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Singapore’s elderly citizens may no longer be worrying about raising families and career advancement, but they have difficult battles of their own. It is no secret that they are often beset with illness and pain; however, there is more to their plight than what meets the eye. Along with old age come the challenges of isolation, loneliness and depression.

Singapore, one of the most rapidly aging countries in Asia, needs to place more importance to the predicament of its elderly citizens. The percentage of older adults (aged 60 years and above) in the population, which is currently at around 8 percent, is slated to grow to 19 percent by 2030. Concurrently, the number of elderly households in Singapore is increasing because of the pervasiveness of smaller families and the growing trend of more people choosing to stay single.

According to the Singapore Longitudinal Ageing Study in 2012 by the National University of Singapore’s Yong Loo Lin School of Medicine, one in five elderly persons in Singapore aged 75 and above show signs of depression.

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Depression in the elderly are often related to other health issues, such as senile dementia and limited mobility. Living in isolation, loneliness and anxiety about finances and no longer having the ability to work also trigger depressive mood swings.

Dr. Chris Tsoi, a consultant at the National University Hospital’s Department of Psychological Medicine, said that among the elderly who suffer from dementia, it is “very common” for depressive features to be present. “The other way round is also true,” he added.

“All the brain functions are somewhat linked … Emotion will affect memory; memory itself will affect emotion. So when the memory function isn’t that good or tends to remember sad things, [the elderly] tend to be sadder,” explained Dr. Tsoi.

Dr. Tsoi said that depression can also have a physical impact. “We have sufficient date to show that depression also could lead to heart disease and other physical problems, even stroke.”

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This series of studies also found that seniors living alone and feeling isolated were twice as likely as their peers to develop depressive symptoms as a result of loneliness.

The numbers of seniors living alone are going up, according to the Department of Statistics, which estimates that 83,000 elderly persons will be living alone by 2030 as compared to the 47,000 seniors aged 65 and above in 2016.

Depression in the elderly needs to be treated as low moods, anxiety, pain, loss of interest in activities, loss of appetite and sleep problems are among the warning signs of suicide.

Samaritans of Singapore (SOS), an organization dedicated to the prevention of suicide, shared these statistics – total suicide deaths in Singapore is at its lowest in recent years, but the number of those aged 60 and above who took their own lives in 2017 has gone up to 129, the highest ever recorded.

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The high predominance of suicide mortality among Singapore’s elderly is a worrying trend – elderly suicides in 2017 was an alarming 123 percent of that in 2011.

A spokesman for Fei Yue Community Services, a voluntary organization committed to the welfare of the vulnerable and disabled, said that most elderly people do not know who to call for help or how to do so.

“Those who are aged and sick have little or no family … and are socially isolated may be more susceptible [to suicide],” said the spokesman.

“Elder isolation is something we need to address in order to tackle elder suicide,” said Ms. Wang Jing, assistant director of Hua Mei Counselling and Coaching at Tsao Foundation.

“Interaction and emotional support are key,” said Ms. Wang Jing, to helping the elderly feel less isolated, less lonely, less depressed and therefore less suicidal.