Geriatric depression, a significant mental health concern among older adults, manifests as a range of depressive symptoms that impair quality of life, functional capacity, and overall well-being. In Colombia, a country marked by socioeconomic challenges, historical violence, and a growing ageing population, geriatric depression presents unique complexities. The prevalence of depression among older adults in Colombia is notably high, with studies indicating that up to 41% of individuals over 60 report depressive symptoms (Ministerio de Salud, 2013). This essay explores the prevalence, risk factors, social resources, and interventions for geriatric depression in Colombia, drawing on recent studies to provide a comprehensive analysis. It also addresses the social resources available to mitigate this condition, emphasising their role in fostering mental health resilience.
Prevalence of Geriatric Depression in Colombia
Depression among older adults in Colombia is a pressing public health issue. According to the Encuesta Nacional de Salud, Bienestar y Envejecimiento (SABE; Ministerio de Salud, 2015), approximately 41% of Colombians aged 60 and older exhibit depressive symptoms, a figure significantly higher than global estimates, which range from 10-20% for older adults (World Health Organisation, 2017). A study conducted in three Colombian cities—Bogotá, Medellín, and Cali—utilising the Yesavage Geriatric Depression Scale (GDS) reported a prevalence of 15% for clinical depression among community-dwelling older adults, with higher rates among women (Gómez et al., 2019). This discrepancy in prevalence estimates may stem from methodological differences, such as self-reported measures versus clinical diagnoses, and the exclusion of rural or institutionalised populations in some studies.
The high prevalence is compounded by underdiagnosis, with nearly half of geriatric depression cases remaining undetected due to stigma, prioritisation of somatic complaints, and limited access to mental health services (Giebel et al., 2023). Colombia’s history of armed conflict, spanning over seven decades, has further exacerbated mental health challenges, with older adults often reporting trauma-related depressive symptoms due to exposure to violence, displacement, or loss (León-Giraldo et al., 2021). The ageing population, projected to increase from 18.7% to 39.5% of the total population by 2050, underscores the urgency of addressing geriatric depression as a public health priority (Guo et al., 2025).
Risk Factors for Geriatric Depression in Colombia
Several risk factors contribute to the high prevalence of geriatric depression in Colombia, encompassing demographic, psychosocial, health-related, and contextual elements. These factors include advancing age, which inherently brings about a decline in physical health and social support networks as older adults often experience the loss of loved ones and friends. In this complex interplay of factors, contextual elements, including societal attitudes towards ageing and mental health stigmas, further complicate the landscape of geriatric depression, emphasising the urgent need for targeted interventions and support systems in Colombia.
1. Demographic and Socioeconomic Factors
Gender is a significant determinant, with women consistently showing higher rates of depression than men. A Bogotá-based study found that being female was associated with a higher risk of depression, potentially due to gender-specific social stressors such as caregiving responsibilities and economic dependency (Rodríguez et al., 2020). Low socioeconomic status and limited education also increase vulnerability, as they restrict access to resources and exacerbate feelings of helplessness (León-Giraldo et al., 2021). Only 23% of Colombians over 60 receive a pension in 2015, leaving many in financial strain, which is a known correlate of depression (SABE, Ministerio de Salud, 2015). However, there is progress as President Gustavo Petro has recently implemented policies targeting these crucial, and problematic factors.
2. Psychosocial Factors
Social isolation and poor social support are critical risk factors. Older adults in Colombia often experience shrinking social networks due to retirement, bereavement, or health decline, which heightens loneliness and depressive symptoms (Ayalon & Levkovich, 2019). Low social support networks were strongly associated with depression, particularly among women. Additionally, exposure to historical violence, including forced displacement and loss of loved ones, has left lasting psychological scars, with older adults reporting persistent trauma (Giebel et al., 2023).
