Late-life depression and the family physician

Late-life depression (LLD) is a common disorder seen in clinical practice. Depression in this population group is often left undetected and untreated. The majority of elderly individuals who seek help present to the primary health care setting. The family physician is ideally placed to screen for symptoms of LLD, given that they often have longitudinal knowledge of the patient's history, premorbid personality, functioning and overall health status. An understanding of risk factors, differential diagnoses, appropriate opportunistic screening toolsand decision-making around management plans can assist the family physician in the early detection and treatment of these patients. In doing so, this may lead to a decrease in mortality and morbidity and enhance the patient's quality of life.Keywords: Late life; depression; older; geriatric mental health; major depressive disorder; antidepressants; cognitive impairment; dementia.

Vision-related quality of life assessment of patients attending a geriatric centre in south-west Nigeria

According to World Health Organization, health not only refers to the absence of physical diseases, but also includes psychological and social well-being of individuals.[1] Quality of life (QoL) on the other hand, lacks a single, universally accepted definition.[2] However, QoL may be defined subjectively as "an individual's perception of his/her life in the context of the culture and value system in which they live, and in relation to their goals, expectations, standards and concerns.[3] QoL also has an objective component which can be measured objectively using validated instruments (e.g. questionnaires) in which a score is assigned to specific indices or characteristics in different domains along a scale in a continuum.[4],[5],[6]Visual function is important for optimal orientation in functional and social life and has effects on physical, psychological, mental and emotional well-being of the individual.[7] Visual function therefore is a domain under which QoL may be assessed. This is referred to as vision-specific or vision-related QoL. The National Eye Institute Visual Function Questionnaire (NEI-VFQ) is an example of an instrument designed and validated for the objective assessment of vision-specific QoL.[8]Broman et al.[9] revealed that a visual acuity of at least 6/12 was found to negatively impact on n individual's quality of life. This was also reiterated by Bekibele et al.[10] The Proyecto VER study[9] observed that visual impairment was associated with a decrease in the quality of life among elderly patients, and that the severity of ocular diseases was related to the level of visual impairment. In relation to persons with no visual impairment, persons with bilateral mild and unilateral or bilateral moderate or severe visual impairment report greater difficulties in performing most vision-dependent daily activities, experience vision-related dependency and poorer vision-related mental health.[11]Ee Munn Chia et al.[12] further disclosed that the impact of visual impairment on mental domains was much greater compared to co-existing medical conditions like stroke.Therefore, data is needed on the effect of ocular diseases on vision-related quality of life among the elderly for the purpose of making recommendations for improved eye care with resultant improvement in their quality of life