Skip to main content

Advertisement

SpringerLink
Log in

Recent Advances in Late-Life Mood Disorders

  • Geriatric Psychiatry (GT Grossberg, Section Editor)
  • Published:
Current Geriatrics Reports Aims and scope Submit manuscript

Abstract

Late-life mood disorders are prevalent and can also have a major impact on an individual’s physical health, family and society as a whole. Many symptoms commonly seen in depressive disorders are similar to the symptoms seen with medical illnesses. Numerous elements make up a complete geriatric mental health work-up. The major treatment options are psychotherapy, pharmacotherapy and neuromodulation. These approaches are evaluated to aid the clinician in making recommendations for evaluation and treatment.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Almeida O. Approaches to decrease the prevalence of depression in later life. Geriatr Psychiatr. 2012;25(6):451.

    Google Scholar 

  2. Wilkinson P, Izmeth Z. Continuation and maintenance treatments for depression in older people. Cochrane Database of Syst Rev 2012;11:CD006727.

  3. Craven M, Bland R. Depression in primary care: current and future challenges. Can J Psychiatry. 2013;58(8):442–8.

    PubMed  Google Scholar 

  4. Lin EH, Katon W, Rutter C, et al. Effects of enhanced depression treatment on diabetes self-care. Ann Fam Med. 2006;4:46–53.

    Article  PubMed Central  PubMed  Google Scholar 

  5. Koenig HG, Blazer DG. Epidemiology of geriatric affective disorders. Clin Geriatr Med. 1992;8:235.

    CAS  PubMed  Google Scholar 

  6. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington: American Psychiatric Association; 2013.

    Google Scholar 

  7. Crossett J. The best is yet to be: preventing, detecting, and treating depression in older women. J Am Med Wom Assoc. 2004;59(3):210–5.

    PubMed  Google Scholar 

  8. Avari JN, Yuen GS, AbdelMalk B, Mahgoub N, Kalayam B, Alexopoulos GS. Assessment and management of late-life depression. Psychiatr Ann. 2014;44(3):131–7. This article provides a comprehensive review of the evaluation of geriatric depression.

    Article  Google Scholar 

  9. Steffens DC. Separating mood disturbance from mild cognitive impairment in geriatric depression. Int Rev Psychiatr. 2008;20(4):374–81.

    Article  Google Scholar 

  10. Folstein MF, Folstein SE, McHugh PR. “Mini-Mental State”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12:189–98.

    Article  CAS  PubMed  Google Scholar 

  11. Banks WA, Morley JE. Memories are made of this: recent advances in understanding, cognitive impairment, and dementia. J Gerontol Med Sci. 2003;58A:314–21.

    Article  Google Scholar 

  12. Dong Y, Lee WY, Basri NA, et al. The Montreal cognitive assessment is superior to the mini-mental state examination in detecting patients at higher risk of dementia. Int Psychogeriatr. 2012;24(11):1749–55.

    Article  PubMed  Google Scholar 

  13. Waern M, Runeson BS, Allebeck P, et al. Mental disorder in elderly suicides: a case-control study. Am J Psychiatry. 2002;159:450.

    Article  PubMed  Google Scholar 

  14. Bottino C, Barcelos-Ferreira R, Ribeiz SRI. Treatment of depression in older adults. Curr Psychiatry Rep. 2012;14:289–97. Presents stepped care approach of treatment in the elderly. Primarily focuses on medication management but does talk about other therapies.

    Article  PubMed  Google Scholar 

  15. Pinquart M, Duberstein PR, Lyness JM. Treatments for later-life depressive conditions: a meta-analytic comparison of pharmacotherapy and psychotherapy. Am J Psychiatry. 2006;163(9):1493–501.

    Article  PubMed  Google Scholar 

  16. Beck AT, Rush AJ, Shaw BF, et al. Cognitive therapy of depression. New York: Guilford Press; 1979.

    Google Scholar 

  17. Alexopoulos GS, Raue PJ, Kanellopoulos D, Mackin S, Arean P. Problem solving therapy for the depression-executive dysfunction syndrome of late-life. Int J Geriatr Psychiatr. 2008;23:782–8.

    Article  Google Scholar 

  18. Klerman GL, Weissman MM, Rounsaville BJ, et al. Interpersonal psychotherapy of depression. New York: Academic Press; 1984.

