This document provides an overview of geriatric depression, including prevalence rates, risk factors, cultural considerations, symptoms, differential diagnosis, and assessment tools. Some key points:
- Depression affects 15-13% of older adults, with higher rates among nursing home residents (54.4%). Risk factors include disability, cognitive impairment, poor health, bereavement and loneliness.
- Cultural factors like race, ethnicity and gender impact presentation and treatment. Assessment considers atypical symptoms like somatic complaints and involves screening tools like the PHQ-9 or GDS.
- Differential diagnosis distinguishes depression from conditions like dementia, delirium, medical illness and medication side effects. Multiple assessment instruments are highlighted for their validity
Depression is more than just feeling sad or blue. It is a common but serious mood disorder that needs treatment. It causes severe symptoms that affect how you feel, think, and handle daily activities, such as sleeping, eating, and working.
Douglas Ziedonis M.D. -
Member, RiverMend Health Scientific Advisory Board for Addiction & Psychiatry
Department of Psychiatry, University of Massachusetts Medical School & UMass Memorial Health Care
Dr. Ziedonis addresses the RiverMend Health Scientific Advisory Board on co-occurring addictions and processes to help treat them.
To watch lecture visit :http://vimeo.com/100314352
For more information visit: http://www.rivermendhealth.com/scientific-advisory-board-addiction.html
Depression is more than just feeling sad or blue. It is a common but serious mood disorder that needs treatment. It causes severe symptoms that affect how you feel, think, and handle daily activities, such as sleeping, eating, and working.
Douglas Ziedonis M.D. -
Member, RiverMend Health Scientific Advisory Board for Addiction & Psychiatry
Department of Psychiatry, University of Massachusetts Medical School & UMass Memorial Health Care
Dr. Ziedonis addresses the RiverMend Health Scientific Advisory Board on co-occurring addictions and processes to help treat them.
To watch lecture visit :http://vimeo.com/100314352
For more information visit: http://www.rivermendhealth.com/scientific-advisory-board-addiction.html
ARE YOU NEURO-PROTECTED?
CLINICAL DEPRESSION is the MOST under treated and under diagnosed medical disorder of modern times.
Its responsible for upto 40-60% decrease in sense of fullfillment, productivity and happiness.
It affects 1 in ever 5 persons in the world.
Mental disorders can affect women and men differently. Some disorders are more common in women, such as depression, anxiety, and eating disorders. There are also certain disorders that are unique to women. For example, some women experience symptoms of depression at times of hormone change, such as during or after pregnancy (perinatal depression), around the time of their period (premenstrual dysphoric disorder), and during menopause (perimenopause-related depression).
When it comes to other mental disorders, such as schizophrenia and bipolar disorder, research has not found sex differences in the rates at which they are diagnosed. But certain symptoms may be more common in women than men, and the course of illness can be affected by a person’s sex. Researchers are only now beginning to tease apart the various biological and psychosocial factors that may impact mental health.What are symptoms of mental disorders in women?
Women and men can develop most of the same mental disorders and conditions, but they may experience different symptoms. Some common symptoms include:
Persistent sadness or feelings of hopelessness
Misuse of alcohol, drugs, or both
Dramatic changes in eating or sleeping habits
Appetite and/or weight changes
Decreased energy or fatigue
Excessive fear or worry
Seeing or hearing things that are not there
Extremely high and low moods
Aches, headaches, or digestive problems without a clear cause
Irritability
Social withdrawal
Thoughts of death or suicide or suicide attemptsWhat are symptoms of mental disorders in women?
Women and men can develop most of the same mental disorders and conditions, but they may experience different symptoms. Some common symptoms include:
Persistent sadness or feelings of hopelessness
Misuse of alcohol, drugs, or both
Dramatic changes in eating or sleeping habits
Appetite and/or weight changes
Decreased energy or fatigue
Excessive fear or worry
Seeing or hearing things that are not there
Extremely high and low moods
Aches, headaches, or digestive problems without a clear cause
Irritability
Social withdrawal
Thoughts of death or suicide or suicide attemptsWhat are symptoms of mental disorders in women?
