Navigating Depression in Aging: Insights into Symptoms, Diagnosis, and Treatment-View Presentation

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Video Summary

Dr. Christina Denise, a geriatric psychiatrist, delves into the complexities of depressive disorders in older adults in her comprehensive presentation. She distinguishes major depressive disorder (MDD) from other depressive types, emphasizing its varied presentations influenced by factors like living environment, comorbidities, and socio-demographics. Notably, the prevalence of MDD is lower in community-dwelling older adults (1-5%) but rises sharply in hospitalized patients (up to 21%) and those in skilled nursing facilities (over 25%).<br /><br />Dr. Denise examines the intricate connection between depression and cognitive disorders, suggesting that depression can be both a risk factor and a prodrome for dementia, particularly Alzheimer's disease. She also highlights various biological, psychological, and social risk factors for late-life depression, including genetics, neurotransmitter dysfunction, personality traits like neuroticism, and significant life stressors.<br /><br />The discussion covers several treatment modalities for late-life depression. These include psychotherapy—such as cognitive behavioral therapy and problem-solving therapy—and pharmacological interventions like SSRIs, noting considerations specific to the older population. Dr. Denise also discusses the utility of neurostimulation techniques like ECT and TMS, particularly in treatment-resistant cases.<br /><br />Further, she emphasizes the importance of a thorough clinical work-up, including screening and collateral information, to tailor effective treatment plans. The Q&A session addresses various clinical concerns such as treatment strategies for apathy, medication-specific issues, and emerging therapies like ketamine for treatment-resistant depression, providing practical insights for practitioners. Overall, Dr. Denise’s talk offers an in-depth understanding of depressive disorders in older adults, underlining the significance of individualized approaches in diagnosis and treatment.

Keywords

geriatric psychiatry

depressive disorders

major depressive disorder

cognitive disorders

Alzheimer's disease

late-life depression

psychotherapy

pharmacological interventions

neurostimulation

treatment-resistant depression

individualized treatment