Oct. 18, 1999 (Cleveland) -- The recent loss of a spouse is a significant risk factor for depression in elderly patients, according to a study published in the October issue of the American Journal of Psychiatry. Some people can continue to have symptoms of depression up to two years after the loss of their spouse.
"Spousal loss should spark extra energy in terms of exploring the possibility of major depression," co-author Robert B. Wallace, MD, tells WebMD. "Also, there is a lore that major depression in the oldest-old is somewhat less common than it is in young and middle-aged adults. But in fact, that's very difficult to measure, and we know that depressive symptoms are often higher [and atypical] in the elderly. So for those reasons, we always need to be looking out for it," he adds.
Lead author Carolyn L. Turvey, PhD, and colleagues looked at more than 5,000 people aged 70 or older. They found that the older people -- and specifically women -- had higher rates of depressive symptoms; they also found that women were more likely to suffer from long-term depression. Newly bereaved individuals had the highest rates of depression and its associated symptoms, such as sadness and lack of interest in activities they once enjoyed.
Compared with married subjects, the newly bereaved had rates of depression that were nearly nine times as high as married subjects, while the rate of depressive symptoms without the full-blown disorder was almost four times as high. At one month after the death of their spouse, 33.3% of patients had six or more symptoms of depression, compared with 12. 2% of patients for whom 19-24 months had passed since the death of their spouse
Nevertheless, notes Wallace, who is a professor of epidemiology and internal medicine at the University of Iowa in Iowa City, depressive symptoms were still higher than before the loss of the spouse. "While on average, depression in these patients did start to go away ... an average of 3 to 6 months [after bereavement], the rates at 2 years were higher than baseline levels. So this loss seems to be associated with some long-standing depression," he says.
Wallace also explains that screening for depression should always be a part of the routine assessment doctors conduct in their patients, especially in the elderly, as should inquiries about conjugal loss. "Primary care physicians should always inquire about spousal loss. I've always felt that a routine part of primary care practice should be periodic screening for major depression, and physicians need to be alert for that because it is treatable and important," says Wallace.
For those who suffer bereavement, discussion -- especially with a physician -- is important. "It's important not to ignore your feelings after bereavement and all of the life changes that go with that," says Joan Gibala, of the American Association of Retired Persons (AARP). Gibala, who is with the AARP's Grief and Loss Program, stresses that newly-bereaved widows and widowers need to seek support and information. "The AARP recommends that you look into bereavement support programs such as the AARP's Widowed Persons Service. Or seek out the closest widowed person program in your community."
According to Gibala, many resources, including print materials, statistics, and support groups are available on the AARP's web site at www.aarp.org/griefandloss.In addition, the AARP has many booklets about widowhood that are available free of charge. For a free single copy of the AARP's booklet "On Being Alone," interested people can call 800-424-3410.