Women and men can develop most of the same mental disorders and conditions, but they may experience different symptoms. Some common symptoms include:
Persistent sadness or feelings of hopelessness
Misuse of alcohol, drugs, or both
Dramatic changes in eating or sleeping habits
Appetite and/or weight changes
Decreased energy or fatigue
Excessive fear or worry
Seeing or hearing things that are not there
Extremely high and low moods
Aches, headaches, or digestive problems without a clear cause
Irritability
Social withdrawal
Thoughts of death or suicide or suicide attemptsWhat are symptoms of mental disorders in women?
Women and men can develop most of the same mental disorders and conditions, but they may experience different symptoms. Some common symptoms include:
Persistent sadness or feelings of hopelessn
Mental health issues such as depression and anxiety are NOT a normal part of aging and are hard to discuss, diagnose and treat. The good news is that there are innovative programs, tools and resources that can help.
ARE YOU NEURO-PROTECTED?
CLINICAL DEPRESSION is the MOST under treated and under diagnosed medical disorder of modern times.
Its responsible for upto 40-60% decrease in sense of fullfillment, productivity and happiness.
It affects 1 in ever 5 persons in the world.
Mental disorders can affect women and men differently. Some disorders are more common in women, such as depression, anxiety, and eating disorders. There are also certain disorders that are unique to women. For example, some women experience symptoms of depression at times of hormone change, such as during or after pregnancy (perinatal depression), around the time of their period (premenstrual dysphoric disorder), and during menopause (perimenopause-related depression).
When it comes to other mental disorders, such as schizophrenia and bipolar disorder, research has not found sex differences in the rates at which they are diagnosed. But certain symptoms may be more common in women than men, and the course of illness can be affected by a person’s sex. Researchers are only now beginning to tease apart the various biological and psychosocial factors that may impact mental health.What are symptoms of mental disorders in women?
Women and men can develop most of the same mental disorders and conditions, but they may experience different symptoms. Some common symptoms include:
Persistent sadness or feelings of hopelessness
Misuse of alcohol, drugs, or both
Dramatic changes in eating or sleeping habits
Appetite and/or weight changes
Decreased energy or fatigue
Excessive fear or worry
Seeing or hearing things that are not there
Extremely high and low moods
Aches, headaches, or digestive problems without a clear cause
Irritability
Social withdrawal
Thoughts of death or suicide or suicide attemptsWhat are symptoms of mental disorders in women?
Women and men can develop most of the same mental disorders and conditions, but they may experience different symptoms. Some common symptoms include:
Persistent sadness or feelings of hopelessness
Misuse of alcohol, drugs, or both
Dramatic changes in eating or sleeping habits
Appetite and/or weight changes
Decreased energy or fatigue
Excessive fear or worry
Seeing or hearing things that are not there
Extremely high and low moods
Aches, headaches, or digestive problems without a clear cause
Irritability
Social withdrawal
Thoughts of death or suicide or suicide attemptsWhat are symptoms of mental disorders in women?
Women and men can develop most of the same mental disorders and conditions, but they may experience different symptoms. Some common symptoms include:
Persistent sadness or feelings of hopelessness
Misuse of alcohol, drugs, or both
Dramatic changes in eating or sleeping habits
Appetite and/or weight changes
Decreased energy or fatigue
Excessive fear or worry
Seeing or hearing things that are not there
Extremely high and low moods
Aches, headaches, or digestive problems without a clear cause
Irritability
Social withdrawal
Thoughts of death or suicide or suicide attemptsWhat are symptoms of mental disorders in women?
Women and men can develop most of the same mental disorders and conditions, but they may experience different symptoms. Some common symptoms include:
Persistent sadness or feelings of hopelessn
Mental health issues such as depression and anxiety are NOT a normal part of aging and are hard to discuss, diagnose and treat. The good news is that there are innovative programs, tools and resources that can help.
Quick review of the essential points— DSM5 diagnosis criteria, assessments, treatments—of these disorders to better prepare for the National Clinical Mental Health Counseling Exam. This was informed by several exam prep programs, and can be used like flashcards or as a presentation.