    Google Scholar 

  19. Werman D. The practice of supportive psychotherapy. New York: Brunner/Mazel, Inc; 1984.

    Google Scholar 

  20. Kiosses D, Leon A, Arean P. Psychosocial interventions for late-life major depression: evidence-based treatments, predictors of treatment outcomes, and moderators of treatment effects. Psychiatr Clin N Am. 2011;34:377–401. Reviews the major system level studies of psychotherapies in the elderly.

    Article  Google Scholar 

  21. Lamers F, Jonkers CC, Bosma H, Kempen GI, Meijer JA, Penninx BW, et al. A minimal psychological intervention in chronically ill elderly patients with depression: a randomized trial. Psychother Psychosom. 2010;79:217–26.

    Article  PubMed  Google Scholar 

  22. Thompson LW, Gallagher-Thompson D, Laidlaw K, et al. Cognitive-behavioural therapy for late-life depression: a therapist manual. UK version. Edinburgh: University of Edinburgh, Department of Psychiatry; 2000.

    Google Scholar 

  23. Mynors-Wallis L. Problem-solving treatment in general psychiatric practice. Adv Psychiatr Treat. 2001;7(6):417–25.

    Article  Google Scholar 

  24. Block S. Assessing and managing depression in the terminally ill patient. Ann Intern Med. 2000;132:209–18.

    Article  CAS  PubMed  Google Scholar 

  25. Neimeyer R. Meaning reconstruction and the experience of loss. Washington: American Psychological Association; 2001.

    Book  Google Scholar 

  26. Chand S, Grossberg G. How to adapt cognitive-behavioral therapy for older adults. Curr Psychiatr. 2013;12:10–5.

    Google Scholar 

  27. Laidlaw L, Davidson K, Toner H, et al. A randomized controlled trial of cognitive behaviour therapy vs treatment as usual in the treatment of mild to moderate late-life depression. Int J Geriatr Psychiatr. 2008;23:843–50.

    Article  Google Scholar 

  28. Kiosses D, Alexopoulos G. Problem-solving therapy in the elderly. Curr Treat Options Psychiatr. 2014;1:15–26. Compares problem solving therapies with other psychotherapies. Also explores adaptations to address access difficulties.

    Article  Google Scholar 

  29. Alexopoulos GS. Pharmacotherapy for late-life depression. J Clin Psychiatry. 2011;72(1):e04.

    Article  PubMed Central  PubMed  Google Scholar 

  30. Kok R. What is the role of medication in late-life depression? Psychiatr Clin N Am. 2013;36(4):597–605.

    Article  Google Scholar 

  31. Coupland C, Dhiman P, Morriss R, Arthur A, Barton G, Hippisley-Cox J. Antidepressant use and risk of adverse outcomes in older people: population based cohort study. BMJ. 2011;343:d4551.

    Article  PubMed Central  PubMed  Google Scholar 

  32. Rojas-Fernandez C, Mikhail M. Contemporary concepts in the pharmacotherapy of depression in older people. Can Pharm J (Ott). 2012;145(3):128.e2–35.e2. Strong review of pharmacology and augmentation strategies.

    Google Scholar 

  33. FDA: FDA Drug Safety Communication: Revised recommendations for Celexa (citalopram hydrobromide) related to a potential risk of abnormal heart rhythms with high doses. Rockville, MD, US Food and Drug Administration, 2012. http://www.fda.gov/Drugs/DrugSafety/ucm269086.htm.

  34. Zivin K, Pfeiffer PN, Bohnert AS, Ganoczy D, Blow FC, Nallamothu BK, et al. Evaluation of the FDA warning against prescribing citalopram at doses exceeding 40 mg. Am J Psychiatry. 2013;170(6):642–50.

    Article  PubMed  Google Scholar 

  35. Campanelli CM. American Geriatric Society’s updated Beers criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2012;60(4):616–31.

    Article  PubMed Central  Google Scholar 

  36. Karaiskos D, Tzavellas E, Spengos K, Vassilopoulou S, Paparrigopoulos T. Duloxetine versus citalopram and sertraline in the treatment of poststroke depression, anxiety, and fatigue. J Neuropsychiatry Clin Neurosci. 2012;24(3):349–53.

