Depression in the elderly Hidden sadness Pr Frans Verhey Prof of - - PowerPoint PPT Presentation

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Depression in the elderly Hidden sadness Pr Frans Verhey Prof of - - PowerPoint PPT Presentation

Depression in the elderly Hidden sadness Pr Frans Verhey Prof of Geriatric Psychiatry/ Neuropsychiatry Alzheimer Centrum Limburg Maastricht University 2/6/2017 Ms Magnee s chair 2/6/2017 Ms Magnee s chair 2/6/2017 Content


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Depression in the elderly – Hidden sadness Pr Frans Verhey Prof of Geriatric Psychiatry/ Neuropsychiatry Alzheimer Centrum Limburg Maastricht University

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Ms Magnee’s chair

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Ms Magnee’s chair

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Content

  • What is depression
  • What is depression in the elderly
  • Why should municipalities bother?
  • What can they do?
  • Conclusion
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What is depression ?

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What is depression ?

  • Depression when lasting for at least 2 weeks, all the time
  • Emotional
  • Physical
  • Thinking/ Cognitive
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Symptoms of depression (DSM-5) Every day, most of the day, > 2 weeks

  • Feeling depressed during most of the day, particularly

in the morning

  • Diminished interest in almost all activities
  • Feeling tired
  • Feeling worthless or guilty
  • Impaired concentration, indecisiveness
  • Cannot sleep
  • Thinking of death or suicide all the time (not just fearing death)
  • Feeling restlessness or being slowed down
  • Significant weight loss or weight gain
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Depression in the elderly

  • ‘Full’ depression less common
  • Depressive symptoms more frequent (‘minor’)
  • Higher level of somatic complaints
  • Less prone to ask for professional help
  • Other profile of risk factors
  • Loneliness
  • Losses
  • of autonomy, of family and friends, of social roles
  • Chronic diseases
  • Informal carers
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Epidemiology

  • 1-2% of elderly
  • ‘Minor’ depression: 10-20%
  • 10-15% in Primary Care
  • 20-30% in Nursing home
  • 11-45% in Inpatient setting
  • >25% of informal carers
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Hidden sadness

  • Elderly do not want to complain
  • Present as somatic disorder (‘tired’)
  • In most cases, they do have somatic conditions
  • Professionals do not recognize as depression
  • Wouldn’t you be depressed yourself?
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Common precipitants

  • Arguments with friends/relatives
  • Rejection or abandonment
  • Death or major illness of loved one
  • Loss of pet
  • Anniversary of a (-) event
  • Major medical illness or age-related deterioration
  • Stressful event at work
  • Medication Noncompliance
  • Substance use
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Why should municipalities bother?

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Why should municipalities bother? Not only a medical problem

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Prevention and treatment of depression

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Prevention: general

  • General education
  • Awareness campaigns
  • Courses for elderly to be prepared to new phase
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Prevention: aimed at risk groups

  • Informal carers
  • Widows
  • Chronic diseases
  • Lonely elderly
  • Elderly who are living in institutions
  • Peer groups, support, respite care, meeting centres
  • Visiting services
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Prevention: Elderly who have some depressive complaints

  • Awareness campaign
  • Social activities
  • Courses (‘In de put, uit de put’)
  • Screening by GP or other HCP
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Conclusion

  • Depression in the elderly is important and frequent problem
  • Underreported, underrecognized
  • Prevention is important task for the communities
  • Senior Friendly Community will assist with their products