Along with the typical health issues that aging Americans face, more than 6.5 million people older than 65 are also dealing with the repercussions of depression, experts say.

“Sometimes, depression occurs for no one clear reason,” said Tina Krenn, a market practice specialist in WellMed’s Winter Park (Fla.) office. Krenn notes that contributing factors can include anything from hormones to drug or alcohol intake, a loss or other illness.

“It certainly isn’t a normal part of aging,” said Dr. George Niederehe of the National Institute of Mental Health. “Most older adults aren’t suffering from depression. So it’s a cause for concern when it does happen. It’s as common for other age groups, but not more so.”

“Depression is very tied to people’s overall health condition,” Niederehe said.

Ken Duckworth, a medical director at the National Alliance on Mental Illness, said that seniors dealing with depression for the first time might face more negative consequences than those who have dealt with it off and on throughout their lives.

“They never developed a core plan,” he said.

Such a management technique might include yoga, medicine or faith, Duckworth said.

He called such an approach a “portfolio of strength.” He named a full social life and a purpose as other key components.

“It’s all about lifestyle and the total wellness picture,” said Kim Lett, district healthy-living director. “This is just one component of that.”

The presence of depression might make the treatment of other medical conditions more complex, Niederehe said.

“One component is probably that people with depression are less adherent with treatment recommendations that they are given, don’t take medication regularly,” he said. “If they are told they need exercise, they may not do it and so forth, and there may be other factors involved.”

Once an older adult begins to struggle with depression, Niederehe said a hardship is attaining the right treatment.

“(There is a) stereotype that depression comes with old age,” he said.

Duckworth said depression might even look like dementia in some cases: pseudo dementia. Medications such a beta blocker can create symptoms of depression in some cases.

Niederehe cited a clinical trial of 18 medical practices in three cities, where, in follow-up studies, there was a lower mortality rate when a “depression-management specialist” was assigned to the practice to ensure that patients were getting the treatment they were prescribed.

WellMed uses a similar approach.

“(WellMed) doctors do more than just treat the illness,” Krenn said. “We create caring relationships with each senior patient. (They) receive more personalized attention and care.”