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Abstract
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BACKGROUND: Rates of depression increase with age, and it is estimated that almost 1 in 4 older people is depressed. However, the majority of such depressed elderly go un-recognized and un-treated due to various patient, clinician, and systemic factors.
Aim: We intend to review the epidemiology, assessment and diagnosis of depression to provide necessary information to help mental health clinicians to correctly identify and assess patients with late-life depression.
Method: Comprehensive literature search using online databases in the field of late-life depression.
Results: Risk factors for depression in the elderly include chronic medical illnesses, social isolation, being a carer, poor social support, bereavement, past history of depression, substance use, and cognitive impairment. Suicide is more common in the depressed elderly than in younger age groups and deserves particular attention during assessment. Syndromal depression often goes unrecognized as it can present in the elderly as somatization, hypochondriasis, and psychomotor retardation or agitation. Accurate and timely diagnosis is also complicated by the fact that late-life depression is often associated with cognitive impairment, physical disability, and anxiety. A diagnosis should only be arrived at after a comprehensive history taking, observation of the patient's behaviour, and corroborative history from a reliable informant.
Conclusions: Depression is common in older adults, and is a major public health issue. Very few depressed elderly consult their general practitioners for help, and consequently remain unrecognized and untreated. Timely screening and appropriate assessment can lead to effective treatment and resolution of symptoms and thereby can significantly reduce morbidity and mortality.
Language: en |