Seasonal Affective Disorder in the Elderly
Seasonal affective disorder (SAD) and vitamin D deficiency can have damaging effects on older adults’ physical and mental health. More seniors are staying home due to the pandemic, so it is imperative to be aware and recognize the signs of SAD. Seasonal affective disorder is a form of depression that cycles with the seasons. It can occur during any time of the year, but it typically affects people during the winter.
As the weather gradually gets colder and the days get shorter, people affected by winter-induced SAD will generally begin to feel the symptoms of depression. Signs of SAD include a loss of energy, changes in appetite and sleeping habits, irritability, and loss of interest in socializing and other activities.
Along with the difficulties that a chronic illness can bring, seniors are also likely to experience losses in the social networks, which can contribute to the formation of clinical depression. The brain can also experience chemical changes with age that can lead to depression.
According to the National Institute of Mental Health, SAD is more prevalent in women and people who live further from the equator, where the sun is not as strong or constant. Individuals with existing mental disorders, such as anxiety disorders, major depressive disorder and bipolar disorder, more commonly experience the so-called “winter blues.”
The main difference between SAD and general depression is that SAD only strikes during certain times of the year. A decline in the amount of daylight during fall and winter affects circadian rhythms and causes hormonal changes that lead to depressive symptoms in people with SAD. These effects can be compounded if a person cannot or does not want to regularly spend time outdoors, which is particularly impactful to seniors who are housebound or live in areas prone to ice and snow.
A non-pharmaceutical option for alleviating the symptoms of SAD is bright light therapy. Bright light therapy utilizes a piece of equipment called a “lightbox,” which is essentially a fluorescent lamp that emits a spectrum of light intended to simulate natural sunlight. A good quality lightbox will come with a filter that blocks harmful UV rays so the light does not damage a person’s eyes or skin.
Research has shown that, when used properly, a lightbox can decrease the amount of melatonin (a hormone that is typically produced at night and causes drowsiness and lethargy) circulating in a person’s body during the day and regulate the neurotransmitters serotonin and epinephrine. Having an imbalance of these chemicals can intensify symptoms of depression. (Shirani, 2009)
According to the National Institutes for Health NIH, Research shows that vitamin D plays an increasingly important role in physical and mental health.
Vitamin D deficiency can have negative health consequences for a person of any age, but it can be particularly dangerous for older adults. Symptoms of vitamin D deficiency are very subtle and can include muscle and bone pain, excessive fatigue, and depressed mood. Seniors who don’t get enough vitamin D are at an increased risk of developing osteoporosis—a dangerous decrease in bone density that can contribute to broken bones.
The NIH has identified elderly people as an at-risk group for vitamin D deficiency. Not only do changes in diet often eliminate foods rich in vitamin D from a senior’s meal choices, but aging bodies have more difficulty converting and absorbing vitamin D from foods.
Additionally, older bodies are less efficient at using sunlight to produce vitamin D, and seniors are more likely to have mobility limitations that prevent them from getting outside to get enough sun exposure. Studies have shown that seniors’ vitamin D levels tend to drop during the winter months when the days are shorter and the sun is at a lower angle in the sky.
The safest way to treat or prevent deficiency is to ensure a senior eats food fortified with vitamin D. A person can obtain vitamin D naturally by eating beef liver, egg yolks, cheeses, and fatty fish like salmon. Certain varieties of milk, yogurt, cereals and juice are fortified to contain extra doses of the vitamin D, but not so much as to pose a hazard to a person’s health.
With the shorter amount of daylight during winter months, coupled with colder weather, possible lack of vitamin D in senior citizens, and more elderly staying indoors due to the pandemic, the risk of SAD increases dramatically. Being aware, recognizing the signs, and knowing the preventative measures of SAD will help you as a caregiver take care of your loved ones and seek any medical intervention that may be needed.
References
HealthCare, Interim. “Combating Seasonal Depression in the Elderly.” News Desk, www.interimhealthcare.com/about-interim-healthcare/news-media/news-desk/combating-seasonal-depression-in-the-elderly/.
Leticia Elizondo-Montemayor, Elena C. Castillo, Carlos Rodríguez-López, José R. Villarreal-Calderón, Merit Gómez-Carmona, Sofia Tenorio-Martínez, Bianca Nieblas, Gerardo García-Rivas, "Seasonal Variation in Vitamin D in Association with Age, Inflammatory Cytokines, Anthropometric Parameters, and Lifestyle Factors in Older Adults", Mediators of Inflammation, vol. 2017, Article ID 5719461, 14 pages, 2017. https://doi.org/10.1155/2017/5719461
“Office of Dietary Supplements - Vitamin D.” NIH Office of Dietary Supplements, U.S. Department of Health and Human Services, ods.od.nih.gov/factsheets/vitamind-healthprofessional/.
“Seasonal Affective Disorder.” National Institute of Mental Health, U.S. Department of Health and Human Services, www.nimh.nih.gov/health/publications/seasonal-affective-disorder/index.shtml.
Shirani, Afshin, and Erik K St Louis. “Illuminating rationale and uses for light therapy.” Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine vol. 5,2 (2009): 155-63.