3. Health-Related Factors
Chronic illnesses, such as diabetes, cardiovascular disease, and cognitive impairment, are prevalent among older Colombians and are closely linked to depression. The SABE survey indicated that 15% of older adults with depression also reported functional deficits, which further impair their ability to engage in daily activities (Gómez et al., 2019). Cognitive decline, assessed using tools like the Montreal Cognitive Assessment Test (MoCA), is another risk factor, as it compounds feelings of helplessness and reduces coping capacity.
4. Contextual Factors
Colombia’s history of armed conflict and ongoing localised violence contribute significantly to mental health challenges. The 2016 Peace and Disarmament Agreement reduced large-scale conflict, but localised violence persists, perpetuating stress and trauma among older adults (Tamayo-Agudelo & Bell, 2018). The COVID-19 pandemic further intensified these issues, with restrictive measures like physical distancing disproportionately affecting older adults, leading to increased isolation and depression (Ministerio de Salud y Protección Social, 2020).
Social Resources for Addressing Geriatric Depression
Social resources play a crucial role in mitigating geriatric depression by fostering social connectedness, providing instrumental support, and reducing isolation. In Colombia, several initiatives and programs target older adults’ mental health, though challenges in accessibility and coverage persist.
- Colombia Mayor: A social pension program that improves social participation but has limited impact on depression due to household resource sharing.
- Community Health Centres: Use tools for screening, though rural access is limited.
- NGOs and Volunteering: Organisations like Fundación para el Bienestar del Adulto Mayor offer social activities, reducing depressive symptoms.
- Digital Support: Internet usage reduces depression by fostering connections, but adoption is low due to digital literacy barriers.
The Above Programmes Explained
The Colombia Mayor program, a social pension initiative, provides cash transfers to low-income older adults to alleviate poverty and improve well-being. The study using the 2015 SABE data found that while the program improved social participation and reduced food insecurity, it had no significant effect on depression levels, possibly due to high levels of intergenerational co-residence, where benefits are shared within households rather than directly benefiting the recipient (Hessel et al., 2020). This highlights the need for targeted mental health components within such programs.
Community-based initiatives, such as those offered by public community health centres, provide screening and support for older adults. A South Korean study, which shares similarities with Colombia’s community-based approach, screened 609 older adults and found that social support moderated the relationship between daily living activities and life satisfaction, suggesting that similar interventions could be effective in Colombia (Kim et al., 2020). In Colombia, community health centres use tools like the Geriatric Depression Scale Short Form (GDSSF-K) to identify at-risk individuals, though coverage is limited in rural areas (Gómez et al., 2019).
NGOs and volunteer programs offer social engagement opportunities that can reduce depressive symptoms. A study on volunteering and depression found that older adults who volunteered reported fewer depressive symptoms, particularly when engaged in religious or community activities (Musick & Wilson, 2003). In Colombia, organisations like the Fundación para el Bienestar del Adulto Mayor provide recreational and social activities, fostering a sense of purpose and community. However, these programs are often urban-centric, limiting access for rural older adults.
Digital Support is based on the fact that internet usage has emerged as a potential tool for reducing depression among older adults. A study from the China Health and Retirement Longitudinal Study, applicable to middle-income contexts like Colombia, found that internet usage reduced depression levels by 1.41% by facilitating social connections and access to information (Guo et al., 2025). In Colombia, initiatives like the Ministry of Information and Communications’ digital literacy programs aim to bridge the digital divide for older adults, though adoption remains low due to limited access and technological literacy.
Interventions and Treatment Approaches
Effective interventions for geriatric depression in Colombia must address both the depressive syndrome and underlying social adversities. Several evidence-based approaches show promise.
- Psychosocial: Problem-solving treatment (PST) combined with case management shows promise for low-income older adults.
- Pharmacological and Integrated Care: Community-based antidepressant management improves outcomes.
- Home-Based Care: Depression care management in home healthcare settings enhances functioning.
