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Mental Health.
Geriatric Depression
Although depressive symptoms are common among the elderly depression is not a normal part of aging and should be vigorously treated, Dr. Carl Salzman said at the annual meeting of the American Association for Geriatric Psychiatry.
Geriatric depression is directly related to degree of independence and failure of health. As people move from the community to the hospital to the nursing home, the incidence of depression goes up from 10% to 30% to 60%. Predictors of poor outcome include late age of onset, chronicity, comorbid medical illness, and presence of delusions. Geriatric depression is associated with an increase in pain, functional impairment, and mortality, said Dr. Salzman of Harvard University in Boston.
The diagnosis of depression in the elderly is exactly the same as that in younger adults. Compared with younger adults who present with depressed mood, however, older depressed patients are more likely to present with symptoms, such as somatic complaints, irritability, insomnia, fatigue, and anxiety.
There are some problems to consider when treating elderly depressed patients, such as increased CNS sensitivity to clinical effects and side effects of antidepressants, decreased metabolism and clearance of antidepressants, elevated levels of tricyclic hydroxy metabolites, increased ...
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