The problem of diagnosis and treatment of depression in the elderly

L.N. Yuryeva, T.I. Shusterman


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.


diagnosis; therapy; depression; old age


Rodrigues A, Sousa-Uva M, Fonseca R, Marques S, Pina N, Matias-Dias C. Depression and unemployment incidence rate evolution in Portugal, 1995–2013: General Practitioner Sentinel Network data. Rev Saude Publica. 2017;51:98. doi: 10.11606/S1518-8787.2017051006675

Economou M, Madianos M, Evangelia Peppou L, Theleritis C, Patelakis A, Stefanis C. Suicidal ideation and reported suicide attempts in Greece during the economic crisis. World Psychiatry. 2013;12(1):53-59. doi: 10.1002/wps.20016

The world health report 2001 – Mental Health: New Understanding, New Hope.

Murray C, Lopez AD. The Global burden of disease: a comprehensive assessment of mortality and disability from diseases, injuries, and risk factors in 1990 and projected to 2020: summary. Geneva: World Health Organization, World Bank & Harvard School of Public Health; 1996. 41 p.

Beekman AT, Deeg DJ, van Tilburg T, Smit JH, Hooijer C, van Tilburg W. Major and minor depression in later life: a study of prevalence and risk factors. J Affect Disord. 1995;36(1-2):65-75. PMID: 8988267

Sachs-Ericsson N, Joiner T, Plant EA, Blazer DG. The influence of depression on cognitive decline in communitydwelling elderly persons. The American journal of geriatric psychiatry: official journal of the American Association for Geriatric Psychiatry. 2005;13(5):402-408.

Gagliardi JP. Differentiating among Depression, Delirium, and Dementia in Elderly Patients. Virtual Mentor. 2008;10(6):383-388. doi: 10.1001/virtualmentor.2008.10.6.cprl1-0806

Institute for health metrics and evaluation. Global burden of disease study. Available from:

Gebretsadik M, Jayaprabhu S, Grossberg GT. Mood Disorders in the Elderly. Medical Clinics of North America. 2006;90(5):789-805 doi: 10.1016/j.mcna.2006.05.015

Eghaneyan BH, Sanchez K, Mitschke DB. Implementation of a collaborative care model for the treatment of depression and anxiety in a community health center: results from a qualitative case study. J Multidiscip Healthc. 2014;7:503-13. doi: 10.2147/JMDH.S69821

Perceva TA, Yur’eva LN, Kujumchjan MS, Dukel’skij AA. Dіagnostika, terapіja ta reabіlіtacіja osіb, shho perenesli psihosocіal'nі stresi ta hvorih na depresії v medichnih ustanovah, shho nadajut’ pervinnu medichnu dopomogu [Diagnostics, therapy and rehabilitation of people who have undergone psychosocial stress and depression in primary care providers]. Dnipro: Kros-Print; 2018. 172 p. (in Ukrainian).

Unützer J. Late-Life Depression. N Engl J Med. 2007;357:2269-76. doi: 10.1056/NEJMcp073754

Sheikh JI, Yesavage JA. Geriatric Depression Scale (GDS): Recent evidence and development of a shorter version. Clin. Gerontol. 1986;5:165-172.

Sheikh JI, Yesavage JA, Brooks JO 3rd et al. Proposed factor structure of the Geriatric Depression Scale. Int Psychogeriatr. 1991;3(1):23-8. PubMed ID: 1863703

Rantakokko M, Pakkala I, Ayravainen I, Rantanen T. The effect of out-of-home activity intervention delivered by volunteers on depressive symptoms among older people with severe mobility limitations: a randomized controlled trial. Aging Ment Health. 2015;19(3):231-8. doi: 10.1080/13607863.2014.924092

Outcalt S, Kroenke K, Krebs E. et al. Chronic pain and comorbid mental health conditions: independent associations of posttraumatic stress disorder and depression with pain, disability, and quality of life. J. Behav. Med. 2015; 38(3):535-43. doi: 10.1007/s10865-015-9628-3

Vyas A, Sambamoorthi U. Multimorbidity and depression treatment. Gen. Hosp. Psychiatry. 2011;33(3):238-45. doi: 10.1016/j.genhosppsych.2011.02.009

Lagerin A, Carlsson AC, Nilsson G, Westman J, Törnkvist L. District nurses’ preventive home visits to 75-year-olds: an opportunity to identify factors related to unsafe medication management. Scand. J. Public Health. 2014;42(8):786-94. doi: 10.1177/1403494814550680

Barnett K, Mercer SW, Norbury M, Watt G, Wyke S, Guthrie B. Epidemiology of multimorbidity and implications for health care, research, and medical education: a crosssectional study. The Lancet. 2012;380(9836):37-43. doi: 10.1016/S0140-6736(12)60240-2

Steinman LE, Frederick JT, Prohaska T. et al. Recommendations for treating depression in community-based older adults. Am J Prev Med. 2007;33(3):175-81. doi: 10.1016/j.amepre.2007.04.034

Balwin R, Wild R. Management of depression in later life. Advances in Psychiatric Treatment. 2004;10(2):131-139. doi:

Miller M, Pate V, Swanson SA, Azrael D, White A, Stürmer T. Antidepressant class, age, and the risk of deliberate self-harm: a propensity score matched cohort study of SSRI and SNRI users in the USA. CNS Drugs. 2014;28(1):79-88. doi: 10.1007/s40263-013-0120-8


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.


© Publishing House Zaslavsky, 1997-2020


   Seo анализ сайта