1 Answers
Late-life depression refers to a major depressive episode occurring for the first time in an older person. The term can also include depression that develops in an older person who had the illness earlier in life. Concurrent medical problems and lower functional expectations of elderly patients often obscure the degree of impairment. Typically, elderly patients with depression do not report depressed mood, but instead present with less specific symptoms such as insomnia, anorexia, and fatigue. Elderly persons sometimes dismiss less severe depression as an acceptable response to life stress or a normal part of aging.
Primary care is most often where diagnosis and treatment of late-life depression occurs, though is often missed or not treated even following a diagnosis. Diagnosis is made in the same way as other age groups, using DSM-5 criteria for major depressive disorder;however, diagnosis can be more difficult due to the unique challenges the elderly face. Common reasons for this difficulty include: medical illnesses and medication side effects that present similarly to depression, difficulty communicating with providers, lack of time in an appointment, and beliefs about mental illness and treatment from the patient, friends, family members, and society. Treatments for late-life depression include medicine and psychotherapy, along with lifestyle changes such as exercise, bright light therapy, and family support In patients who do not respond to initial treatments, neurostimulation techniques such as electroconvulsive therapy can be used. ECT has demonstrated effectiveness in treating the elderly.