ABSTRACT
Suicide rates among the elderly are the highest of any age group, perhaps as high as double the rate seen in the general population. White men over age 85 are at the greatest risk and are the target of a Healthy People 2000 objective. Aging and the changes it entails can often bring profound loss for older persons at a time when they are least able to handle it. Primary care physicians play a key role in recognizing depression among their elderly patients and in providing appropriate treatment. Therapies include antidepressants, ECT, and counseling. By identifying and treating depression, many suicides can be prevented.
Subject(s)
Suicide Prevention , Age Factors , Aged , Aged, 80 and over , Antidepressive Agents/therapeutic use , Counseling , Depressive Disorder/diagnosis , Depressive Disorder/epidemiology , Depressive Disorder/psychology , Electroconvulsive Therapy , Humans , Primary Health Care , Risk Factors , Suicide/statistics & numerical dataABSTRACT
Dizziness is a common and potentially disabling complaint among older patients. A major consequence of dizziness is falls, which can lead to death or significant functional disability. Dizziness can be separated into four broad categories: vertigo, disequilibrium, near-syncope, and nonspecific. Given its multitude of possible etiologies, dizziness often poses a diagnostic dilemma for the physician. Symptoms can result from a disturbance in any number of balance control systems, including the visual pathways, vestibular apparatus, cardiovascular system, and CNS. In evaluating dizziness, the physician should first obtain a careful medical history and perform a targeted physical examination. Depending upon the organ system involved, an audiologist, otolaryngologist, neurologist, cardiologist, and/or psychiatrist should then be consulted for further assessment and management.
