Depression in the aged. An overview

Depression in the aged is common and associated with substantial medical and social morbidity and mortality. It is often missed or misdiagnosed because of masked or somatic symptoms, delusions, and pseudodementia. At any given time, about 2 per cent of the elderly have major depression and a third to a half of older psychiatric inpatients and outpatients have mood disorders. Aged depressives have more somatization, hypochondriasis, anxiety, retardation, and delusionality but less guilt, loss of libido, and family history of depression than young ones. Both the illnesses common in the elderly and the medicines used to treat them may be etiologically connected with depression. After precipitating causes are remedied, remaining symptoms respond to antidepressant treatment. Medication doses are much lower and side effects more troublesome. ECT or concomitant antipsychotic medication are more likely to be indicated.