DOI: https://doi.org/10.22141/2224-0713.3.105.2019.169918

The problem of diagnosis and treatment of depression in the elderly

L.N. Yuryeva, T.I. Shusterman

Abstract


The article discusses the problem of diagnosis and treatment of depression in the elderly. Depression is one of the most common disorders in general medical practice. By 2020, depressive disorders will rank second in the integrative assessment of the burden of disease in the world community. In the elderly, depression is the most common mental disorder. The prevalence of depression in the elderly averages 12.3 %, progressively increasing with deterioration in somatic status and disability. Older women suffer from depression twice as often, older men with depression have the highest risk of completed suicide. Depression complicates the rehabilitation process, worsens the results of treatment, the prognosis and course of somatic diseases, and is a risk factor for the development of dementia and suicidal behavior. Modification of the clinical picture of depression in the elderly depends on the age. For the express diagnosis of depression in the elderly, the Geriatric Depression Scale is used. The therapy of depressive disorders is based on pharmacotherapy, psychoeducational programs for patients and their relatives, as well as on psychotherapy and psychocorrection. When choosing antidepressants for the treatment of depressive disorders in elderly patients, doctors should take into account the principles of efficacy and safety. Antidepressants from the group of selective serotonin reuptake inhibitors have a proven safety and efficacy profile compared with other antidepressant groups. Escitalopram has high rates of effectiveness and frequency of remission, is optimal for preventing relapses, which makes it the drug of choice in the treatment of elderly patients with depression.

Keywords


diagnosis; therapy; depression; old age

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