Abstract
Depression is very common in older people and it is associated with negative consequences such as functional decline, increased morbidity and mortality and higher healthcare costs. Despite this, it is still underdiagnosed and undertreated and the issue is particularly relevant for people older than 80 years. The main reasons for underdiagnosis are: atypical presentation, concomitant cognitive decline, inadequate diagnostic tools, and prejudice that depression is a normal part of ageing. On the other hand, the main reasons for undertreatment are: multimorbidity, concerns about adverse events and drug interactions, lack of confidence in the efficacy and safety of pharmacological and non-pharmacological treatments in the oldest old depressed patients, who are underrepresented in clinical studies. The new antidepressants are the drugs most frequently used, due to their perceived more favorable safety profile than older antidepressants. Psychotherapy is equally effective but less frequently used and should request some adaptive strategies for the peculiarities of octogenarians. Electroconvulsive therapy is limited to severe psychotic late-life depression resistant to other treatments. In light of the heterogeneity of people aged 80 years and over, with multiple and different medical, functional, socioeconomic problems, a multidimensional approach is probably the most suitable both for diagnosis and treatment, in order to develop an individualized care plan. These considerations should guide the formulation of future research studies, specifically tailored for the oldest depressed patients.
Keywords: Depression, oldest old, underdiagnosis, undertreatment, antidepressant drugs.
Current Pharmaceutical Design
Title:Diagnosing and Treating Depression in Older and Oldest Old
Volume: 21 Issue: 13
Author(s): V. Morichi, G. Dell`Aquila, F. Trotta, A. Belluigi, F. Lattanzio and A. Cherubini
Affiliation:
Keywords: Depression, oldest old, underdiagnosis, undertreatment, antidepressant drugs.
Abstract: Depression is very common in older people and it is associated with negative consequences such as functional decline, increased morbidity and mortality and higher healthcare costs. Despite this, it is still underdiagnosed and undertreated and the issue is particularly relevant for people older than 80 years. The main reasons for underdiagnosis are: atypical presentation, concomitant cognitive decline, inadequate diagnostic tools, and prejudice that depression is a normal part of ageing. On the other hand, the main reasons for undertreatment are: multimorbidity, concerns about adverse events and drug interactions, lack of confidence in the efficacy and safety of pharmacological and non-pharmacological treatments in the oldest old depressed patients, who are underrepresented in clinical studies. The new antidepressants are the drugs most frequently used, due to their perceived more favorable safety profile than older antidepressants. Psychotherapy is equally effective but less frequently used and should request some adaptive strategies for the peculiarities of octogenarians. Electroconvulsive therapy is limited to severe psychotic late-life depression resistant to other treatments. In light of the heterogeneity of people aged 80 years and over, with multiple and different medical, functional, socioeconomic problems, a multidimensional approach is probably the most suitable both for diagnosis and treatment, in order to develop an individualized care plan. These considerations should guide the formulation of future research studies, specifically tailored for the oldest depressed patients.
Export Options
About this article
Cite this article as:
Morichi V., Dell`Aquila G., Trotta F., Belluigi A., Lattanzio F. and Cherubini A., Diagnosing and Treating Depression in Older and Oldest Old, Current Pharmaceutical Design 2015; 21 (13) . https://dx.doi.org/10.2174/1381612821666150130124354
DOI https://dx.doi.org/10.2174/1381612821666150130124354 |
Print ISSN 1381-6128 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-4286 |
Call for Papers in Thematic Issues
"Tuberculosis Prevention, Diagnosis and Drug Discovery"
The Nobel Prize-winning discoveries of Mycobacterium tuberculosis and streptomycin have enabled an appropriate diagnosis and an effective treatment of tuberculosis (TB). Since then, many newer diagnosis methods and drugs have been saving millions of lives. Despite advances in the past, TB is still a leading cause of infectious disease mortality ...read more
Current Pharmaceutical challenges in the treatment and diagnosis of neurological dysfunctions
Neurological dysfunctions (MND, ALS, MS, PD, AD, HD, ALS, Autism, OCD etc..) present significant challenges in both diagnosis and treatment, often necessitating innovative approaches and therapeutic interventions. This thematic issue aims to explore the current pharmaceutical landscape surrounding neurological disorders, shedding light on the challenges faced by researchers, clinicians, and ...read more
Emerging and re-emerging diseases
Faced with a possible endemic situation of COVID-19, the world has experienced two important phenomena, the emergence of new infectious diseases and/or the resurgence of previously eradicated infectious diseases. Furthermore, the geographic distribution of such diseases has also undergone changes. This context, in turn, may have a strong relationship with ...read more
Melanoma and Non-Melanoma Skin Cancer Treatment: Standard of Care and Recent Advances
In this thematic issue, we aim to provide a standard of care of the diagnosis and treatment of melanoma and non-melanoma skin cancer. The editor will invite authors from different countries who will write review articles of melanoma and non-melanoma skin cancers. The Diagnosis, Staging, Surgical Treatment, Non-Surgical Treatment all ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
Carbon Monoxide and the Brain: Time to Rethink the Dogma
Current Pharmaceutical Design The Tumor Necrosis Factor-Derived TIP Peptide: A Potential Anti-Edema Drug
Letters in Drug Design & Discovery Ghrelin, A Novel Peptide Hormone in the Regulation of Energy Balance and Cardiovascular Function
Recent Patents on Endocrine, Metabolic & Immune Drug Discovery Recent Patents on Nucleic Acid-Based Antiviral Therapeutics
Recent Patents on Anti-Infective Drug Discovery Emerging Risk Factors for Cerebrovascular Disease
Current Drug Targets Long-Term Effects of Perinatal Glucocorticoid Treatment on the Heart
Current Pediatric Reviews The Use of Infliximab in Dermatology
Anti-Inflammatory & Anti-Allergy Agents in Medicinal Chemistry Intravenous Antihypertensives within Cardiovascular-Based Continuity of Care
Current Vascular Pharmacology Treatment of Inflammatory and Paraproteinemic Neuropathies
Current Drug Targets - Immune, Endocrine & Metabolic Disorders Pathogenesis and Management of Intradialytic Hypertension
Current Hypertension Reviews Recent Advances in Clinical Immunology, Endocrine & Metabolic Drugs: An Editorial Overview
Clinical Immunology, Endocrine & Metabolic Drugs (Discontinued) Effects of ACE-Inhibitors and Angiotensin Receptor Blockers on Inflammation
Current Pharmaceutical Design Psoriatic Arthritis and its Novel Therapeutics
Current Rheumatology Reviews Inotropic and Vasoactive Drugs in Pediatric ICU
Current Drug Targets Neuroprotection by Alpha 2-Adrenergic Agonists in Cerebral Ischemia
Current Neuropharmacology Adverse HBOC-Endothelial Dysfunction Synergism: A Possible Contributor to Adverse Clinical Outcomes?
Current Drug Discovery Technologies Anti-Inflammatory Effects of Intravenous Anesthetics on Endotoxemia
Mini-Reviews in Medicinal Chemistry The Effects of Drugs Used in Anaesthesia on Platelet Membrane Receptors and on Platelet Function
Medicinal Chemistry Reviews - Online (Discontinued) Levosimendan: A New Inodilatory Drug for the Treatment of Decompensated Heart Failure
Current Pharmaceutical Design Thrombolysis in Ischemic Stroke: Focus on New Treatment Strategies
Recent Patents on Cardiovascular Drug Discovery