Key features of depression and its management in general practice.
 
Emmanuelle… Main Points
 

1. Depression affects up to 27% of community dwelling residents and 50% of nursing home residents.

2.Reliable indicators of depression in the elderly include:
-sleep disturbance
-decline in appetite
-anxiety

3. Depression is more likely to become chronic in old age.

4. SSRIs are the antidepressants of choice in the elderly.

5. Adverse effects of SSRIs are more common in older patients.

6. Antidepressants be continued at least two years in the elderly.

7. Long-term treatment should be of the same type, and same intensity, as was used in the initial, acute phase.

8.The suicide rate in the elderly is increasing, especially in men and women aged 80 to 84 years.

9. The suicide rate among elderly white "oldest old" men (those aged 85 years and older) is 6 times the rate of the general population

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