement and job loss are major risk factors for depression. Generally, negative life events were noticed to cause poorer mental health in advanced age and cumulative stressful events or traumas untreated too. Furthermore, cognitive functions may be affected negatively by lifelong chronic stressors. These events can cause quite a few different impacts in distinct cultures and lifestyles. The consequences also depend on the duration, or on the life period that these episodes occur. The treatment of depression in the elderly should target both medication and psychotherapy in order to account for psychological aspects, especially treatments based on life review. These perspectives are important due to the possibility of development of specific target strategies in order to prevent those risk factors and improve quality of life in elderly. Many points were contradictorily related, overdue the papers had noticed different conclusions about the same studied points. Face of this, we grouped relevant articles with the same results. Notwithstanding, there were points that require more studies, considering the relevance of the theme.