Depression, Geriatric

Depression, Geriatric is a topic covered in the 5-Minute Clinical Consult.

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Basics

Description

  • Depression is a primary mood disorder characterized by a depressed mood and/or a markedly decreased interest or pleasure in normally enjoyable activities most of the day, almost every day for at least 2 weeks, and causing significant distress or impairment in daily functioning with at least four other symptoms of depression.
  • Depression is not a normal result of aging.

Epidemiology

Prevalence rates among the elderly vary largely depending on the specific diagnostic instruments used and their current health and/or home environment:

  • 2–10% of community-dwelling elderly
  • 5–10% seen in primary care clinics
  • 10–37% of hospitalized elderly patients
  • 12–27% of nursing home residents

Etiology and Pathophysiology

  • Significant gaps exist in the understanding of the underlying pathophysiology.
  • Ongoing research has identified several possible mechanisms, including the following:
    • Monoamine transmission and associated transcriptional and translational activity
  • Epigenetic mechanisms and resilience factors
  • Neurotrophins, neurogenesis, neuroimmune systems, and neuroendocrine systems
  • Depression appears to be a complex interaction between heritable and environmental factors.

Risk Factors

  • General
    • Female sex
    • Lower socioeconomic status
    • Widowed, divorced, or separated marital status
    • Chronic physical health condition(s)
    • History of mental health problems
    • Family history of depression
    • Death of a loved one
    • Caregiving
    • Social isolation
    • Functional/cognitive impairment
    • Lack/loss of social support
    • Significant loss of independence
    • Uncontrolled or chronic pain
    • Insomnia/sleep disturbance
  • Prevalence of depression in medical illness
    • Stroke (22–50%)
    • Cancer (18–50%)
    • Myocardial infarction (15–45%)
    • Parkinson disease (10–39%)
    • Rheumatoid arthritis (13%)
    • Diabetes mellitus (5–11%)
    • Alzheimer dementia (5–15%)
  • Suicide
    • Suicide is the 11th leading cause of death in the United States for all ages.
    • Elderly account for 24% of all completed suicides.
    • Suicide rates are highest for males aged >85 years (rate 55/100,000).

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Citation

* When formatting your citation, note that all book, journal, and database titles should be italicized* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Depression, Geriatric ID - 116949 ED - Baldor,Robert A, ED - Domino,Frank J, ED - Golding,Jeremy, ED - Stephens,Mark B, BT - 5-Minute Clinical Consult, Updating UR - https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116949/all/Depression__Geriatric PB - Wolters Kluwer ET - 27 DB - Medicine Central DP - Unbound Medicine ER -