What Are the Signs of Geriatric Depression?

Elderly depression refers to depression patients aged 55 or over. The narrow sense can also refer to depression patients whose first onset age is 55 or 60 years old. No matter which type, there are many old ages. specialty. Mild depression is common in clinical practice, but its harmfulness cannot be ignored. If it is not diagnosed and treated in a timely manner, it will lead to serious consequences such as a decline in quality of life, an increase in the risk of illness and death of psychosomatic diseases (such as cardiovascular and cerebrovascular diseases).

Basic Information

Visiting department

Psychiatry

Multiple groups

55 and 60 years old

Common symptoms

Low mood, slow thinking, reduced will activity, suicidal ideation, behavior, physical symptoms, suspected symptoms

Contagious

no

Causes of elderly depression

At present, the etiology is not clear, and it may be related to genetics, brain anatomy and pathological changes, biochemical and sociopsychological factors. These factors are intricate and intertwined, and have a significant impact on the occurrence of depression.

Clinical manifestations of geriatric depression

Typical depressive episodes are depression, slow thinking and reduced speech activity. The clinical symptoms of senile depressive episodes are often not typical, and there are some differences with young patients. Complaints of cognitive impairment and physical discomfort are more common.

Emotional depression

Is the core symptom of depression. Mainly manifested as persistent emotional depression, patients often feel depressed, depressed, and live like years; previous hobbies and interests become boring, life feels dull and boring, life is boring; can't lift the spirit, can't get up, and even feel Despair, extremely disappointed in the future, obvious sense of helplessness and uselessness, self-blame and sin.

More than half of the elderly patients with depression can also have anxiety and agitation, nervousness, restlessness, and sometimes physical anxiety can completely cover up the symptoms of depression.

2. Slow thinking

Depression patients have slow associations and slow responses. Consciously "the brain is obviously harder than before".

Most of the elderly patients with depression have a certain degree of impairment of cognitive function (memory, computing power, understanding and judgment ability, etc.), the more obvious is the decline in memory, which needs to be distinguished from senile dementia. Dementia is mostly irreversible, while depression can improve with the improvement of emotional symptoms, and the prognosis is better.

3. Decreased will activity

Patients can show slow action, lazy life, do not want to speak (less speech, low intonation, slow speech), do not want to do things, and do not want to interact with people around them. I always feel lack of energy, fatigue, and even take care of myself in my daily life. Not only has the past enthusiasm for life diminished or lost, it has become increasingly reluctant to participate in social activities, and even lives behind closed doors and alienates relatives and friends.

4. Suicidal ideas and behaviors

Patients with severe depressive episodes are often accompanied by negative suicidal ideas and behaviors. The suicide risk of elderly patients with depression is much greater than that of patients in other age groups. Especially in the case of depression and physical disease, the suicide success rate is higher. Therefore, family members of patients need to pay more attention to and take precautions.

5. Physical symptoms

Such symptoms are common and are mainly manifested in: pain syndromes such as headache, neck pain, back pain, abdominal pain and chronic pain throughout the body; symptoms of the digestive system, such as abdominal distension, nausea, belching, diarrhea or constipation; Symptoms of cardiovascular system diseases, such as chest tightness and palpitations; autonomic nervous system dysfunction, such as flushing, hot flushes, sweating, hand shaking, etc.

In addition, most people also show sleep disorders, difficulty falling asleep, light sleep and easy to wake up, early wake up and so on. Obvious changes in weight, loss of libido, etc.

6. Suspected symptoms

Patients often pay too much attention to their own health, with physical discomfort as the main complaint (digestive system is the most common, and constipation and gastrointestinal discomfort are the main symptoms). They actively ask for treatment, but often deny or ignore the emotional symptoms, and only consider the physical discomfort not good.

His concern and feeling for physical illness far exceeded the severity of the actual illness, so he showed obvious nervousness and excessive worry. When I walked around the major hospitals and searched for famous doctors, when the results of the tests were negative or the problems were not serious or serious, they would refuse to believe the results of the tests. Asking to go to other large hospitals and other departments for examinations will also complain that the doctors did not check carefully, seriously, and irresponsibly.

Geriatric depression diagnosis

It is mainly diagnosed by a specialist based on medical history, family history, clinical symptoms, course and scale tests, physical examination and laboratory tests. The most important of these are clinical symptoms and disease course. Specific diagnostic criteria can refer to the diagnosis of depressive episodes in the International Classification of Diseases (ICD-10).

In addition, because patients often deny psychological and emotional problems, and the main complaints are physical symptoms, it is best to have family and friends to identify early to avoid missed diagnosis. The following situations belong to high-risk groups:

1. chronic pain;

2. Patients with chronic medical diseases (such as diabetes, cardiovascular disease, gastrointestinal disease);

3. Patients who have difficulty explaining physical symptoms;

4. Repeated medical treatment;

5. Recently there are psychosocial stressors.

Geriatric depression treatment

Drug treatment

(1) Precautions for medication (1) Individualized medication (need to be guided by a specialist) is the principle of medication that must be followed. Starting medication gradually increased from a small dose to the treatment volume, and should be gradually reduced when stopping the drug, so as not to cause a withdrawal reaction. Hepatic and renal dysfunction in elderly patients with slow drug metabolism. Therefore, the dosage of medication for the elderly is relatively low. Elderly patients have low tolerance for adverse reactions, so they should try to choose drugs with less adverse reactions. Elderly patients are often accompanied by physical diseases (such as Parkinson's disease, heart disease, hypertension, diabetes, glaucoma, etc.). In the treatment, it is necessary to consider both comprehensiveness and the interaction of various drugs. The treatment should also be sufficient. The continuous maintenance treatment is very important, and the treatment is relatively long.

(2) Drug selection for the treatment of depressive episodes Tricyclic antidepressants have many adverse reactions. The most common are sedation, drowsiness, tachycardia, dry mouth, blurred vision, constipation, and tremor. Selective serotonin reuptake inhibitors are currently in clinical use with fluoxetine, paroxetine, fluvoxamine, sertraline, and citalopram. These drugs have fewer adverse reactions, are easier to tolerate, are safer, and are more suitable for elderly patients. other new antidepressants venlafaxine, mirtazapine and trazodone.

2. Psychotherapy

Psychotherapy is very important. Combining antidepressants with psychotherapy is a cure for the symptoms and the root cause. The effect is much higher than that of antidepressants or psychotherapy alone. Psychotherapy can improve prognosis and help prevent relapses.

3. Electroconvulsive therapy

Traditional electroconvulsive therapy for ECT is not suitable for elderly patients. Modern modified electroconvulsive therapy has a wide indication for MECT. Older patients without serious cerebral organic and cardiovascular diseases can also choose MECT for treatment. Common adverse effects of MECT are forgetting and disturbance of consciousness.

Geriatric depression prevention

Preventing elderly depression requires the joint efforts of the elderly themselves and their families. First of all, they must participate in group activities more, make more friends, cultivate hobbies, and actively carry out outdoor activities. Secondly, their children should pay more attention, accompany and support, and create a good family atmosphere.