Now, let’s explore these in more detail:
Psychosocial Interventions
Problem-solving treatment (PST) combined with case management has shown feasibility in addressing geriatric depression among low-income older adults. A model developed by UCSF and Cornell University integrates PST with case management, teaching patients to identify problems, set goals, and create action plans while linking them to social services (Areán et al., 2010). In Colombia, such interventions could be adapted for community health centres, where nurses are well-positioned to deliver depression care management (DCM).
Pharmacological and Integrated Care
Antidepressant medication management integrated into primary care settings has improved depression outcomes in older adults, with benefits lasting up to two years (Hunkeler et al., 2006). In Colombia, the transition from hospital-based to community-based mental health care, initiated by the 1990 Declaration of Caracas, has increased access to such treatments, though rural areas lag behind (Caldas de Almeida & Horvitz-Lennon, 2010).
Home-Based Care
Home-based care is particularly effective for older adults with mobility limitations or disabilities. Studies integrating mental health care into home healthcare (HHC) settings have shown reduced depression and improved functioning (Rabins et al., 2000). In Colombia, HHC nurses could be trained to implement DCM, leveraging tools like the OASIS-C depression screening to identify and manage cases (Pickett et al., 2022).
Challenges and Recommendations
Despite the availability of social resources and interventions, several challenges hinder effective management of geriatric depression in Colombia. Limited mental health infrastructure, particularly in rural areas, restricts access to care. Stigma surrounding mental health discourages older adults from seeking help, and the prioritisation of physical health over mental health in clinical settings exacerbates underdiagnosis (Giebel et al., 2023). Additionally, the lack of integration between social programs like Colombia Mayor and mental health services limits their impact on depression.
To address these challenges, the following recommendations are proposed:
- Enhance Community-Based Screening: Expand the use of validated tools in community health centres and train healthcare workers to recognise atypical presentations of depression in older adults.
- Integrate Mental Health into Social Programs: Incorporate mental health components into programs like Colombia Mayor, such as peer support groups or counselling, to directly address depressive symptoms.
- Promote Digital Inclusion: Increase investment in digital literacy programs to enable older adults to access online mental health resources and social networks.
- Strengthen Rural Access: Develop mobile health units and telehealth services to reach rural older adults and ensure equitable access to mental health care.
- Combat Stigma: Launch public awareness campaigns to reduce stigma and encourage help-seeking behaviours among older adults.
Conclusion
Geriatric depression in Colombia is a multifaceted issue driven by socioeconomic disparities, historical trauma, and health challenges. While social resources like Colombia Mayor, community health centres, and NGO-led initiatives offer valuable support, their impact on depression is limited by accessibility and integration issues. Evidence-based interventions, such as PST, integrated care, and home-based DCM, show promise but require broader implementation. By addressing structural barriers and leveraging social resources, Colombia can enhance mental health outcomes for its ageing population, ensuring that older adults live with dignity and resilience.