This presentation is about geriatric Psychiatry awareness. it contains basic information about what is geriatric psychiatry, which are the main psychiatry disorder found in elderly and how to manage them?. it contains some detailed information about late life depression, delirium and dementia in geriatric population.
The cornerstone of someone's mental health is how they think, feel, and behave. Mental health specialists can help people with disorders like addiction, bipolar disorder, depression, and anxiety.
Mental health can have an effect on daily life, interpersonal connections, and physical health.
This connection, nevertheless, also functions the opposite way around. Personal circumstances, social ties, and physical ailments can all have an impact on mental illness. Maintaining
Similar to ARGEC Module: Assessment of Geriatric Depression Final (20)
The French Revolution, which began in 1789, was a period of radical social and political upheaval in France. It marked the decline of absolute monarchies, the rise of secular and democratic republics, and the eventual rise of Napoleon Bonaparte. This revolutionary period is crucial in understanding the transition from feudalism to modernity in Europe.
For more information, visit-www.vavaclasses.com
Safalta Digital marketing institute in Noida, provide complete applications that encompass a huge range of virtual advertising and marketing additives, which includes search engine optimization, virtual communication advertising, pay-per-click on marketing, content material advertising, internet analytics, and greater. These university courses are designed for students who possess a comprehensive understanding of virtual marketing strategies and attributes.Safalta Digital Marketing Institute in Noida is a first choice for young individuals or students who are looking to start their careers in the field of digital advertising. The institute gives specialized courses designed and certification.
for beginners, providing thorough training in areas such as SEO, digital communication marketing, and PPC training in Noida. After finishing the program, students receive the certifications recognised by top different universitie, setting a strong foundation for a successful career in digital marketing.
Acetabularia Information For Class 9 .docxvaibhavrinwa19
Acetabularia acetabulum is a single-celled green alga that in its vegetative state is morphologically differentiated into a basal rhizoid and an axially elongated stalk, which bears whorls of branching hairs. The single diploid nucleus resides in the rhizoid.
Read| The latest issue of The Challenger is here! We are thrilled to announce that our school paper has qualified for the NATIONAL SCHOOLS PRESS CONFERENCE (NSPC) 2024. Thank you for your unwavering support and trust. Dive into the stories that made us stand out!
Model Attribute Check Company Auto PropertyCeline George
In Odoo, the multi-company feature allows you to manage multiple companies within a single Odoo database instance. Each company can have its own configurations while still sharing common resources such as products, customers, and suppliers.
A Strategic Approach: GenAI in EducationPeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
Operation “Blue Star” is the only event in the history of Independent India where the state went into war with its own people. Even after about 40 years it is not clear if it was culmination of states anger over people of the region, a political game of power or start of dictatorial chapter in the democratic setup.
The people of Punjab felt alienated from main stream due to denial of their just demands during a long democratic struggle since independence. As it happen all over the word, it led to militant struggle with great loss of lives of military, police and civilian personnel. Killing of Indira Gandhi and massacre of innocent Sikhs in Delhi and other India cities was also associated with this movement.
Macroeconomics- Movie Location
This will be used as part of your Personal Professional Portfolio once graded.
Objective:
Prepare a presentation or a paper using research, basic comparative analysis, data organization and application of economic information. You will make an informed assessment of an economic climate outside of the United States to accomplish an entertainment industry objective.
2. Objectives
Provide prevalence rates for geriatric depression
across diverse populations
Identify risk factors for depression for older adults
Discuss cultural considerations
Present a summary of symptomotology
Contrast differential diagnosis with dementia and
delirium
Highlight common assessment instruments
3. Importance of Diagnosis
Depression affects 15 out of every 100 adults over age 65
(Geriatric Mental Health Foundation, 2011).
Rates of depression in the community range from 1-13%.
Major depressive disorders (MDD) - 1.8%.
All depressive syndromes considered clinically relevant -13.5%.
Depression among residents of long-term care (LTC) during the first year - 54.4%.
Negative outcomes of depression include
cognitive decline, mortality, suicide, and
hospitalization.
Suicide rates are highest among the elderly.
