Special populations
editElderly
editDepression is a common and serious disease which occurs at all ages, but is especially prevalent among those over 65 years of age and increases in frequency with age beyond that.[1] In addition the risk of depression increases in relation to the age and frailty of the individual. Depression is one the most important factors which negatively impact quality of life in adults as well as the elderly.[1] Both symptoms and treatment among the elderly different from those of the rest of the adult populations.[1]
As with many other diseases it is common among the elderly not to present classical depressive symptoms.[1] Diagnosis and treatment is further complicated in that the elderly are often simultaneously treated with a number of other drugs, and often have other concurrent diseases.[1] Treatment differs in that studies of SSRI-drugs have shown lesser and often inadequate effect among the elderly, while other drugs with more clear effects have adverse effects which can be especially difficult to handle among the elderly.[1] Duloxetin is an SNRI-drug with documented effect on recurring depression among the elderly, but has adverse effects in form of dizziness, dryness of the mouth, diarrhea, and constipation.[1]
Elderly with depression as very seldom offered any type of psychological treatment, and the evidence surround which treatments are effective is incomplete.[1] Problem solving therapy was as of 2015 the only therapy with proven effect, and can be likened to a simpler form of cognitive behavioral therapy.[1] Electroconvulsive therapy (ECT or electric-shock therapy) has been used as treatment of the elderly, and has been verified as effective in registry-studies, although it is slightly less effective among the elderly than among the rest of the adult population.[1]
The risks involved with treatment of depression among the elderly as opposed to benefits is today not entirely clear.[1] Awaiting more evidence on how depression-treatment among the elderly is best designed it is especially important to follow up treatment results among the elderly, and to reconsider changing treatments if it does not help.[1]
- ^ a b c d e f g h i j k l Services, Statens beredning för medicinsk och social utvärdering (SBU); Swedish Agency for Health Technology Assessment and Assessment of Social. "Depression treatment for the elderly". www.sbu.se. Retrieved 2016-06-16.
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