Psychogeriatrics

Many elderly manifest "functional" psychiatric symptoms that are not necessarily associated with a dementing process. The vast majority of these psychiatric syndromes are amenable to treatment if it is instituted early. Early treatment may prevent institutionalization. Of all age groups, the elderly have the highest suicide rate. The possibility of suicide must be evaluated and openly discussed. Drug abuse and alcoholism should also be considered. The elderly respond to much smaller doses of psychopharmacologic agents and are very sensitive to the side effects of these drugs. Polypharmacy, decreased compliance, and drug-drug interactions are common occurrences in the elderly. Not all psychiatric reactions of the elderly require pharmacologic intervention. Many respond to psychotherapy, which should be used more frequently than has been the practice in the past.