References
Areán, P. A., Raue, P., Kanellopoulos, D., Sirey, J. A., & Alexopoulos, G. S. (2010). Treating depression in disabled, low-income elderly: A conceptual model and recommendations for care. International Journal of Geriatric Psychiatry, 25(8), 765–769. https://doi.org/10.1002/gps.2556
Ayalon, L., & Levkovich, I. (2019). A systematic review of research on social networks of older adults. The Gerontologist, 59(3), e164–e176. https://doi.org/10.1093/geront/gnx218
Caldas de Almeida, J. M., & Horvitz-Lennon, M. (2010). Mental health care reforms in Latin America: An overview of mental health care in Latin America and the Caribbean. Psychiatric Services, 61(3), 218–221. https://doi.org/10.1176/ps.2010.61.3.218
Giebel, C., Zuluaga, M. I., Martinez, R., Castro, S., & Gomez, D. (2023). “Mental health has been left behind”: A qualitative exploration of stakeholders’ perceptions of older adults’ mental well-being in Colombia. Journal of Aging & Social Policy, 35(4), 512–530. https://doi.org/10.1080/08959420.2023.2201818
Gómez, F., Corchuelo, J., Curcio, C. L., Calzada, M. T., & Mendez, F. (2019). Depression in the elderly: A study in three cities of Colombia. Revista Redalyc, 21(3), 45–56. https://www.redalyc.org/articulo.oa?id=10557689004
Guo, L., Li, Y., Cheng, K., Zhao, Y., Yin, W., & Liu, Y. (2025). Impact of internet usage on depression among older adults: Comprehensive study. Journal of Medical Internet Research, 27, e65399. https://doi.org/10.2196/65399
Hessel, P., Avendano, M., Torres, J. M., & Barrientos, A. (2020). Association between social pensions with depression, social, and health behaviors among poor older individuals in Colombia. The Journals of Gerontology: Series B, 75(9), 2006–2015. https://doi.org/10.1093/geronb/gbaa149
Hunkeler, E. M., Katon, W., Tang, L., Williams, J. W., Kroenke, K., Lin, E. H., & Unützer, J. (2006). Long term outcomes from the IMPACT randomised trial for depressed elderly patients in primary care. BMJ, 332(7536), 259–263. https://doi.org/10.1136/bmj.38683.710255.BE
Kim, J., Lee, S., & Chun, S. (2020). Depression, loneliness, social support, activities of daily living, and life satisfaction in older adults at high-risk of dementia. International Journal of Environmental Research and Public Health, 17(20), 7648. https://doi.org/10.3390/ijerph17207648
León-Giraldo, S., Casas, G., Cuervo, J. D., Florez, F., & Botero, J. (2021). Mental health outcomes among older adults in Colombia: The role of conflict and socioeconomic factors. PLoS ONE, 16(3), e0248484. https://doi.org/10.1371/journal.pone.0248484
Ministerio de Salud y Protección Social (2013). Sistema Nacional de Estudios y Encuestas Poblacionales para la Salud: Conceptualización y Guía Metodológica. Bogotá: Ministerio de Salud y Protección Social. Available at: https://www.minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/VS/ED/GCFI/guia-estudios-poblacionales.pdf (Accessed: 4 June 2025).
Ministerio de Salud y Protección Social (2015). Encuesta Nacional de Salud, Bienestar y Envejecimiento (SABE Colombia 2015): Resumen Ejecutivo. Bogotá: Ministerio de Salud y Protección Social. Available at: https://www.minsalud.gov.co/sites/rid/lists/bibliotecaDigital/RIDE/VS/ED/GCFI/Resumen-ejecutivo-encuesta-SABE.pdf (Accessed: 4 June 2025).
Musick, M. A., & Wilson, J. (2003). Volunteering and depression: The role of psychological and social resources in different age groups. Social Science & Medicine, 56(2), 259–269. https://doi.org/10.1016/S0277-9536(02)00025-4
Pickett, Y., Raue, P. J., & Bruce, M. L. (2022). Evaluation of geriatric home healthcare depression assessment and care management: Are OASIS-C depression requirements enough? Journal of the American Medical Directors Association, 23(5), 789–795. https://doi.org/10.1016/j.jamda.2021.08.036
Rabins, P. V., Black, B. S., Roca, R., German, P., McGuire, M., Robbins, B., & Brant, L. (2000). Effectiveness of a nurse-based outreach program for identifying and treating psychiatric illness in the elderly. JAMA, 283(21), 2802–2809. https://doi.org/10.1001/jama.283.21.2802
Tamayo-Agudelo, W., & Bell, V. (2018). Armed conflict and mental health in Colombia. BJPsych International, 16(2), 40–42. https://doi.org/10.1192/bji.2018.4
World Health Organization. (2017). Mental health of older adults. Available at: https://www.who.int/news-room/fact-sheets/detail/mental-health-of-older-adults (Accessed: 25 May 2025)







