La depresión del anciano vista por el geriatra / No disponible

La depresión es un problema de elevada prevalencia en los mayores; sin embargo, con frecuencia, la depresión geriátrica es infradiagnosticada e infratratada. Los estudios epidemiológicos indican que la fragilidad, un estado de elevada vulnerabilidad a los malos resultados de salud, es común en la edad avanzada. La evidencia reciente sugiere que la depresión comparte muchas características y con fragilidad y, por lo tanto, también puede desempeñar un papel importante en la determinación de vulnerabilidad a resultados adversos para la salud. La presentación clínica de la depresión en el anciano puede ser distinta a la del adulto joven, siendo menos común que en los adultos más jóvenes el estado de ánimo bajo, mientras que la irritabilidad, la ansiedad y los síntomas somáticos pueden ser más frecuentes, y con frecuencia se asocia a comorbilidad somática y/o deterioro cognitivo. El proceso diagnóstico de la depresión en el anciano debe comenzar por la diferenciación del origen del cuadro depresivo. Teniendo en cuenta estas particularidades, el tratamiento de la depresión en los ancianos puede ser tan eficaz como en el resto de la población, y por ello es fundamental su detección y correcto diagnóstico

Depression is a problem of high prevalence in the elderly; however, often, geriatric depression is underdiagnosed and under-treated. Epidemiological studies indicate that frailty, a state of high vulnerability to poor health outcomes, is common in old age. Recent evidence suggests that depression shares many characteristics and symptoms with fragility and, therefore, may also play an important role in determining vulnerability to adverse health outcomes. The clinical presentation of depression in the elderly may be different from that of the young adult, with less common lower mood than in younger adults, howewer irritability, anxiety and somatic symptoms may be more frequent, and It is often associated with somatic comorbidity and/o cognitive impairment. The diag-nostic process of depression in the elderly should begin by differentiating the origin of the depressive condition. Taking into account these particularities, the treatment of depression in the elderly can be as effective as in the rest of the population, and therefore its detection and correct diagnosis is essential

[Study protocol concerning the determining factors of physical and psychosocial destabilisation in the elderly]. / Protocolo de estudio sobre condicionantes de desestabilización física y psicosocial en los mayores.

OBJECTIVE: The main objective of this study is to define the factors associated with frailty and psychosocial imbalance in elderly people who live in the community. METHODS: Multicentre prospective study with a representative sample of subjects older than 75 years who live in the community in the province of Huesca (Spain). 5-year follow-up with biannual assessment. Standardised individual assessment carried out by GPs trained to assess depression, anxiety, cognitive impairment, psychotic symptoms, sarcopenia, social network, dependence for basic and instrumental activities of daily living, physical severity, risk of dependence and quality of life. Further assessment two and five years later to quantify adverse events: institutionalisation, functional impairment or mortality. Possible risk factors will be assessed: gender, age, social status, functional status, mental status and physical severity. Predictive and individual risk models will be designed in order to identify elderly people with high psychosocial frailty and destabilisation risk. CONCLUSIONS: An understanding of the possible risk factors would facilitate the identification of elderly subjects at greater risk of psychosocial frailty, thereby enabling preventive activities to be implemented aimed at reducing frailty and associated adverse events (institutionalisation, mortality, etc.).