In a typical sleep cycle, we initially enter the early stages of sleep followed by deeper sleep stages and ultimately (after about 90 minutes) rapid eye movement (REM) sleep. For people suffering from narcolepsy, REM sleep occurs almost immediately in the sleep cycle as well as periodically during the waking hours. It is in REM sleep that we can experience dreams and muscle paralysis which explains some of the symptoms of narcolepsy.

Narcolepsy usually begins between the ages of 15 and 25, but it can become apparent at any age. In many cases, narcolepsy is undiagnosed and, therefore, untreated.

What Causes Narcolepsy?

The cause of narcolepsy is not known; however, scientists have made progress toward identifying genes strongly associated with the disorder. These genes control the production of chemicals in the brain that may signal sleep and awake cycles. Some experts think narcolepsy may be due to a deficiency in the production of a chemical called hypocretin by the brain. In addition, researchers have discovered abnormalities in various parts of the brain involved in regulating REM sleep. These abnormalities apparently contribute to symptom development. According to experts, it is likely narcolepsy involves multiple factors that interact to cause neurological dysfunction and REM sleep disturbances.
What Are the Symptoms of Narcolepsy?

Symptoms of narcolepsy include:

* Excessive daytime sleepiness (EDS): In general, EDS interferes with normal activities on a daily basis, whether or not a person with narcolepsy has sufficient sleep at night. People with EDS report mental cloudiness, a lack of energy and concentration, memory lapses, a depressed mood, and/or extreme exhaustion.
* Cataplexy: This symptom consists of a sudden loss of muscle tone that leads to feelings of weakness and a loss of voluntary muscle control. It can cause symptoms ranging from slurred speech to total body collapse depending on the muscles involved and is often triggered by intense emotion, for example surprise, laughter, or anger.
* Hallucinations: Usually, these delusional experiences are vivid and frequently they are frightening. The content is primarily visual, but any of the other senses can be involved. These are called hypnagogic hallucinations when accompanying sleep onset and hypnopompic hallucinations when occurring during awakening.
* Sleep paralysis: This symptom involves the temporary inability to move or speak while falling asleep or waking up. These episodes are generally brief lasting a few seconds to several minutes. After episodes end, people rapidly recover their full capacity to move and speak.

How Is Narcolepsy Diagnosed?

A clinical examination and exhaustive medical history are essential for proper diagnosis of narcolepsy. However, none of the major symptoms is exclusive to narcolepsy. Several specialized tests, which can be performed in a sleep disorders clinic, usually are required before a diagnosis can be established. Two tests that are considered essential in confirming a diagnosis of narcolepsy are the polysomnogram (PSG) and the multiple sleep latency test (MSLT).

The PSG is an overnight test that takes continuous multiple measurements while a patient is asleep to document abnormalities in the sleep cycle. A PSG can help reveal whether REM sleep occurs at abnormal times in the sleep cycle and can eliminate the possibility that an individual’s symptoms result from another condition.

The MSLT is performed during the day to measure a person’s tendency to fall asleep and to determine whether isolated elements of REM sleep intrude at inappropriate times during the waking hours. As part of the test, an individual is asked to take four or five short naps usually scheduled two hours apart.
How Is Narcolepsy Treated?

Although there is no cure for narcolepsy, the most disabling symptoms of the disorder (EDS and symptoms of abnormal REM sleep, such as cataplexy) can be controlled in most people with drug treatment. Sleepiness is treated with amphetamine-like stimulants while the symptoms of abnormal REM sleep are treated using antidepressant medications.

There has recently been a new medication approved for those who suffer from narcolepsy with cataplexy. This medication, called Xyrem, helps people with narcolepsy get a better night’s sleep, allowing them to be less sleepy during the day. Patients with narcolepsy can be substantially helped — but not cured — by medical treatment.

Lifestyle adjustments such as avoiding caffeine, alcohol, nicotine, and heavy meals, regulating sleep schedules, scheduling daytime naps (10-15 minutes in length), and establishing a normal exercise and meal schedule may also help to reduce symptoms.

What Causes Menopause?

A woman is born with a finite number of eggs, which are stored in the ovaries. The ovaries also produce the hormones estrogen and progesterone, which regulate menstruation and ovulation. Menopause occurs when the ovaries no longer produce an egg every month and menstruation stops.

