Mood disorders in the elderly: prevalence, functional impact, and management challenges

Abstract

Despite the lower prevalence of severe mood disorders in the elderly as compared to younger adults, late-life depression and bipolar disorder (BD) are more strongly associated with negative outcomes related to the presence of medical comorbidities, cognitive deficits, and increased suicide risk and overall mortality. The mechanisms that contribute to these associations are probably multifactorial, involving pathological factors related directly and indirectly to the disease itself, ranging from biological to psychosocial factors. Most of the accumulated knowledge on the nature of these associations derives from naturalistic and observational studies, and controlled data are still scarce. Nonetheless, there has clearly been a recent growth of the scientific interest on late-life BD and geriatric depression. In the present study, we review the most relevant studies on prevalence, clinical presentation, and cognitive/functional impact of mood disorders in elderly. Several clinical–epidemiological studies were dedicated to the study of the prevalence of mood disorders in old age in distinct settings; however, fewer studies investigated the underlying neurobiological findings and treatment specificities in late-life depression and BD. In the present study, we further discuss the implications of these findings on the management of mood disorders in older adults.

The association between urinary Alzheimer-associated neuronal thread protein and cognitive impairment in late-life depression: a controlled pilot study

“…Late-life depression (LLD), defined as major depression occurring in older adults regardless of the age of onset 1 , is common (10%-38%) among older people 2 - 4 , and is associated with an increased risk of disability, suicide, high mortality and poor quality of life 5 , 6 . Cognitive impairment, such as in episodic memory, speed of information processing, executive functioning, and visuospatial ability 7 - 9 often occurs in LLD 10 , which is associated with increased relapse rate, functional impairment and poor treatment adherence 1 .…”

Estudo comparativo do perfil de idosos atendidos em um hospital terciário: ambulatório de psiquiatria geriátrica e unidade de internação psiquiátrica

“…15,16 O fato de possuir companheiro está associado à redução da solidão e melhoria do bemestar. 17 (12,9) ,000 Outros 5 (1,0) 5 (1,9) 0 (0,0) ,000…”

“…comum de morbidade psiquiátrica em idosos, 8 sendo a depressão, ansiedade e o transtorno do humor bipolar os mais prevalentes com graus variados de gravidade. [9][10][11] Desta forma, torna-se imprescindível avaliarmos e entendermos o perfil dos indivíduos de meia-idade e idosos, bem como seus principais diagnósticos, visto que a tendência é aumentar a demanda de atendimento desta população nos ambulatórios e na internação psiquiátrica hospitalar.…”

Recommendations for the Use of ICT in Elderly Populations with Affective Disorders

“…In elderly populations, affective disorders may have specific clinical symptoms compared to younger adults (Valiengo et al, 2016) and often constitute early clinical symptoms of dementia that may precede cognitive disturbances. The two most prevalent affective disorders in elderly populations are MDDs and apathy, followed by generalized anxiety disorder.…”