[Depression in the elderly; future prospects].
Extensive research has been achieved on the old age depression during the last decades. Specific clinical features and management have been reported. Indirect clinical and behavioural indicators, and even biological ones should be considered for the detection of depression. Cognitive assessment must be promoted in standard practice to differentiate depression from incipient dementia, but also in depression occurring in long stay care, vascular depression and in the depression-executive dysfunction syndrome. Distinction between recurrent depressive episode and late-onset depression has to be clarified. Therapeutic strategies have to be reconsidered in duration, according to the trend toward chronicity of late life depression. They remain based on the use of pluri-aminergic antidepressants. Depressive disorder in the elderly is associated with hippocampus dysfunction, but other biological variables should be taken into account according to a dynamic stress-vulnerability model.
Clément
Jean-Pierre
JP
Pôle universitaire de psychiatrie du sujet âgé, Centre Hospitalier Esquirol, Limoges, France. jean-pierre.clement@chello.fr
D000368:Aged; D000544:Alzheimer Disease / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology; D000928:Antidepressive Agents / Q000627:therapeutic use; D015140:Dementia, Vascular / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology; D003866:Depressive Disorder / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology; D003937:Diagnosis, Differential; D005544:Forecasting; D005602:France; D006624:Hippocampus / Q000187:drug effects / Q000503:physiopathology; D006801:Humans; D009483:Neuropsychological Tests; D012106:Research / Q000639:trends; D012307:Risk Factors; D013315:Stress, Psychological / Q000150:complications
D000928:Antidepressive Agents