4. Risk Factors for Depression
Disability
Cognitive impairment/decline
New medical illness
Poor health status
Prior depression
Loneliness & isolation
Low socioeconomic status
Poor self-perceived health
Sleep disturbance
Recent bereavement
Institutional placement
5. Depression in Sub Populations
Race/ethnicity
Compared to non-Hispanic
Whites, minorities have a higher
prevalence of depression.
African American older adults are
more likely to internalize stigma
and less likely to seek treatment
(Conner et al., 2010).
Gender
Women have twice the rate of
depression than men.
Men are 3-5 times as likely as
women to die from suicide, and
depression is the most common
associated condition
(Grigoradis & Robinson, 2007).
White men over age 85 have the
highest rates of suicide of any
group.
6.
7. A Discussion About Cultural
Considerations
This podcast features Dr. Ugochi Ohuabunwa, Assistant
Professor of Medicine Emory University and Medical
Director of the Grady Memorial Hospital Geriatric Center
in Atlanta, Georgia.
Dr. Ohuabunwa will talk about her experience assessing
and diagnosing depression in minority older adults.
She will highlight the cultural issues that are part of
assessing older adults from diverse cultural groups and
things that healthcare providers should consider when
assessing this population.
Click on or copy and paste the weblink below to listen to
the podcast:
https://gsu.sharestream.net/ssdcms/i.do?u=a1a2f63ba0144f3
Dr. Ugochi Ohuabunwa
8.
9. Depression: “SIG-E-CAPS”:
S leep Disturbance (insomnia or hypersomnia)
I nterest (anhedonia or loss of interest in usually pleasurable
activities)
G uilt and/or low self-esteem
E nergy (loss of energy, low energy, or fatigue)
C oncentration (poor concentration, forgetful)
A ppetite changes (loss of appetite or increased appetite)
P sychomotor changes (agitation or slowing/retardation)
S uicide (morbid or suicidal ideation)
10. Atypical Presentation of Depressed Older Adults
Deny sadness or depressed mood
May exhibit other symptoms of depression
Unexplained somatic complaints
Hopelessness
Helplessness
Anxiety and worries
Memory complaints (may or may not have objective signs of cognitive
impairment)
Anhedonia
Slowed movement
Irritability
General lack of interest in personal care
(Gallo and Rabins, 1999)
11. Compared to Younger Adults,
Older Adults:
Are more likely to report somatic symptoms than depressed mood.
Are more likely to experience sleep disturbance, fatigue, psychomotor
retardation, loss of interest in living, and hopelessness about the future
(Christensen et al., 1999).
Are less likely to endorse cognitive-affective symptoms of depression,
including dysphoria and worthlessness/guilt (Gallo et al., 1994).
Are more likely to have subjective complaints of poor memory and
concentration (Fiske et al., 2009).
12.
13. Assessment and Diagnosis of Depression
Eve Byrd is a Family Nurse
Practitioner, Psychiatric Clinical Nurse
Specialist, and Executive Director of
the Fuqua Center for Late Life
Depression, located in Atlanta, GA.
Click on or copy and paste the weblink below to view a
lecture on assessment and diagnosis of depression in
older adults:
http://www.youtube.com/watch?v=NadEQBnVTZ4
14. Case Study 1
Ms. G is a 75-year old female living alone in her apartment
in New York City. Her husband died suddenly two years ago of
a heart attack. Their two children are alive and living out-of-
state. Both of her sons maintain weekly phone contact with
Ms. G and visit usually once a year. Ms. G has been doing well
until about 6 weeks ago when she fell in her apartment and
sustained bruises but, did not require a hospital visit. Since
then, she has been preoccupied with her failing eyesight and
decreased ambulation. She does not go shopping as often,
stating she doesn’t enjoy going out anymore and feels “very sad
and teary.” Ms. G states that her shopping needs are less, since
she is not as hungry as she used to be and she states, “I’m
getting too old to cook for one person only”.
15. Case Study 1: Questions
What risk factors might account for Ms. G’s
Depression?
What are Ms. G’s depressive symptoms?