Menopause, when it occurs after the age of 40, is considered “natural” and is a normal part of aging. But, some women can experience menopause early, either as a result of a surgical intervention, such as hysterectomy, or damage to the ovaries, such as from chemotherapy. Menopause that occurs before the age of 40, regardless of the cause, is called premature menopause.
How Does Natural Menopause Occur?

Natural menopause is the permanent ending of menstruation that is not brought on by any type of medical treatment. For women undergoing natural menopause, the process is gradual and is described in three stages:

* Perimenopause . Perimenopause begins several years before menopause, when the ovaries gradually produce less estrogen. Perimenopause lasts up until menopause, the point when the ovaries stop releasing eggs. In the last one to two years of perimenopause, the decrease in estrogen accelerates. At this stage, many women experience menopause symptoms (see below).
* Menopause. Menopause is the point when a woman has her last menstrual period. At this stage, the ovaries have stopped releasing eggs and producing most of their estrogen. Menopause is diagnosed when a woman has gone without a period for 12 consecutive months.
* Postmenopause. These are the years after menopause. During this stage, menopausal symptoms, such as hot flashes, ease for most women. However, health risks related to the loss of estrogen increase as the woman ages.

What Conditions Cause Premature Menopause?

Premature menopause can be the result of genetics, autoimmune disorders, or medical procedures. Here are some other conditions that may cause early menopause.

* Premature ovarian failure. Normally, the ovaries produce both estrogen and progesterone. Changes in the levels of these two hormones occur when the ovaries, for unknown reasons, prematurely stop producing eggs. When this happens before the age of 40, it is considered to be premature ovarian failure. Unlike premature menopause, premature ovarian failure is not always permanent.
* Induced menopause. “Induced” menopause occurs when the ovaries are surgically removed for medical reasons, such as uterine cancer or endometriosis. Induced menopause can also result from damage to the ovaries caused by radiation or chemotherapy.
What Are the Symptoms of Menopause?

Most women going through menopause will experience hot flashes, a sudden feeling of warmth that spreads over the upper body that is often accompanied by blushing and some sweating. The severity of hot flashes varies from mild in most women to severe in others.

Other common menopause symptoms include:

* Irregular or skipped periods
* Insomnia
* Mood swings
* Fatigue
* Depression
* Irritability
* Racing heart
* Headaches
* Joint and muscle aches and pains
* Changes in libido (sex drive)
* Vaginal dryness
* Bladder control problems

Not all women get all of these symptoms.
How Do I Know When I Am Going Through Menopause?

When you begin to notice the signs of menopause, either you’ll suspect the approach of menopause on your own, or your doctor will put two and two together when you report your symptoms. Two very simple tests can accurately determine what’s going on and what stage of menopause you’re in. Your follicle stimulating hormone (FSH) levels will dramatically rise as your ovaries begin to shut down; these levels are easily checked through one blood test.

In addition, your vaginal walls will thin, and the cells lining the vagina will not contain as much estrogen. Your doctor will simply take a Pap-like smear from your vaginal walls — simple and painless — and analyze the smear to check for vaginal “atrophy,” the thinning and drying out of your vagina. It helps if you keep track of your periods and chart them as they become irregular. Your menstrual pattern will be an added clue to your doctor about whether you are pre- or perimenopausal.
What Long-Term Health Problems Are Associated With Menopause?

The loss of estrogen associated with menopause has been linked to a number of health problems that become more common as women age.

After menopause, women are more likely to suffer from:

* Osteoporosis (brittle-bone disease).
* Heart disease.
* Poor bladder and bowel function.
* Poor brain function (increased risk of Alzheimer’s disease).
* Poor skin elasticity (increased wrinkling).
* Poor muscle power and tone.
* Some deterioration in vision, such as from cataracts (clouding of the lens of the eye) and macular degeneration (breakdown of the tiny spot in the center of the retina that is the center of vision).

There are a number of treatments to consider that can reduce the risks associated with menopause.

THURSDAY, April 2 (HealthDay News) — Gene mutations that cause
infertility in men could point the way to a male birth control pill,
American and Iranian researchers say.

“We have identified CATSPER1 as a gene that is involved in
non-syndromic male infertility in humans, a finding which could lead to
future infertility therapies that replace the gene or the protein. But,
perhaps even more importantly, this finding could have implications for
male contraception,” co-study author Michael Hildebrand, a postdoctoral
researcher in otolaryngology at the University of Iowa, said in a
university news release.

