Depression, Geriatric
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Basics
Description
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
Epidemiology
Incidence- 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
Prevalence
- The Global Burden of Disease Study (2015) estimated the prevalence of depressive disorders among older adults (>60 years old) of 4–6% among males and 5–8% among females.
- Suicide is the 11th leading cause of death in the United States for all ages.
- The elderly account for 24% of all completed suicides with the highest rates for males aged >85 years.
Etiology and Pathophysiology
- A complex interaction between heritable and environmental factors
- Abnormalities in neurotrophins, neurogenesis, neuroimmune systems, and neuroendocrine systems
Genetics
Possible mechanisms, including genetic influences on
- Monoamine transmission and associated transcriptional and translational activity and dysregulation in biologic processes and proteostasis involving C-peptide, FABP-liver, and ApoA-IV proteins
Risk Factors
- 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
Commonly Associated Conditions
Chronic disease (e.g., stroke, cancer, Parkinson disease)
-- To view the remaining sections of this topic, please log in or purchase a subscription --
Basics
Description
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
Epidemiology
Incidence- 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
Prevalence
- The Global Burden of Disease Study (2015) estimated the prevalence of depressive disorders among older adults (>60 years old) of 4–6% among males and 5–8% among females.
- Suicide is the 11th leading cause of death in the United States for all ages.
- The elderly account for 24% of all completed suicides with the highest rates for males aged >85 years.
Etiology and Pathophysiology
- A complex interaction between heritable and environmental factors
- Abnormalities in neurotrophins, neurogenesis, neuroimmune systems, and neuroendocrine systems
Genetics
Possible mechanisms, including genetic influences on
- Monoamine transmission and associated transcriptional and translational activity and dysregulation in biologic processes and proteostasis involving C-peptide, FABP-liver, and ApoA-IV proteins
Risk Factors
- 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
Commonly Associated Conditions
Chronic disease (e.g., stroke, cancer, Parkinson disease)
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