Advertisement

Biopsychosocial Approaches to Depression in the Older Adults

  • David BaronEmail author
  • Jessica Uno
Chapter

Abstract

There is no health without mental health. This commonly cited phrase is particularly true in the elderly. Depression can be challenging to diagnose and treat in older adults patients and has a significant negative impact on the overall quality of physical and emotional well-being. A comprehensive biopsychosocial approach to assessment and management of depression is necessary to ensure maximal quality of life. Assessment of mood must take into account current life stressors, such as chronic and acute health problems, social isolation, age-related cognitive decline, prior history of depressions, recent losses (family, friends), drug and alcohol use, and financial challenges. Treatment interventions should address issues identified in the biopsychosocial assessment, with an emphasis on psychosocial treatment (such as enjoyable exercise and increased social interactions). Pharmacotherapy should be used cautiously and conservatively, as side effects and drug-drug interactions are a common problem in this population. Keeping the Golden Years truly golden requires attention to the overall mood state of older adult patient, not a sole focus on physical functioning.

Keywords

Biopsychosocial Exercise Older adults Assessment 

Suggested Reading

  1. 1.
    Almeida OP, McCaul K, Hankey GJ, Yeap BB, Golledge J, Norman PE, Flicker L. Duration of diabetes and its association with depression in later life: the health in men study (HIMS). Maturitas. 2016;86:3–9.CrossRefPubMedGoogle Scholar
  2. 2.
    ASCP Fact Sheet. Administration on Aging, 2012; Center for disease control and prevention, 2012; National Council on Aging, 2014. https://www.ascp.com/articles/about-ascp/ascp-fact-sheet.
  3. 3.
    Conradsson M, Rosendahl E, Littbrand H, Gustafson Y, Olofsson B, Lövheim H. Usefulness of the geriatric depression scale 15-item version among very old people with and without cognitive impairment. Aging Ment Health. 2013;17(5):638–45.CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    D’ath P, Katona P, Mullan E, Evans S, Katona C. Screening, detection and management of depression in elderly primary care attenders. I: the acceptability and performance of the 15 item geriatric depression scale (GDS15) and the development of short versions. Fam Pract. 1994;11(3):260–6.CrossRefPubMedGoogle Scholar
  5. 5.
    Hoeft TJ, Hinton L, Liu J, Unützer J. Directions for effectiveness research to improve health services for late-life depression in the United States. Am J Geriatr Psychiatry. 2016;24(1):18–30.CrossRefPubMedGoogle Scholar
  6. 6.
    Kapp MB. Geriatric depression. Elder Law Rev. 2016;10:1.Google Scholar
  7. 7.
    Kwak YT, Song SH, Yang Y. The relationship between geriatric depression scale structure and cognitive-behavioral aspects in patients with Alzheimer’s disease. Dementia and Neurocognitive Disorders. 2015;14(1):24–30.CrossRefGoogle Scholar
  8. 8.
    Lavretsky H, Reinlieb M, St. Cyr N, Siddarth P, Ercoli LM, Senturk D. Citalopram, methylphenidate, or their combination in geriatric depression: a randomized, double-blind, placebo-controlled trial. Am J Psychiatr. 2015;172(6):561–9.CrossRefPubMedGoogle Scholar
  9. 9.
    Li Z, Jeon YH, Low LF, Chenoweth L, O’Connor DW, Beattie E, Brodaty H. Validity of the geriatric depression scale and the collateral source version of the geriatric depression scale in nursing homes. Int Psychogeriatr. 2015;27(9):1–10.CrossRefGoogle Scholar
  10. 10.
    Lockwood KA, Alexopoulos GS, van Gorp WG. Executive dysfunction in geriatric depression. Am J Psychiatr. 2014;159(7):1119–26.CrossRefGoogle Scholar
  11. 11.
    Lyness JM, Noel TK, Cox C, King DA, Conwell Y, Caine ED. Screening for depression in elderly primary care patients: a comparison of the Center for Epidemiologic Studies—Depression Scale and the geriatric depression scale. Arch Intern Med. 1997;157(4):449–54.CrossRefPubMedGoogle Scholar
  12. 12.
    Morimoto SS, Kanellopoulos D, Manning KJ, Alexopoulos GS. Diagnosis and treatment of depression and cognitive impairment in late life. Ann N Y Acad Sci. 2015;1345(1):36–46.CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Poelke G, Ventura MI, Byers AL, Yaffe K, Sudore R, Barnes DE. Leisure activities and depressive symptoms in older adults with cognitive complaints. Int Psychogeriatr. 2016;28(01):63–9.CrossRefPubMedGoogle Scholar
  14. 14.
    Rapp MA, Dahlman K, Sano M, Grossman HT, Haroutunian V, Gorman JM. Neuropsychological differences between late-onset and recurrent geriatric major depression. Am J Psychiatr. 2014;162(4):691–8.CrossRefGoogle Scholar
  15. 15.
    Riepe MW. Clinical preference for factors in treatment of geriatric depression. Neuropsychiatr Dis Treat. 2015;11:25.PubMedGoogle Scholar
  16. 16.
    Roose SP, Sackeim HA, Krishnan KRR, Pollock BG, Alexopoulos G, Lavretsky H, Old-Old Depression Study Group. Antidepressant pharmacotherapy in the treatment of depression in the very old: a randomized, placebo-controlled trial. Am J Psychiatr. 2015;161(11):2050–9.CrossRefGoogle Scholar
  17. 17.
    Spyrou IM, Frantzidis C, Bratsas C, Antoniou I, Bamidis PD. Geriatric depression symptoms coexisting with cognitive decline: a comparison of classification methodologies. Biomedical Signal Processing and Control. 2016;25:118–29.CrossRefGoogle Scholar
  18. 18.
    Thomas AJ, Davis S, Morris C, Jackson E, Harrison R, O’Brien JT. Increase in interleukin-1β in late-life depression. Am J Psychiatr. 2014;162(1):175–7.CrossRefGoogle Scholar
  19. 19.
    Yesavage JA, Brink TL, Rose TL, Lum O, Huang V, Adey M, Leirer VO. Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res. 1983;17(1):37–49.CrossRefGoogle Scholar
  20. 20.
    Yesavage JA, Sheikh JI. Geriatric depression scale (GDS) recent evidence and development of a shorter violence. Clin Gerontol. 1986;5(1–2):165–73.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Keck School of Medicine, University of Southern CaliforniaLos AngelesUSA

Personalised recommendations