He and his colleagues discovered the gene mutations while analyzing the
genetics of families in Iran — where there are relatively high rates of
disease-causing gene mutations — to identify the genetic causes of
deafness.

During their study, the researchers identified two families in which
male infertility appeared to be inherited. Further investigation revealed
that both families had mutations in the CATSPER1 gene. It’s believed the
mutations affect sperm motility, the motion sperm use to enter an egg
during fertilization.

“Identification of targets such as the CATSER1 gene that are involved
in the fertility process and are specific for sperm — potentially
minimizing side effects of a drug targeting the protein’s function –
provide new targets for a pharmacological male contraceptive,” Hildebrand
said.

The study appears in the April 2 online edition of the American
Journal of Human Genetics. ]]> http://www.medicalhealthadvice.org/health-news/genetic-finding-may-lead-to-male-contraceptive-healthday/feed 0 http://www.medicalhealthadvice.org/health-news/hispanic-children-more-likely-to-have-hearing-loss-healthday http://www.medicalhealthadvice.org/health-news/hispanic-children-more-likely-to-have-hearing-loss-healthday#comments Fri, 03 Apr 2009 19:50:06 +0000 Dr. Whoo http://www.medicalhealthadvice.org/health-news/hispanic-children-more-likely-to-have-hearing-loss-healthday

FRIDAY, April 3 (HealthDay News) — Children from Hispanic or
low-income families are more likely to have hearing loss, and a serious
but rare eye disease is often missed or mistreated among urban
preschoolers.

The hearing finding was based on a review of five studies conducted
between 1966 and 2007, all of which explored hearing loss among children
of various ethnicities from birth through the age of 19.

In contrast, the vision finding was drawn from a new investigation
conducted between 2003 and 2007 that looked into so-called “refractive
eyesight errors” among black and white children (aged 6 months to about 6
years) living in the Baltimore area.

“Based on the data available in the various studies we looked at, it
appears that in the Hispanic population and in low-income homes, there is
likely a higher burden of pediatric hearing loss,” said Dr. Donald G.
Keamy, lead author of the hearing study and a surgeon at the Massachusetts
Eye and Ear Infirmary and an instructor in the departments of otology and
laryngology at Harvard Medical School.

“But we don’t know the absolute cause of that increased rate,” Keamy
noted. “And it is also very important to point out that the information we
looked at is actually both somewhat old and very fractured, in the sense
that there is no unified national approach to collecting pediatric hearing
loss information. So, we can not even say if the finding is absolutely
true until we have a much more systematic and fresh analysis of the
problem, which would require a more national approach to the assessment of
hearing loss in children.”

Keamy published his team’s observations in the April issue of
Otolaryngology-Head and Neck Surgery. The vision study team, from
Johns Hopkins Medical School in Baltimore, reported its findings in the
April issue of Ophthalmology.

Keamy and his colleagues point out that hearing loss is one of the most
common birth disorders in the United States, noting that two to four of
every 1,000 children are born either deaf or hard-of-hearing.

The current review examined prior research gleaned from medical
databases and U.S. Centers for Disease Control and Prevention reports.

The hearing study authors found that the average rate of hearing
impairment from birth to adolescence was “significantly higher” among all
subgroups of Hispanic-Americans (Mexican-American, Cuban-American, and
Puerto Rican) and to a similar degree among low-income households.

“The bottom line is that pediatric hearing loss is a largely
under-recognized problem that has a great impact on a number of issues,
with regard to learning and language development,” noted Keamy. “And until
we really completely understand the scope of the problem, we can’t fix it
and make things better.”

“So the point here,” he stressed, “is that despite the fact that most
states now screen newborns for hearing loss before hospital discharge, the
process is not entirely standardized, and different techniques are used
which have different sensitivities for detecting hearing loss. So the
indication about the higher risk among Hispanics is, of course, important.
But what we truly hope to accomplish with this work is to encourage the
adoption of a more systematic approach to the overall problem.”

“This study really shows the need for an apples-to-apples approach to
pediatric hearing loss,” agreed Robert D. Frisina, an associate chair of
otolaryngology at the University of Rochester Medical School in New
York.

“This is a relatively novel and interesting analysis,” said Frisina.
“And I haven’t heard of a higher risk among Hispanic households before,
which makes it a little bit surprising and provocative. But before any
health recommendations could be made, it does need to be followed up to
find out with certainty whether or not there is a sampling error here. And
to do that, I think a national repository and national standards for
hearing loss data collection are very much needed.”

