Overview: Depression in the elderly

Depression in the elderly population is a major public health problem. It has a high prevalence, is frequently co-morbid with medical illnesses, impacts negatively on quality of life, increases the number of visits to different medical services, and carries a high risk of suicide, especially in men. Imaging studies have increased our understanding of the biological mechanisms of depression in the elderly. Depression is sometimes difficult to diagnose in the elderly. It should be differentiated from apathetic states ("negative syndrome"), and its treatment requires knowledge of specific physiological changes that occur in this age group. Geriatric depression is more somatic and less ideational than depression in other age groups. Acute treatments with various antidepressant medications, augmentation strategies, electroconvulsive treatments, and psychotherapy must be coupled with maintenance strategies to prevent recurrences, which are common.