16. Types of Depression
Endogenous depression (biological) – chronic or lifelong state of
depression for which there is no apparent precipitating cause, genetic link
Exogenous depression (reactive) – short-term depression caused by
loss or extreme trauma
Most common form of depression in older adults
Diagnosed as an adjustment disorder with depressed mood
Mild to moderate case that occurs after a significant loss or in response
to serious life adjustment.
19. Video and Case Study 2
Video - Dementia, delirium and depression are the three
most prevalent mental disorders in the elderly. Click on or
copy and paste the following weblink to view a 45-minute
video exploring the work up and management of elderly
persons presenting with these mental disorders by Dr.
James Bourgeois, professor of Clinical Psychiatry at UC
Davis.
http://www.youtube.com/watch?v=lNs9d9cpQos
Case Study – Click on or copy and paste the weblink
below to a review and case study of Depression,
Delirium, and Dementia in older adults.
https://mcnmedia.illinoisstate.edu/flash/hartford/activity10.html
20. Assessment Instruments at a Glance
TOOL
ORIGINALLY
DESIGNED
FOR
# ITEMS
TIME TO
COMPLETE
METHOD OF
ADMIN.
RESPONSE
SENSITIVITY/
SPECIFICITY*
GERIATRIC
DEPRESSION
SCALE
Geriatric
patients
30
10-15
minutes
Self-
Administered
Yes/No 92%/95%
BECK
DEPRESSION
INVENTORY
Patients with
previously
diagnosed
depression
21 5-10 minutes
Self-
Administered
0-3 Ranked
Responses
100%/96%
HAMILTON
DEPRESSION
SCALE
All populations 21
15-20
minutes
Professionally
administered
interview
0-2 or 0-4
Ranked
Responses
Not Available
CES-D
Adult
community
members
20 5-10 minutes
Self
4 point Likert
4 point
Likert Scale
82%/94%
PHQ-9
All populations
effective for
Geriatrics
9 5 minutes
Self-
Administered
4 point
Likert Scale 88%/88%
21. Geriatric Depression Scale (GDS)
Designed specifically for persons age 65 and older.
Unlike other instruments, there is no somatic component to the GDS,
because many physical manifestations of depression can easily be
associated with other simultaneous illnesses in older adults.
Not suitable for assessing depression in individuals with cognitive disorders
and cannot be used to assess the effects of pharmacological therapy.
Sample Questions
Are you in good spirits most of the time? YES/NO
Do you feel full of energy? YES/NO
Have you dropped many of your activities and interests? YES/NO
(Olin et al., 1992;Yesavage et al., 1983)
22. Beck Depression Inventory (BDI)
Initially designed to measure the severity of previously diagnosed depression, but has
since been validated for use in the geriatric population.
Uses ranked responses ranging from 0-3 to allow the BDI to assess variations in the
severity of depression over time.
Some studies show higher non-response rates associated with the BDI for the geriatric
population, particularly concerning questions related to “sexual interest”.
Sample Questions
Sadness
0 I do not feel sad.
1 I feel sad.
2 I am sad all the time and I can’t snap out of it.
3 I am so sad or unhappy that I can’t stand it.
Loss of Energy
0 I have as much energy as ever.
1 I have less energy in the past two weeks.
2 I don’t have enough energy to do very much.
3 I don’t have enough energy to do anything.
(Jefferson et al., 2000; Olin et al., 1992)
23. Hamilton Depression Scale (HAM-D)
Created with emphasis on the psychological aspects of depression across a variety of
populations.
For proper results a professional is required to perform a “semi-structured” interview
and then answer and evaluate the resulting score provided by the tool.
Not validated for the geriatric population, but considered useful in populations with
cognitive defects.
Several questions relate to somatic symptoms.
Sample Question
Suicide
0 = absent
1 = feels life is not worth living
2= wishes he were dead or any thoughts of possible death to self
3 = suicidal ideas or gesture
4 = attempts at suicide
(Hedlung & Vieweg, 1979)
24. Center for Epidemiologic Studies Depression Scale
(CES-D)
Designed to screen adult community members for research purposes, but
also validated as an assessment tool for use in other populations, including
the elderly.