As for the vision findings, the Hopkins team — led by Dr. David
Friedman, of the Bloomberg School of Public Health — found that despite
the fact that 5 percent of the nearly 2,300 urban children they examined
had a defect in the eye’s ability to focus on light that was serious
enough to warrant treatment, just 1 percent actually got necessary medical
attention.

On the other side of the coin, they actually uncovered some evidence of
over-treatment, given that one-third of 29 children who had been
prescribed eyeglasses before the study launch actually didn’t need
them.

FRIDAY, April 3 (HealthDay News) — Poor children are exposed to
more secondhand smoke than their wealthier counterparts, a new study has
found.

A big reason for this is that “poor kids are far more likely to live
with multiple adult smokers than are non-poor kids,” said study author Dr.
Michael Weitzman, a professor of pediatrics at New York University.

Children exposed to secondhand smoke are more likely to develop
respiratory infections, earaches and severe asthma. In addition, studies
have linked exposure to secondhand smoke to hyperactivity disorder and
behavioral problems.

“This paper demonstrates the complex network of who exposes children in
their homes,” Weitzman said. “Secondhand smoke is the most ubiquitous and
pernicious child environmental health exposure in the U.S.”

For the study, which is in the April issue of Pediatrics, the
researchers collected data on families who participated in the Medical
Expenditure Panel Survey conducted from 2000 to 2004.

They found that slightly more than a third of the children lived in
homes with at least one adult smoker. But about 49 percent of children
from lower-income households lived with someone who smoked, compared with
21 percent of kids from wealthier families, and poorer children were more
apt to live with more than one smoker as well.

Among the approximately 5 million children who did not live with their
parents, about 53 percent lived with a grandparent who smoked, and 46
percent lived with another relative who smoked, whereas 33 percent of
children who lived with their parents co-existed with an adult smoker.

Considering just children who lived with someone who smoked, the smoker
was the child’s mother 59 percent of the time, and 57 percent of the
children lived in homes where two people smoked. In contrast, 17 percent
of the children whose mother did not smoke lived with other adult smokers,
the researchers noted.

“The best thing you can do as a smoker in a household of kids is to
stop smoking,” said Danny McGoldrick, research director at the Campaign
for Tobacco-Free Kids. “We know that kids who have parents who smoke are
much more likely to become smokers themselves.”

“Once again, it’s the most vulnerable in our society who pay the price
for tobacco use,” he said.

But beyond direct exposure to smoke from their living situations, young
people also appear to be influenced, when deciding whether to smoke, by
the movies they watch.

Another study in the same issue of Pediatrics found that seeing
movie characters smoking has an effect on teenagers.

“This is the first study to demonstrate that movie smoking exposure has
a long-term impact on smoking behavior,” said lead author Madeline Dalton,
director of the Hood Center for Children and Families at Dartmouth Medical
School.

Dalton’s research team asked 1,791 teens about their movie-watching and
smoking habits, first when they were 14 or 15, and then again when they
were 18.

Compared with those who watched the fewest movies with characters who
smoked, teens who saw the most smoking in movies were twice as likely to
become established smokers as young adults, Dalton said.

“Importantly, movie smoking exposure was a stronger predictor of who
went on to become an established smoker than having friends or parents who
smoke,” she said.

Eliminating exposure to smoking in movies when kids are young could
reduce by a third the number of young adults who become addicted smokers,
Dalton said. And that could be a key factor in preventing long-term
adverse health consequences related to smoking, she said.

“Children’s exposure to movie smoking can be eliminated through a
combination of policy changes and parental behavior,” Dalton said.
“Parents should be aware that what children watch at a young age
influences their behavior later in life. The movie industry should act
responsibly and take steps to ensure that children are not exposed to
smoking in movies.”

McGoldrick also thinks that smoking in movies needs to be curbed.

“This study adds to the evidence that kids exposed to smoking in movies
are more likely not only to experiment with smoking, but become
established smokers later in life,” he said.

The Campaign for Tobacco-Free Kids calls for movies that show smoking
to be rated R. The group also would like filmmakers to certify that they
received no money from tobacco companies or others to use a particular
brand of cigarettes in the film.

“In addition, movies with smoking in them should have anti-smoking ads
before the movie,” McGoldrick said.

NEW YORK (Reuters Health) –
Japanese researchers say mumps-related hearing loss in children may be 20 times more common than previously suggested.

