Mental Health in Older Adults: Signs of Depression You Might Miss
Published: April 27, 2026
By: Dr. Sue Paul, Sr. Dir. Well-being & Brain Health, Asbury Communities, Inc.
May is Mental Health Awareness Month, and for this month’s Ask Asbury conversation, I sat down with Dr. Karen Miller, a neuropsychologist, to talk about how mental health shows up in older adults and what we may be missing.
One of the biggest takeaways from our discussion is that depression in older adults does not always look the way people expect. We often associate depression with sadness or emotional distress. In aging adults, it is more likely to present as physical complaints, cognitive changes, apathy, or difficulty staying organized. These shifts are often misattributed to aging or medical conditions, which means depression can go unrecognized.
We also talked about the importance of looking beyond medication. Dr. Miller emphasized that non-pharmacological approaches such as therapy, social engagement, movement, mindfulness, learning, and meaningful activity are essential to supporting both mental and cognitive health.
Another key theme was the impact of loneliness and isolation. Isolation is not just a social concern. It is a significant risk factor for both depression and cognitive decline, with real consequences for overall brain health.
Here are a few key takeaways from our conversation:
- Depression in older adults often presents as physical symptoms, cognitive concerns, or disengagement rather than sadness
- Changes in energy, motivation, or organization should not be dismissed as normal aging
- Non-pharmacological strategies are essential and should be part of any mental health approach
- Social connection is protective and plays a direct role in brain health
- Loneliness and isolation increase the risk of both depression and cognitive decline
What stands out most is how interconnected all of this is. Mental health, brain health, and daily function are closely linked. When we support engagement, purpose, and connection, we are influencing much more than mood.
As we recognize Mental Health Awareness Month, this is an opportunity to look a little closer and think differently about how we identify and support mental health in older adults.