Depression in old age

About 6 million elderly people in the United States suffer from depression. And only 10% of patients receive adequate treatment. Depression is often missed due to concomitant somatic and neurological diseases and various medications. For the elderly, a prolonged course of the disease is characteristic. The risk of suicide is high, the level of which is higher at the age of 65-85 than among other age categories. Elderly patients often face illness and death of relatives, retirement, chronic diseases, difficulties in adapting to new trends in society. 

 Sleep disturbance is one of the main symptoms of depression in the elderly. Insomy is an indicator of protracted course and the possibility of relapse of depression. When treating sleep disorders in elderly patients with depression, it is necessary to avoid prescribing benzodiazepine drugs , tranquilizers, due to the formation of dependence, cardiovascular disorders, an increased risk of falling, and a deterioration in cognitive abilities. Depression often occurs in reclusive or lonely women with prolonged stress. Strokes, hypertension, heart rhythm disturbances, diabetes mellitus, and tumors increase the risk of depression. With magnetic resonance imaging in old age, discirculatoryencephalopathy, expansion of perivascular spaces.

Sleep disturbances in old age are best treated with antidepressants or melatonin medications. Also effective is the new drug belsomra , which is an orexin receptor antagonist. Survexant belsomra promotes the transition of the brain from wakefulness to sleep. The effectiveness of antidepressants in old age is small, therefore, in the treatment of depression, it is necessary to use physiotherapy, psychotherapy. This approach is dictated by the fact that elderly patients are very sensitive to the side effects of antidepressants, psychotropic drugs. So the use of tricyclic antidepressants can cause orthostatic collapse. Therefore, psychotherapy is important in the treatment of depression in the elderly in three forms: individual, family, and group. Electroconvulsive therapy and transcranial magnetic stimulation are also effective . Depression in old age is difficult to treat as it is associated with hypochondria and physical illness.

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