Depressive disorders in old age: an overview

Severe depression is one of the most prevalent health problems of the elderly. Approximately 10% to 20% of the elderly population is affected. Unfortunately, major depression frequently presents in atypical forms among the elderly. Frequent presentations include masked depression, where multiple somatic complaints are prominent; pseudodementia, in which the depressed elderly person presents as a primary dementia; and delusional depression, in which paranoid delusions are prominent. Diagnosis is complicated by a multiplicity of other physical problems and polypharmacy for medical disorders. If adequately diagnosed, major depression can generally be treated successfully with antidepressants. Caution must be exercised in the use of antidepressants, as their sideeffects are in general more noxious in the elderly.