This week it’s Mental Health Awareness Week. As we think about mental health in society today, one key group is people in their later years. How common are mental health conditions in older people, and what factors mean older people are more at risk of suffering with them?
In the early months of 2021, we explored the prevalence of mental health conditions in people aged 50 or above in England using data collected in 2018-19 for the English Longitudinal Study of Ageing (ELSA). We carried out analysis using the CES-D scale, which measures the presence of symptoms of depression.
The chart below shows prevalence of depression among people aged 50 or above is at its lowest after reaching state-pension age, but increases in later life. Depression affects 15-20% of those in their late 60s or early 70s, while more than 30% of people in their late 80s and aged 90 and above report symptoms of depression.
What are some key risk factors that play a role in depression becoming increasingly common as people advance through their retirement years?
Our analysis highlights three areas associated with depression in later life, all of which are generally associated with poor mental health outcomes: income deprivation, social isolation and poor physical health.
Income deprivation and food security
Our analysis of ELSA shows that older people in England who receive state benefits are around three times more likely to be affected by depression (44%) compared to those who do not receive state benefits (15%).
Food security is also important in predicting the presence of depression among older people. During the ELSA interview, study participants were asked how often they could afford to eat balanced meals.
16% of those who could always afford to eat balanced meals reported symptoms of depression, while depression was more common amongst those who could afford to eat balanced meals often (49%) or just sometimes (56%).
Another key factor in depression among older people that has been acutely highlighted during the pandemic is social isolation.
Losing contact with friends and family is an experience for many older people, and our analysis shows clearly that symptoms of depression are more common among older people with lower levels of social interaction.
This holds true when it comes to both friends and family. One third (33%) of older people meeting friends and one quarter (25%) meeting family once a year or never had symptoms of depression. A much lower proportion, around one in seven (15%), of those older people meeting friends or family once or twice a week had symptoms of depression.
Interestingly, we found no association between geographical distance from children and grandchildren and symptoms of depression.
Physical and cognitive health
The third and final key factor we considered in relation to depression in older people is the role of physical and cognitive decline due to ageing.
Our analysis shows depression affects higher proportions of people reporting poor memory (48%), mental abilities (64%) or eyesight (46%), while it is significantly lower in those reporting that their memory, eyesight and mental abilities were excellent (16%, 10% and 12% respectively).
A similar picture emerges when we look at other indicators of physical health. 44% of people requiring support with at least one activity of daily living reported symptoms of depression, compared to 13% of older people not requiring any assistance with daily activities.
Some of the key factors that can trigger depression – poor physical health, social isolation, bereavement, lack of exercise – are commonly experienced in later life. The pandemic has also exacerbated these issues for people in their later years, as evidence from the ELSA COVID-19 sub-study demonstrates.
At the same time, economic vulnerability and physical health, both of which are strongly associated with depression among older individuals, are shaped earlier in life.
As we emerge from the pandemic and as our society ages, we will need to address both the shorter- and longer-term determinants of poor mental health to support the mental wellbeing of people in their later years.
The analysis in this blog of the 9th Wave of the English Longitudinal Study of Ageing was originally carried out for NatCen’s 2021 Society Watch report, “Mental Health: Should we be worried?”. The report provides a new picture of mental health in Britain today, presented ‘from the cradle to the grave’.