Responses are based on frequency of occurrence, which enables the CES-D
to follow changes in depression over time.
Considered useful for elderly across different racial, ethnic, and economic
backgrounds because of its exceptional psychometric properties.
Sample Questions
I felt hopeful about the future:
Rarely or none of the time (<1 day)
Some or a little of the time (1-2 days)
Occasionally or a moderate amount of the time (3-4
days)
Most or all of the time (5 -7 days)
(Ross et al., 2011)
I was bothered by things that don’t usually bother me:
Rarely or none of the time (<1 day)
Some or a little of the time (1-2 days)
Occasionally or a moderate amount of the time (3-4
days)
Most or all of the time (5-7 days)
25. PHQ-9
Can track severity of depression as well as the specific symptoms
that are improving or not with treatment.
Has proven effective in a geriatric population (Li et al, 2007)
Nine items are based directly on the nine diagnostic criteria for
major depressive disorder in the DSM-IV.
Sample Questions
Over the last 2 weeks, how often have you been bothered by any of the following problems?
Response (not at all, several days, more than half the days, nearly every day)
Little interest or pleasure in doing things
Feeling down, depressed or hopeless
Thoughts that you would be better off dead, or of hurting yourself in some way
(Li et al., 2007)
26. IMPACT
IMPACT is an evidence based depression program
specifically designed for older adults.
The IMPACT website (http://impact-uw.org/) provides a
source of information and materials designed to help
clinicians and organizations implement IMPACT in a
variety of settings.
Click on or copy and paste the weblink below and go to
Tools- PHQ-9. Scroll down the page to view a video
showing an administration of the PHQ-9.
http://impact-uw.org/tools/phq9.html
27. Fuqua Center for Late-Life Depression
10th Anniversary Video
The Fuqua Center for Late-Life Depression is a non-
profit organization whose mission is to improve the
community’s understanding and recognition of mental
illnesses in older adults and improving access to
geriatric psychiatric services.
Click on or copy and paste the weblink below to view a
collection of patients and community partners speaking about
the Fuqua Center's contributions to the mental health of older
adults.
http://www.youtube.com/watch?v=uPMeAOBtfpw
28. References
Cole, M., & Dendukuri, N. (2003). Risk factors for depression among elderly community subjects: A
systematic review and meta-analysis. American Journal of Psychiatry.160(6), 1147-1156.
Christensen, H., Jorm A. F., Mackinnon, A. J., Korten, A. E., Jacomb, P. A., & Rodgers, B. (1999).
Age differences in depression and anxiety symptoms: A structural equation modelling analysis of data
from a general population sample. Psychological Medicine, 29(2), 325–339.
Conner, K. O., Copeland, V. C., Grote, N. K., Rosen, D., Albert, S., McMurray, M. L.,…Koeske, G.
(2010). Barriers to treatment and culturally endorsed coping strategies among depressed African-
American older adults. Aging & Mental Health, 14(8), 971-983. doi: 10.1080/13607863.2010.501061
Fiske, A., Wetherell, J. L., & Gatz, M. (2010). Depression in older adults. Annual Review of Clinical
Psychology, 5, 363-389. doi: 10.1146/annurev.clinpsy.032408.153621
Gallo, J., & Rabins, P. (1999). Depression without sadness: Alternative presentations of depression in
late life. American Family Physician, 60(3), 820-826.
Gallo, J. J., Anthony, J. C., & Muthén, B. O. (1994). Age differences in the symptoms of depression:
A latent trait analysis. Journal of Gerontology, 49(6), P251–P264 .
Geriatric Mental Health Foundation. (2011). Late life depression: A fact sheet. Retrieved from
http://www.gmhfonline.org/gmhf/consumer/factsheets/depression_factsheet.html
Grigoriadis, S., & Robinson, G. (2007). Gender issues in depression. Annals of Clinical Psychiatry:
Official Journal Of The American Academy Of Clinical Psychiatrists, 19(4), 247-255.
