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General Medicine

Depression, Geriatric

Reviewed 06/2020
 


BASICS

DESCRIPTION

Depression is a primary mood disorder characterized by a depressed mood and/or a markedly decreased interest or pleasure in normally enjoyable activities most of the day, almost ever...

DIAGNOSIS

HISTORY

  • Depressed mood most of the day, nearly every day, and/or loss of interest/pleasure in life for at least 2 weeks

  • Other common symptoms include the following:

    • Feeling hopeless, helpless, ...

TREATMENT

Although response alone, usually interpreted as a 50% reduction in symptoms, can be clinically meaningful, the goal is to treat patients to the point of remission (i.e., essentially the abse...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Due to the delay of benefit following initiation of antidepressant therapy, it is necessary to ensure open communication with the patient to prevent premature dis...

REFERENCES

1
Blake H, Mo P, Malik S, et al. How effective are physical activity interventions for alleviating depressive symptoms in older people? A systematic review. Clin Rehabil.  2009;23(10):8...

ADDITIONAL READING

SEE ALSO

Algorithms: Depressed Mood Associated with Medical Illness; Depressive Episode, Major 

CODES

ICD10

  • F32.9 Major depressive disorder, single episode, unspecified

  • F03 Unspecified dementia

  • F43.21 Adjustment disorder with depressed mood

  • F34.1 Dysthymic disorder

  • Z60.0 Problems of adjustment to lif...

CLINICAL PEARLS

  • Depression is not a normal part of aging.

  • Depression in the elderly may be difficult to diagnose precisely due to medical and cognitive comorbidities.

  • Depression may present primarily wi...

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Antidepressant drugs and the biochemical life cycles of norepinephrine and serotonin. MAO inhibitors, tricyclics, and SSRIs are used as antidepressants. MAO inhibitors enhance the actions of NE and 5-HT by preventing their enzymatic destruction. Tricyclics enhance NE and 5-HT action by blocking uptake. SSRIs act the same way but are selective for serotonin.

 

Antidepressant drugs and the biochemical life cycles of norepinephrine and serotonin. MAO inhibitors, tricyclics, and SSRIs are used as ant...

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