While symptoms of depression are obviously impacted by physical illness the consequences of the aging process can also mimic some of these symptoms.  These considerations have caused many to question whether somatic symptoms of depression such as insomnia, fatigue and appetite and weight loss are really valid indicators in the elderly.  One recent survey looking at this issue determined that appetite loss was not a valid symptom of depression in the elderly, but concluded that sleep disturbance and fatigue were.  With this study, fatigue was demonstrated by diminished levels of energy and by feeling that almost everything was very difficult to accomplish. Fatigue was particularly associated with symptoms of depression among the old-old long-term care subjects in this study. 

This information was not meant to conclude that appetite and weight loss were never associated with symptoms of depression among long-term care residents.  These studies reflect the fact that there are many causes for appetite loss in the elderly including physical illness, the aging process in general and symptoms of depression.  These results indicate that lack of appetite loses the powerful association with symptoms of depression that are usually seen in younger adults.  Nevertheless, there are many residents of long-term care facilities who lose their appetite and sometimes significant weight due to depression.  As a result, long-term care residents who lose more than a couple of pounds should always be evaluated for depression symptoms when a clear physical cause is not easily identified. 

A study by Morley and Kraenzle evaluating residents in long-term care facilities who lost five or more pounds over a period of three or more months, may underscore the importance of recognizing the multiple factors usually associated with weight loss for residents in long-term care facilities.  They found that depression was the cause of weight loss for large minority (36%) of long-term care facilities in their study.  For about half of the residents in their study, it was determined that physical causes such as medications, swallowing disorders or cancer may actually be the causative factor.

Some information from the Merck Manual of Health and Aging 

Additional information and webpage by Paul Susic M.A. Licensed Psychologist Ph.D Candidate (Health and Geriatric Psychologist)                                       

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