title: Recent understandings in geriatric affective disorder.
abstract: OBJECTIVE
  This article focuses on recent research into depression, bipolar disorder and anxiety in older people.
  
  
  RESULTS
  Many physical illnesses are associated with a high prevalence of depression but overall medical burden may largely account for this. The relationship between depression and vascular disease is two way. Frontal brain dysfunction may underlie depression both in cerebrovascular disease and neurodegenerative disorders. Besides antidepressants, psychological treatments, psychosocial interventions and enhanced primary care services are effective. Longer-term outcomes are poor but preventive strategies show promise. Medical and psychiatric comorbidity are also important themes in later-life anxiety and bipolar disorders.
  
  
  CONCLUSIONS
  Improving prognosis is a key concern and more research into novel pharmacological approaches (including vasoprotection), psychological interventions and prevention is needed.
authors.affiliation: Manchester Mental Health & Social Care Trust, Edale House, Manchester Royal Infirmary, Manchester, UK. robert.c.baldwin@manchester.ac.uk
authors.forename: Robert C
authors.initials: RC
authors.lastname: Baldwin
mesh_terms: D000367:Age Factors; D000368:Aged; D001008:Anxiety Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D001714:Bipolar Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D006801:Humans