Studies indicate that 50-70% of all primary care medical visits are related to psychological factors such as anxiety, depression, and stress. In rural and underserved areas, it may be that primary care medical services are the only health care available. Physical and mental health affect each other. For example, older adults with medical problems such as heart disease have higher rates of depression than those who are medically well. Conversely, untreated depression in an older person with heart disease negatively affects the outcome of the disease. Even mild depression lowers immunity and may compromise a person's ability to fight infections and cancers. 2
Depression has a powerful negative impact on ability to function, resulting in high rates of disability. The World Health Organization projects that by the year 2020, depression will remain a leading cause of disability, second only to cardiovascular disease. Recognition and treatment of mental health conditions in the medically ill may be especially difficult. As most older adults have one or more chronic medical conditions, psychologists' skills are particularly useful in diagnosis and treatment. Integration and coordination of care by geropsychologists with primary care professionals have been shown to decrease the frequency of older adults' primary care visits and use of medication.