29. References con’t
Hedlung, J. L., & Vieweg, B.W. (1979). The Hamilton Rating Scale for Depression. Journal of Operational
Psychiatry. 10, 149-165.
Jefferson, A. L., Powers, D. V. P., & Pope, M. (2000). Beck Depression Inventory-II (BDI-II) and the Geriatric
Depression Scale (GDS) in older women. Clinical Gerontologist, 22(3/4), 3-12.
Kurlowicz, L., & Greenberg, S. (2007). The Geriatric Depression Scale (GDS). Try This: Best Practices in Nursing
Care to Older Adults, 4.
Li, M. M., Friedman, B., Conwell, Y., & Fiscella, K. (2007). Validity of the Patient Health Questionnaire 2 (PGQ-
2) in identifying major depression in older people. Journal of the American Geriatric Society, 55(4), 596-602.
Olin, J. T., Schneider, L. S., Eaton, E. M., Zemansky, M. F., & Pollock, V. E. (1992). The Geriatric Depression
Scale and the Beck Depression Inventory as screening instruments in an older adult outpatient population.
Psychological Assessment, 4(2), 190-192.
Roman, M. W., & Callen, B. L. (2008). Screening instruments for older adult depressive disorders: Updating the
evidence-based toolbox. Issues in Mental Health Nursing 29(9), 924-941. doi: 10.1080/01612840802274578
Ros, L., Latorre, J. M., Aguilar, M. J., Serrano, J. P., Navarro, B., & Ricarte, J. J. (2011). Factor structure and
psychometric properties of the Center for Epidemiologic Studies Depression Scale (CES-D) in older populations
with and without cognitive impairment. International Journal of Aging & Human Development, 72(2), 83-110.
Yesavage, J. A., Brink, T. L., Rose, T. L., Lum, O., Huang, V., Adey, M. B., & Leirer, V. O. (1983). Development
and validation of a geriatric depression screening scale: A preliminary report. Journal of Psychiatric Research,
17(1), 37-49.
Editor's Notes
The elderly population (individuals &gt; 65 years) is growing. About 1 in 8 Americans were elderly in 1994, but about 1 in 5 will be elderly by the year 2030 (US Census Bureau, http://www.census.gov/population/www/pop-profile/elderpop.html)
Depression is a concern because it affects a large number of older adults and can contribute to a variety of negative health outcomes.
Older adults face significant life changes that place them at high risk for depression. The most common being health problems, death of family and friends, retirement and increased isolation.
All older adults should be screened for signs/symptoms of depression.
Biological factors like hormonal changes may make older women more vulnerable. Evidence suggests that depression in post-menopausal women generally occurs in women with prior histories of depression.
Of every 100,000 people ages 65 and older, 14.3 died by suicide in 2007. This figure is higher than the national average of 11.3 suicides per 100,000 people in the general population.
Evidence Based Criteria for diagnoses for major, minor and dysthymic depressive disorders in adults and older adults.
O’Connor EA, Whitlock EP, Gaynes B, Beil TL. Screening for Depression in Adults and Older Adults in Primary Care: An Updated Systematic Review. Evidence Synthesis No. 75. AHRQ Publication No. 10-05143-EF-1. Rockville, Maryland: Agency for Healthcare Research and Quality, December 2009.
Simple Pneumonic to help with identifying symptoms of depression.
However, need to add depressed mood. interpretation: Criteria for Major Depression Five of 9 major positive answers everyday for 2 weeks
Depression in older adults is typically underreported and underdiagnosed for three reasons, stigma, atypical presentation, and comorbidities
In elderly pts we see more: Anxious mood, somatic complaints, social withdrawal, completed suicide, memory deficits
Geriatric depression also differs from depression in younger people because of more comorbid issues, cognitive, medical and medications.
Diagnosis is complicated because medical conditions or medications can cause symptoms of depression, such as weight loss or appetite change, psychomotor retardation, loss of energy or fatigue, insomnia or hypersomnia, and difficulty concentrating.
Confusion often presents a challenge in the care of older adults. Three common states that result in confusion are delirium, dementia, and depression. This table helps you sort through the various signs and symptoms associated with each of the conditions and how they differ in presentation.