What is it about ?
The depression is a mental illness which is characterized primarily by a change of mood and interest. Depression is classified into mild, moderate and severe form based on a number of criteria.
Physical illnesses, reduced mobility, loss (e.g. death of a loved one), loneliness, onset of dementia, etc. are factors that increase the risk of depression. This is especially the case in the elderly. In this age group, the risk of severe depression is also greater.
What is its frequency?
About 12% of people over 65 have depression. In 2 to 5% of cases, it is a severe form.
How to recognize it?
A depression is characterized by a sad mood and a loss of interest or pleasure in almost all activities, for most of the day, for more than two weeks. These manifestations are often accompanied by feelings of guilt and inferiority, impaired concentration, suicide tendencies and morbid thoughts. Physical symptoms can also occur, such as weightloss, loss of appetite, insomnia, etc.
The older person usually also suffers from other conditions that limit their activities. This is why we think less quickly of the possibility of depression. Often it is family members or home caregivers who notice the problem. The older person will often not talk about it on their own.
How is the diagnosis made?
The doctor will always try to objectify the symptoms. To rule out the role of physical ailments, he will perform a number of routine examinations, such as a blood test and, if necessary, a CT scan of the brain.
The diagnosis of depression is laid on the basis of the table of symptoms and complaints and the results of psychological tests. The GDS-15 (Geriatric Depression Scale) questionnaire, for example, assesses the presence of depression using 15 questions.
Elements to consider in the management
- The risk of depression severe is more important in the elderly. Their complaints should therefore always be taken seriously.
- The diagnosis is complicated by the presence of other conditions. In this group, it is therefore less advisable to wait to see how things develop.
- The supported is always multidisciplinary, through close collaboration between family members, informal caregivers, the home nurse, the physiotherapist (for example through adapted exercise sessions), the psychologist (for example through speech therapy ), the occupational therapist, the general practitioner and, if necessary, one or the other specialist. A detailed care plan is put in place.
- In principle, the treatments non-medicinal products are the same as those applied in adults. Psychotherapy is sometimes more difficult given the decline in cognitive functions. There is also less scientific evidence specific to seniors. The retrospective of life is one of the interventions that has proven its effectiveness.
- Antidepressants are indicated for depression severe. Most older people are already taking some medication. This can influence the effectiveness of medicines for depression. In addition, these drugs are often degraded more slowly in the body. They may also take longer to take effect. Treatment is therefore often started at a low dose, for example half the usual dose. In addition, the doctor always maintains the treatment for a minimum of 2 months before appreciating the result. If the result is satisfactory, the processing is continued for 6 to 12 months. Sleeping pills and sedatives (benzodiazepines) are rather not recommended for the elderly because of the risk of falling.
Want to know more?
- Depression – let’s talk about health
- Depression: drugs or psychotherapy? – mongeneraliste.be – SSMG – Scientific Society of General Medicine
- Sleeping pills and sedatives, think before consuming – FAMHP – Federal Agency for Medicines and Health Products
- Sleeping pills or tranquilizers, an update on your consumption – Stop or else?
Are you looking for more specialized help?
Sources