"Deafness is a rare but important complication of mumps virus infection," the researchers note in a report in The Pediatric Infectious Disease Journal.

They determined the incidence of sudden hearing loss in children with mumps based upon a population-based office survey of more than 7500 patients from 40 pediatric practices in Japan, a country where mumps is endemic (constantly present).

Among 7400 children who took hearing tests after the onset of mumps, 7, or 0.1 percent, had confirmed hearing loss.

Hearing loss in the 7 children was confined to one ear but was "severe and did not improve over time," the researchers note.

"We were surprised so many people get hearing loss after mumps," Dr. Hiromi Hashimoto, from Hashimoto Pediatric Clinic in Osaka, Japan, told Reuters Health.

None of the 7 children with mumps-related hearing loss had been vaccinated against mumps.

"I'm afraid many Japanese people, including physicians, don't know about mumps deafness," Hashimoto said. "Many Japanese people believe mumps is a slight illness if only caught in childhood. We want many people to have a proper understanding about mumps and the importance of vaccination."

In a commentary on the Hashimoto's report, Dr. Stanley A. Plotkin from the University of Pennsylvania, Doylestown, highlights the lack of universal mumps vaccination in Japan.

The absence of vaccination against mumps is "surprising for a developed country," Plotkin wrote, "and this regrettable policy must be changed for the sake of Japanese children."

NEW YORK (Reuters Health) –
Severe stress during pregnancy has been proposed as a risk factor for autism, but a new study finds that at least one source of such stress appears unrelated to the disorder.

The study, which analyzed records on 1.5 million children born in Denmark, found no evidence of an increased autism risk among children whose mothers lost a close family member shortly before or during pregnancy.

The findings, reported in the journal Pediatrics, suggest that mothers' bereavement — as an indicator of substantial stress — does not contribute to autism risk.

However, the researchers say, the study does not prove that prenatal stress plays no role in autism development.

While genetics are thought to be important in autism risk, experts also believe that environmental factors are involved. Just what those factors are remains unclear. In theory, severe stress during pregnancy could affect fetal brain development in a way that raises the risk of future autism.

Accurately measuring prenatal stress is "very difficult," Dr. Jiong Li, the lead researcher on the current study, told Reuters Health.

"A simple indicator of stress, like bereavement in our study, may fail to unveil the association between stress and autism," explained Li, a researcher at the University of Aarhus in Denmark.

In addition, Li pointed out, bereavement around the time of pregnancy is fairly infrequent, which makes it more difficult for a study to detect a general effect.

The findings are based on records for nearly 1.5 million children born between 1978 and 2003. More than 37,000 of those mothers lost a child, spouse, parent or sibling during pregnancy or in the year before becoming pregnant. There was no evidence that their children had a higher risk of developing autism.

"What we can say is, our data do not support a strong association, and people should not be panic about such an event," Li said.

"But," the researcher added, "our data would not argue against the evidence from other studies that severe stress could affect neurological development in fetus."

SOURCE: Pediatrics, April 2009.

THURSDAY, April 2 (HealthDay News) — Low levels of a stress
hormone may be responsible for the obsession with routine and dislike for
new experiences common in children with a certain type of autism.

U.K. researchers found that children with Asperger syndrome (AS) do
not experience the normal twofold increase of cortisol upon waking up.
Levels of the hormone in their bodies do continue to decrease throughout
the day, though, just as they do in those without the syndrome.

The body produces cortisol, among other hormones, in stressful
situations. Cortisol increases blood pressure and blood sugar levels,
among other duties, to signal the body’s need to adapt to changes
occurring around it. It’s thought that the increase shortly after waking
helps jump-start the brain for the day ahead, the researchers said.

People with Asperger syndrome notably have very repetitive or narrow
patterns of thought and behavior, such as being obsessed with either a
single object or topic. Though tending to become experts in this limited
domain, they have otherwise very limited social skills, according to the
study.

“Although these are early days, we think this difference in stress
hormone levels could be really significant in explaining why children with
AS are less able to react and cope with unexpected change,” study
co-leader Mark Brosnan, from the psychology department at the University
of Bath, said in a news release issued by the school.

If these Asperger symptoms are caused primarily by stress, caregivers
could learn to steer children away from situations that would add to
anxiety, the researchers said.

“This study suggests that children with AS may not adjust normally to
the challenge of a new environment on waking,” study researcher David
Jessop, from the University of Bristol, said in the news release. “This
may affect the way they subsequently engage with the world around them.”

