Depression in the Elderly

Depression is a common problem among elderly patients in both primary care clinics and inpatient settings. As we all age, we would like to pursue our functions, like driving, without limitations, in order maintain quality in our life. But, unfortunately, aging is a significant risk for serious illness like cardiovascular events, namely heart attacks and strokes, cancer, and musculoskeletal and neurodegenerative diseases. When elderly patients suffer functional limitations, they tend to develop depression manifesting as lack of interest in hobbies, poor energy level, poor appetite, cognitive dysfunction, suicidal thoughts, loss of libido, and loneliness. Also, loss of spouse and financial burden, particularly medical bills, are significant risk factors for depression in seniors that are worth mentioning here.

Primary care physicians are the first to encounter such a situation. It is important to recognize and treat these situations in order to preserve some quality of life in these patient populations and better manage their medical comorbidities that may be the trigger for depression. I have seen several patients in the hospital settings who ended up with major depression after a prolonged hospitalization for a major illness or surgery that has left them with significant functional deficits. These patients have a hard time undergoing aggressive rehabilitation once discharged form the hospital. Medications, constant motivation, emotional support of family and friends, and an empathetic, mutidisciplinary medical team can make a significant difference in the management of these complicated patients.

Dr. Pillai, Kirkman Medical Center, Orlando, FL