Applicability of depression scales to the old old person

Depression is a major health problem in the elderly. The existing literature indicates that depression may be qualitatively different in this population. For example, a condition said to be prevalent among the elderly is masked depression which is marked by a cluster of vegetative symptoms without prominent dysphoria or guilt. Specific symptoms of depression reported most commonly in the elderly include loss of self-esteem, feelings of helplessness, and complaints of cognitive deficit. Based on this information, the contents of six currently used depression rating scales were compared. It was found that although these scales are responsive to standard DSM-III criteria for depression, for the most part they do not address the symptoms reported to be more common among depressed elderly. In addition, they had not been validated on the old old and therefore seem to have limited applicability as a sensitive screening tool for this rapidly growing segment of the population.