Geriatric Depression

6 important questions on Geriatric Depression

Why does Late Life depression carries worse prognosis than early onset?

increase relapse rate, increase medical comorbidities
alongside with cognitive impairment and mortality

What are the key differences between late onset depression and early onset depression?

Their chief complaint and presentation
Less commonly mood symptoms
Complaint of tiredness is common
More somatic symptoms and tend to be hospitazlied

Subsyndromal depressive symptoms in Older Adult

1. New Medical complaint
2. Exacerbation of GI symptom/arthritic pain
3. Preoccupation with health
4. Cardiovascular symptoms
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Relationship between Depression and Dementia

Depression in PRE-EXISTING Dementia
• Depression as a PRODROME of Dementia
• Depression is a RISK FACTOR for dementia •
Depression mimicking dementia/ Cognitive Impairment (PSEUDODEMENTIA) as a feature of depression

Organic cause of Depression in Older Adult

I-MOOD
Infection - post viral, neurosyphilis
Metabolic cause - hypothyroidism, Cushing's Disease
Occult Carcinoma - of the lungs/pancrease
Organic brain disease - SOL, Dementia
Drugs  - Steroids, Beta blockers, Methyldopa

Risk factor of suicide in Older Adult depression

Biological Factors
  • Male Gender:
  • Physical Illness & Chronic Pain:
  • Sensory Impairment:
  • Substance Misuse:
2. Psychological Factors
  • The "Depressive Triple Threat":
    1. Hopelessness:
  1. Helplessness:
    1. Worthlessness.
  • Personality Traits: A history of "neuroticism"
  • History of Prior Attempts

3. Social Factors
  • Social Isolation & Loneliness:
Retirement & Loss of Role:
  • Financial Insecurity: .
  • Access to Lethal Means:

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