The researchers, whose findings were published in the journal
Psychoneuroendocrinology, will next study if this lack of cortisol
upon waking also occurs in children with other types of autism. ]]> http://www.medicalhealthadvice.org/health-news/asperger-syndrome-tied-to-low-cortisol-levels-healthday/feed 0 http://www.medicalhealthadvice.org/health-news/for-some-more-costly-care-is-not-by-choice-healthday http://www.medicalhealthadvice.org/health-news/for-some-more-costly-care-is-not-by-choice-healthday#comments Thu, 02 Apr 2009 19:49:10 +0000 Dr. Whoo http://www.medicalhealthadvice.org/health-news/for-some-more-costly-care-is-not-by-choice-healthday

THURSDAY, April 2 (HealthDay News) — Many low-income American
families with sick children are being enrolled in high-deductible
health-care plans, a new study has found.

In 2007, about 10 percent of employers offered high-deductible plans,
and about 14.8 million adults were enrolled in the plans. But as more
families with sick children are enrolled in these plans, there are
concerns that families facing high out-of-pocket costs might fail to get
recommended care for their children, according to background information
in a news release on the study from Children’s Hospital Boston.

About half of the people enrolled in high-deductible plans in 2007 did
not have a choice of plans, according to a national survey that year.

In this study, researchers analyzed enrollment and claims data from
Harvard Pilgrim Health Care in New England. They identified 839 families
with children who initially had traditional HMO (health maintenance
organization) plans through Harvard Pilgrim but whose employers switched
them to a high-deductible health plan when Harvard Pilgrim began offering
it. The researchers compared these families with 5,133 families whose
employers stayed with the traditional plan.

About one-third of the families who were switched to a high-deductible
plan had a child with a chronic condition, 13 percent lived in
neighborhoods with high poverty, 36 percent had an above-average burden of
illness, and 19 percent had incurred more than $7,000 a year in
health-care costs, including out-of-pocket costs.

The study also found:

• Among families who got their insurance through large employers, those
  living in high-poverty neighborhoods were 1.78 times more likely than
  families in higher-income areas to be switched to a high-deductible
  plan.
• Families with coverage through a small employer were less likely to be
  switched to a high-deductible plan if they had more children, an
  above-average burden of illness and higher health-care expenditures. Those
  who were switched tended to be healthier and have fewer
  children.

The study was published in the April issue of the journal
Pediatrics.

“The usual assumption is that high-deductible plans attract healthy and
wealthy people, based on studies of people who chose those plans
themselves,” Dr. Alison Galbraith, of Children’s Hospital Boston and
Harvard Medical School and an author of the study, said in the news
release.

“Our population only had one plan offered to them, and we found that
many of those who were switched to high-deductible plans had children with
chronic conditions,” Galbraith said. “There wasn’t a difference in the
amount of chronic illness between the high-deductible and traditional
families, but it was striking that there wasn’t less illness in the high
deductible group. We need to be aware of this as these plans become more
popular.”

The findings “show that families with children in high-deductible plans
may comprise two distinct groups, one with higher-risk characteristics and
one with lower-risk characteristics compared to traditional plans,” she
said. “This makes it important to monitor the effects of enrollment in
high-deductible plans on children’s use of needed care, especially for
vulnerable populations that are enrolled.” ]]> http://www.medicalhealthadvice.org/health-news/for-some-more-costly-care-is-not-by-choice-healthday/feed 0 http://www.medicalhealthadvice.org/health-news/health-tip-depression-among-seniors-healthday http://www.medicalhealthadvice.org/health-news/health-tip-depression-among-seniors-healthday#comments Fri, 27 Mar 2009 19:47:53 +0000 Dr. Whoo http://www.medicalhealthadvice.org/health-news/health-tip-depression-among-seniors-healthday

(HealthDay News) — Depression affects more than 6 million people
aged 65 or older in the United States, but only about 10 percent of them
are treated, the Cleveland Clinic says.

The clinic offers this list of risk factors for depression in
seniors:

• Living alone without much social interaction.
• Having persistent pain or illness.
• Being overly afraid of dying.
• Having a family history or personal history of depression or suicide
  attempts.
• Having had a recent bereavement, such as the death of a close family
  member.
• Having problems with drugs or alcohol.
• Taking certain medications, alone or combined with other
  medications.
• Problems with body image after a surgery or major illness, such as
  cancer or heart disease.