Late-life depression: issues for the general practitioner

Abstract

Axel Van Damme,1 Tom Declercq,2 Lieve Lemey,3 Hannelore Tandt,4 Mirko Petrovic5 1Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium; 2Department of General Practice and Primary Health Care, Ghent University, Ghent, Belgium; 3Department of Psychiatry, AZ Sint-Jan Brugge-Oostende AV, Brugge, Belgium; 4Department of Psychiatry, Ghent University Hospital, Ghent, Belgium; 5Department of Internal Medicine, Section of Geriatrics, Ghent University, Ghent, Belgium Abstract: Late-life depression (LLD) is both a prevalent and life-threatening disorder, affecting up to 13.3% of the elderly population. LLD can be difficult to identify because patients mainly consult their general practitioner (GP) for somatic complaints. Moreover, patients may be hesitant to express the problem to their GP. Increased vigilance on the part of the GP can only benefit older people with depression. To recognize the risk of LLD, screening tools are provided in addition to treatment options for LLD. This review aims to provide the GP with guidance in recognizing and treating LLD. It tries to connect mainstream etiologies of LLD (e.g., vascular, inflammation, hypothalamo–pituitary–adrenal axis) with risk factors and current therapies. Therefore, we provide a basis to the GP for decision-making when choosing an appropriate therapy for LLD. Keywords: geriatric mental health, major depressive disorder, elder care, psychosomatic, geriatric psychiatry

Keywords

• late-life depression
• old age
• geriatric medicine