Population aging is a worldwide phenomenon. The oldest of the old, persons aged 85 years and older, comprise the fastest growing segment of the aged. Since the life expectancy has consistently been higher for women than for men, the elderly population is composed of more women than men. So, in absolute terms, aging is affecting women more than men. Among persons aged 65 years and older in the United States, almost 60% are women. The proportion of women in the older populations climbs with age to over 70% in those aged 85 years and older. This trend can be observed across the developed world, where women typically outlive men by 5 to 9 years. This chapter describes the extent of depression experienced in women and men in old age. Subsequently, important biological, physical, and psychosocial risk factors for depression in older women will be described. The chapter will finish with describing the physical consequences of late-life depression in women.

PREVALENCE OF DEPRESSION IN OLDER WOMEN AND MEN

Major depression (also called major depressive disorder) is diagnosed in the Diagnostic and Statistical Manual of the American Psychiatric Association (American Psychiatric Association, 1989) when a person exhibits five or more out of the following nine symptoms: depressed mood, lack of interest, feelings of worthlessness or inappropriate guilt, diminished ability to concentrate or make decisions, fatigue, psychomotor agitation or retardation, insomnia or hypersomnia, significant decrease or increase in weight or appetite, and recurrent thoughts of death or suicidal ideation.