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Saturday, December 8, 2007

6 Considerations for Late-Life Depression

Elderly can become depressed. Depression is not a normal part of aging. Depression increases the risk of suicide, it is not self limiting, and can be treated. Also in the elderly.

There are some considerations when thinking of a depression in an elderly compared to adults:

  • Additional screening is recommended in case of cognitive impairment

  • Effective treatment of late life depression has been associated with improved quality of life, and reduced mortality

  • Several forms of psychotherapy are also effective for late life depression: cognitive therapy, interpersonal therapy, problem solving therapy.

  • When antidepressants are indicated, mono therapy is preferred, starting dose should be low compared to adults, up to 12 weeks of treatment may be needed to elicit a full response.

  • Antidepressant treatment should be continued for at least 6-12 months when effective

  • ECT is particularly indicated and efficacious with depression in elderly that is resistant to other treatments

Relevant links:
National Institute of Mental health: Older Adults and Depression

Geriatric Mental Health Foundation

IMPACT evidence-based depression care

Based on:
NEJM Volume 357:2269-2276 November 29, 2007 Number 22
Late-Life Depression
Jürgen Unützer, M.D., M.P.H.

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