Depressive disorders in old age.

ABSTRACT

People are living longer life since with the improvement in health and medical services provided. Developing countries are not lagging behind the developed world as far as the life expectancy is concerned. The principal mental disorders of elderly people are mood disorders and dementia. In older people living in a community the rates of depressive disorders are likely to be the same as for all age groups of the general population, yet its prevalence in old age institution is high. Aetiology of depression in old age is caused by a variety of conditions namely genetic factors, physiological changes in all the systems, disability, loss of resources, some medical illness, etc. Clinical features include depressed mood most of the day, significant weight loss, persistent sleeplessness, fatigue, feelings of worthlessness, recurrent thoughts of death and suicidal attempt, etc. Tricyclic antidepressants are effective in elderly depressives. Selective serotonin re-uptake inhibitors are well tolerated by elderly patients and are effective too. Electroconvulsive therapy is an alternative treatment of acute depression. Psychotherapy is often helpful and long-term care should be planned for to reduce disability.