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7/25/2019 Psychological Disorders in Late Life
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Psychological Disorders inLate Life
By: Seemab Zahra
7/25/2019 Psychological Disorders in Late Life
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Prevalence:
How common are Psychological Disorders in
Late Life?
Current estimates indicate that person oer !" hae the
lowest oerall prealence of mental disorders of all age
groups#
Prealence rate for alcohol abuse or dependence rates are
less than %
'en rates for depression and an(iety appear lower than in
younger population#
)ost people !" years of age and older are free from serious
psychopathology#
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Medical Issues in DiagnosingPsychological Disorders
)edical conditions are more common in elderly it is particular to rule
out the e(planations for diagnosis
)edical problems such as thyroid problems* +ddison,s disease*
Cushing,s disease* Par-inson,s disease* +l.heimer,s disease*
hypoglycemia* anemia* and itamin de/ciencies can produce
symptoms that mimic schi.ophrenia*depression* or an(iety 0)arengo
1 2estermeyer* 344!5#
+ngina* congestie heart failure*and e(cessie ca6eine consumption
may all cause a faster heart rate* which can be mista-en as a
symptom of an(iety 07isher 1 8oll* 344!5
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Contd9
+gerelated deterioration in the estibular
system0innerear control of one,s sense of balance5
can account for panic symptoms such as seere
di..iness0;a5#
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Major Depressive
Disorder:;esearchers initially
belieed that symptoms of
depression di6ered in late
life* but researchers hae
identi/ed only one
consistent di6erencecognitie symptoms 0such
as memory de/cits and
confusion5 appear more
pronounced when
depression emerges in late
life compared to earlier
adulthood#
+lthough depression is lesscommon among older adultsthan younger ones* it accountsfor a ery large proportion ofthe psychiatric hospitaladmissions among the aged#
0Daid @oung2ol6APhoto'dit#5
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Depression vs. Dementia
he freuent presence of cognitie symptoms in late life
depression can ma-e it hard to di6erentiate whether
memory problem is due to dementia or depression
ndeed* depression in older adults is often misdiagnosed
as dementia because of the seere cognitie
impairment#
Ef course* people can hae both dementia anddepression# Cognitie diFculties in late life do predict
increases in depression oer time 0Gin-ers et al#* %>>5#
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Is it Depression orDementia?
Symptoms ofDepression Symptoms ofDementia
)ental decline is relatiely rapid )ental decline happens slowly
Inows the correct time* date* andwhere he or she is
Confused and disorientedJbecomes lost in familiar locations
DiFculty concentrating DiFculty with shortterm memory
DiFculty concentrating 2riting* spea-ing* and motors-ills are impaired
8otices or worries about memoryproblems Doesn,t notice memory problems
or seem to care
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DSMI! DI"#$%S&ICC'I&('I"
" or more symptoms lasting K% w-* change from
preious functioning:
Depressed mood andAor loss of interest
+ltered sleep* loss of energy* appetite change or
weight loss* feelings of
worthlessnessAguilt*psychomotor changes* loss ofconcentration and focus* recurrent thoughts of
death
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(tiology of Depression in %lder "dults
+s you grow older* you face signi/cant life changes that can put
you at ris- for depression# Causes and ris- factors that contribute
to depression in older adults and the elderly include:
*ealth pro+lems llness and disabilityJ chronic or seere painJ
cognitie declineJ damage to body image due to surgery or
disease#
Loneliness and isolation Liing aloneJ a dwindling social circle
due to deaths or relocationJ decreased mobility due to illness or
loss of driing priileges#
'educed sense of purpose 7eelings of purposelessness or loss
of identity due to retirement or physical limitations on actiities#
,ears 7ear of death or dyingJ an(iety oer /nancial problems or
7/25/2019 Psychological Disorders in Late Life
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&reatment of depression
here are seeral treatment options aailable for
depression#
hey include :
+ntidepressant medication
Psychotherapy
'lectroconulsie therapy
Sometimes* a combination of these treatments
may be
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"ntiDepressantMedication
7our groups of antidepressant medications hae been used to
e6ectiely treat depressie illness:
selectie serotonin reupta-e inhibitors 0SS;s5 and norepinephrineand serotonin reupta-e inhibitors 08S;s5*
and less commonly* tricyclics* monoamine o(idase inhibitors 0)+Es5*
)edication adherence is especially important* but can present
challenges among forgetful indiiduals# t is important to note that all
medicines hae side e6ects as well as bene/ts#* and the selection of
the best treatment is often made based on tolerability of the side
e6ects#
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Psychotherapy)ost depressed people /nd that support from family and friends*
inolement in selfhelp and support groups* and psychotherapy are
helpful#
Psychotherapy is especially bene/cial for those who prefer not to ta-e
medicine and who hae mild to moderate symptoms# t also is helpful for
people who cannot ta-e drugs because of side e6ects* interactions with
other medicines* or other medical illnesses#
Psychotherapy in older adults can address a broad range of functional and
social conseuences of depression# )any doctors recommend the use of
psychotherapy in combination with antidepressant medicines#
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(lectroconvulsive therapy-(C&
'C 0also -nown as shoc- treatment5 may
be ery useful in the treatment of seere
depression in older adults#
7or carefully selected people* 'C can be
a lifesaing interention# 7or e(ample* an
M> year old man who lies alone* has
been depressed for months* lost !>
pounds and has delusions about his body
as a -ind of presentation that may
improe uic-ly with 'C#
'C can impact memory so that is an
important consideration in comparing it to
other interentions#
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Suicide
Elder people are =( more li-ely to -ill themseles
than younger people
Depression is the ris- factor# Ether factors
include* physical illness* loss of loed ones* and dire /nancialcircumstances
Elder people are less li-ely to communicate their
intentions to commit suicide
Ene treatment program to reduce depression
and suicidal rate among the elderly draws on the /nding that
elderly people are more li-ely to isit primary care doctors than to
see specialty mental health proiders
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