    Article  CAS  PubMed  Google Scholar 

  37. Johnston SS, Udall M, Cappelleri JC, et al. Potential drug-drug and drug-condition interactions among fibromyalgia patients initiating pregabalin or duloxetine: prevalence and health care expenditure impact. Pain Med. 2014;15:1282–93. doi:10.1111/pme.12330.

    Article  PubMed  Google Scholar 

  38. Fetzima. St.Louis, MO. Forest Pharmaceuticals; July, 2014. www.Fetzima.com.

  39. Singh M, Schwartz TL. Clinical utility of vilazodone for the treatment of adults with major depressive disorder and theoretical implications for future clinical use. Neuropsychiatr Dis Treat. 2012;8:123–30.

    CAS  PubMed Central  PubMed  Google Scholar 

  40. Hamilton M. A rating scale for depression. J Neurol Neurosurg Psychiatry. 1960;23:56–62.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  41. Brintellix. Deerfield, IL. Takeda Pharmaceuticals America and Lundbeck; September, 2013. www.BRINTELLIX.com.

  42. Fava M. Augmentation and combination strategies for complicated depression. J Clin Psychiatry. 2009;70(11):e40.

    Article  PubMed  Google Scholar 

  43. Sproule BA, Hardy G, Shulman KI. Differential pharmacokinetics of lithium in elderly patients. Drugs Aging. 2000;16(3):165–77.

    Article  CAS  PubMed  Google Scholar 

  44. Topel ME, Zajecka JM, Goldstein CN, Siddiqui UA, Schwartz TL. Using what we have: combining medications to achieve remission. Clin Neuropsychiatr. 2011;8(1):4–27.

    Google Scholar 

  45. Lavretsky H, Kim MD, Kumar A, Reynolds CF. Combined treatment with methylphenidate and citalopram for accelerated response in the elderly: an open trial. J Clin Psychiatry. 2003;64(12):1410–4.

    Article  CAS  PubMed  Google Scholar 

  46. Schwartz E, Morelli V, Holtorf K. Hormone replacement therapy in the geriatric patient: current state of the evidence and questions for the future-estrogen, progesterone, testosterone, and thyroid hormone augmentation in geriatric clinical practice: part 2. Clin Geriatr Med. 2011;27:561–75.

    Article  PubMed  Google Scholar 

  47. Carpenter L, Yasmin S, Price L. A double-blind, placebo-controlled study of antidepressant augmentation with mirtazapine. Biol Psychiatry. 2002;51:183–8.

    Article  CAS  PubMed  Google Scholar 

  48. Kuehn B. FDA warns antipsychotic drugs may be risky for elderly. JAMA. 2005;293(20):2462.

    Article  CAS  PubMed  Google Scholar 

  49. Locklear JC, Svedsäter H, Datto C, Endicott J. Effects of once-daily extended release quetiapine fumarate (quetiapine XR) on quality of life and sleep in adults with major depressive disorder. J Affect Disord. 2013;149:189–95.

    Article  CAS  PubMed  Google Scholar 

  50. Sajatovic M, Gildengers A, Al Jurdi RK, Gyulai L, Cassidy KA, Greenberg RL, et al. Multisite, open-label, prospective trial of lamotrigine for geriatric bipolar depression: a preliminary report. Bipolar Disord. 2011;13(3):294–302.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  51. Baruch Y, Tadger S, Plopski I, Barak Y. Asenapine for elderly bipolar manic patients. J Affect Disord. 2013;145(1):130–2.

    Article  CAS  PubMed  Google Scholar 

  52. Loebel A, Cucchiaro J, Silva R, Kroger H, Hsu J, Sarma K, et al. Lurasidone monotherapy in the treatment of bipolar I depression: a randomized, double-blind, placebo-controlled study. Am J Psychiatry. 2014;171(2):160–8.

    Article  PubMed  Google Scholar 

  53. Beck DA, Koening HG, Beck JS. Depression. Clin Geriatr Med. 1998;14(4):765–86.

    CAS  PubMed  Google Scholar 

  54. Lexicomp, Inc. Wolters Kluwer Health. (Philadelphia, PA) accessed 29 June 2014. https://online.lexi.com/.

  55. Kerner N, Prudic J. Current electroconvulsive therapy practice and research in the geriatric population. Neuropsychiatry. 2014;4(1):33–54. An up to date review of ECT.

