4 signs of depression in older adults hidden in plain sight


There are a lot of things that are normal consequences of aging. Some gray hair is not all that unexpected. The need for reading glasses usually comes as no surprise. Even occasional aches and pains are pretty typical. But one thing that is not a normal part of aging? Depression.

Unfortunately, statistics show that about 60 percent of the population believes that it’s perfectly normal to get more depressed with age. After all, a lot of changes take place during the latter decades of life.

Biologically, shifts in the production of various hormones and neurotransmitters can lead to mood changes. And the general twists and turns of life that occur in our 60s, 70s, and beyond—such as retirement, empty nesting, deaths of loved ones, and health challenges—can also cause emotional distress. It certainly can take time for the body to mentally adjust and regain balance.

Most of the time, that’s exactly what happens. But when the negative feelings persist, that’s when it’s more than sadness—and possibly depression.

Depression is a serious medical issue that ultimately affects how we feel, think, and handle daily activities. It is by no means “normal” in seniors, but it is common, with 6 million Americans aged 65 and over afflicted.

What’s worse, only about 10 percent of seniors seek treatment because depression presents itself differently in the older generation compared to younger folks. In fact, while most people automatically associate sadness as the main symptom of depression, many seniors do not feel (or at least outwardly display) sadness at all.

It is important to recognize depression, especially in older adults, as it can lead not only to decreased quality of life but increased risk of other medical problems as well as premature death and suicide.

If you are concerned that you or an elderly loved one might have depression, here are 4 little-known signs to look for.

1) Sleep Problems

Insomnia, night awakening, and other sleep disturbances are a huge sign of mood disorders in older adults. According to one study that examined this connection in participants aged 65 and over found that waking up frequently in the middle of the night was the most common sleep issue linked to mood disorders. Insomnia or trouble falling asleep was the second most frequent sleep-related concern.

In another two-year study of 351 adults aged 60 and older, researchers discovered that “depression recurrence was predicted by sleep disturbance, and this association was independent of other depressive symptoms, chronic medical disease, and antidepressant medication use.”

They concluded that sleep problems were an independent risk factor for depression and a sign that should not be ignored.

2) Confusion/Memory Problems

In seniors in particular, depression and anxiety can affect memory, causing confusion. The confusion usually stems from a sense of apathy on the part of the sufferer. Often, the assumption is that the patient is developing dementia or Alzheimer’s—which unfortunately prolongs the time it takes to get an accurate diagnosis.

One study followed 100 people (aged 60 and older) and found that late-life depression is characterized by slowed information processing. More than half of the participants who suffered from depression had significant problems with executive function (decision making) and information processing.

3) Headaches

Research has also established a connection between frequent headaches and depression.

In a study of more than 1,400 Chinese senior citizens, those who suffered more frequent or severe headaches were more likely to be depressed. In fact, two of the strongest predictors of depression were being a lifetime headache sufferer, and having had headaches seven or more days a month within the past year.

4) Irritability

Often, older adults express their sadness and despair in atypical ways. Rather than look solemn, or even cry, they instead become grouchy, irritable, angry, or even hostile. A lot of this could be generational or cultural, but it’s something to be aware of.

Other more commonly associated symptoms of depression to watch out for include:

  • Changes in appearance
  • Problems maintaining the home, finances, etc.
  • Changes in appetite or weight
  • Social withdrawal
  • Unexplained fatigue
  • Feelings of guilt, hopelessness, or worthlessness

If you notice any of these signs in yourself or a loved one, seek the help of a trusted doctor or certified therapist. There is no need to suffer alone. Treatments—whether drugs, supplements, or counseling, or a combination of all three—can help dramatically.


  • Leblanc MF, et al. Sleep problems in anxious and depressive older adults. Psychol Res Behav Manag. 2015; 8: 161–9.Last accessed Sept. 18, 2018.
  • Cho HJ, et al. Sleep Disturbance and Depression Recurrence in Community-Dwelling Older Adults: A Prospective Study. Am J Psychiatry. 2008 Dec; 165(12): 1543–1550.  Last accessed Sept. 18, 2018.
  • Butters MA, et al. The nature and determinants of neuropsychological functioning in late-life depression. Arch Gen Psychiatry. 2004 Jun;61(6):58–95. Last accessed Sept. 18, 2018.
  • Wang SJ, et al. Cormorbidity of headaches and depression in the elderly. Pain. 1999 Sep;82(3):239–43. Last accessed Sept. 18, 2018.


Last Updated: January 2, 2020
Originally Published: October 9, 2018