    Article  PubMed  Google Scholar 

  56. George MS, Taylor JJ, Short EB. The expanding evidence base for rTMS treatment of depression. Curr Opin Psychiatr. 2013;26(1):13–8. doi:10.1097/YCO.0b013e32835ab46d.

  57. Jorge RE, Robinson RG. Treatment of late-life depression: a role of non-invasive brain stimulation techniques. Int Rev Psychiatry. 2011;23(5):437–44.

    Article  PubMed Central  PubMed  Google Scholar 

  58. Lozano AM, Mayberg HS, Giacobbe P, et al. Subcallosal cingulate gyrus deep brain stimulation for treatment-resistant depression. Biol Psychiatry. 2008;64:461–7.

    Article  PubMed  Google Scholar 

  59. Dols A, Kupka RW, van Lammeren A, Beekman AT, Sajatovic M, Stek ML. The prevalence of late-life mania: a review. Bipolar Disord. 2014;16:113–8.

    Article  PubMed  Google Scholar 

  60. Azorin JM, Kaladjian A, Addia M, Fakra E. Late-onset bipolar illness: the geriatric bipolar type VI. CNS Neurosci Ther. 2012;18:208–13.

    Article  PubMed  Google Scholar 

  61. Reinares M, Sánchez-Moreno J, Fountoulakis KN. Psychosocial interventions in bipolar disorder: what, for whom, and when. J Affect Disord. 2014;156:46–55.

    Article  PubMed  Google Scholar 

  62. Vieta E, Pacchiarotti I, Valenti M, Berk L, Scott J, Colom F. A critical update on psychological interventions for bipolar disorders. Curr Psychiatry Rep. 2009;11:494–502.

    Article  PubMed  Google Scholar 

  63. Sajatovic M, Chen P. Geriatric bipolar disorder. Psychiatr Clin N Am. 2011;34(2):319–33. Comprehensive review and treatment of mania in the elderly.

    Article  Google Scholar 

  64. D'Souza R, Rajji TK, Mulsant BH, Pollock BG. Use of lithium in the treatment of bipolar disorder in late-life. Curr Psychiatry Rep. 2011;13(6):488–92.

    Article  PubMed  Google Scholar 

  65. Kessing L, Søndergård L, Forman J, Andersen P. Lithium treatment and risk of dementia. Arch Gen Psychiatry. 2008;65(11):1331–5.

    Article  PubMed  Google Scholar 

  66. Diniz BS, Nunes PV, Machado-Vieira R, Forlenza OV. Current pharmacological approaches and perspectives in the treatment of geriatric mood disorders. Curr Opin Psychiatry. 2011;24(6):473–7.

    PubMed  Google Scholar 

  67. Maher AR, Theodore G. Summary of the comparative effectiveness review on off-label use of atypical antipsychotics. J Manag Care Pharm. 2012;18(5 suppl B):S1–S20.

    PubMed  Google Scholar 

  68. Loebel A, Cucchiaro J, Silva R, Kroger H, Hsu J, Sarma K, et al. Lurasidone monotherapy in the treatment of bipolar I depression: a randomized, double-blind, placebo-controlled study. Am J Psychiatry. 2014;171(2):160–8.

    Article  PubMed  Google Scholar 

Download references

Compliance with Ethics Guidelines

Conflict of Interest

David A. Beck, Jacob A. Beck, and Garrett Lambert declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Author information

Authors and Affiliations

  1. Department of Psychiatry, Missouri University Psychiatric Center, University of Missouri, Columbia, MO, 65212, USA

    David A. Beck & Garrett Lambert

  2. University of Kentucky College of Pharmacy, 3175 Beaumont Centre, Lexington, KY, 40513, USA

    Jacob A. Beck

Authors
  1. David A. Beck
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jacob A. Beck
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Garrett Lambert
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to David A. Beck.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Beck, D.A., Beck, J.A. & Lambert, G. Recent Advances in Late-Life Mood Disorders. Curr Geri Rep 3, 245–252 (2014). https://doi.org/10.1007/s13670-014-0100-y

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13670-014-0100-y

Keywords

Search

Navigation