Late-Life Depression

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We live in an aging world. Illnesses that are prevalent and cause significant morbidity and mortality in older people will consume an increasing share of health care resources. One such illness is depression. This illness has a particularly devastating impact in the elderly because it is often undiagnosed or inadequately treated. Depression not only has a profound impact on quality of life but it is associated with an increased risk of mortality from suicide and vascular disease. In fact for every medical illness studied, e.g. heart disease, diabetes, cancer, individuals who are depressed have a worse prognosis. Research has illuminated the physiological and behavioral effects of depression that accounts for these poor outcomes. The deleterious relationship between depression and other illnesses has changed the concept of late-life depression from a "psychiatric disorder" that is diagnosed and treated by a psychiatrist to a common and serious disorder that is the responsibility of all physicians who care for patients over the age of 60.
This is the first volume devoted to the epidemiology, phenomenology, psychobiology, treatment and consequences of late-life depression. Although much has been written about depressive disorders, the focus has been primarily on the illness as experienced in younger adults. The effects of aging on the brain, the physiological and behavioral consequences of recurrent depression, and the impact of other diseases common in the elderly, make late-life depression a distinct entity. There is a compelling need for a separate research program, specialized treatments, and a book dedicated to this disorder. This book will be invaluable to psychiatrists, gerontologists, clinical psychologists, social workers, students, trainees, and others who care for individuals over the age of sixty.

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Editorial Reviews

Doody's Review Service
Reviewer: Ellyn M. Lee, MD (Rush University Medical Center)
Description: This comprehensive review of depression in the elderly covers the diagnosis, treatment, and nuances of depression in the geriatric population and how it varies from depression at other stages of life.
Purpose: This book increases awareness of an underdiagnosed and undertreated problem and gives a detailed account of all aspects of depression in older patients.
Audience: This publication targets clinicians, researchers, students, educators, academic faculty, clinical and research fellows, residents and graduate students. It is appropriate for everyone involved in the clinical setting and those specifically researching the field of psychiatry. Healthcare practitioners have, and will continue to have, more elderly patients so increasing awareness of health in this population is pertinent to virtually all generalists and specialists.
Features: The authors make a point of why late-life depression is an important topic and how much impact on society it has as well as the quality of life of each patient. This is iterated in the epidemiology section of the book. The biologic abnormalities that exist with depression in late life are many and some theories about the basis of this disease are not yet proven. The diagnostic process is often difficult due to a muddled picture of somatic and cognitive symptoms, which are prevalent in the aging population, and because depressive symptoms do not always equate to major depression. Treatment is largely the same as in younger adults but often a challenge due to issues with noncompliance, polypharmacy, and the high rate of adverse reactions in older patients. A whole chapter is dedicated to electroconvulsive therapy, which signifies its importance in the elderly population.
Assessment: The book provides concrete facts from current literature that are easily applicable in the clinical setting. The graphs and tables offer concise data. The breakdown of the chapters and sections are well thought out. It is written by some of the foremost authorities in their respective areas of expertise.
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Product Details

  • ISBN-13: 9780195152746
  • Publisher: Oxford University Press, USA
  • Publication date: 7/28/2004
  • Pages: 420
  • Product dimensions: 11.10 (w) x 8.60 (h) x 1.10 (d)

Table of Contents

1. The Epidemiology of Depressive Disorders in Late Life, Dan G. Blazer
2. The Social and Financial Burden of Late-Life Depression to Society and Individuals, Barry D. Lebowitz and Jason T. Olin
3. Unipolar Depression, George S. Alexopoulos and William Apfeldorf
4. Bipolar Disorders, Robert C. Young
5. Dysthymic Disorder in the Elderly, D.P. Devanand
6. Non-Major Clinically Significant Depression in the Elderly, Anand Kumar, Helen Lavretsky, and Virginia Elderkin-Thompson
7. Mixed Cognitive and Depressive Syndromes, Helen Lavretsky and Gary W. Small
8. Suicide, Yeates Conwell
9. Bereavement and Depression, Paula J. Clayton
10. Neuropsychological Assessment of Late-Life Depression, Wilfred G. van Gorp, James C. Root, and Harold A. Sackeim
11. Structural and Functional Brain Imaging in Late-Life Depression Harold A. Sackeim
12. Late-Life Depression and the Vascular Hypothesis, K.R. Ranga Krishnan
13. Hypothalmic-Pituitary-Adrenal Axis Activity in Mood and Cognition in the Elderly: Implications for Symptoms and Outcomes, Jennifer Keller, Theresa M. Buckley, and Alan F. Schatzberg
14. The Neuroendocrinology of Aging, Stuart N. Seidman
15. Pharmacokinetics and Pharmacodynamics in Late Life, Bruce G. Pollock
16. Antidepressant Medication for the Treatment of Late Life Depression, Steven P. Roose and Harold A. Sackeim
17. Antidepressant Side Effects, Carl Salzman
18. Mood Stabilizers, Charles L. Bowden and Nancy U. Karren
19. Stimulants, J. Craig Nelson and Leon J. Epstein
20. Antipsychotics, Christian R. Dolder, Jonathan P. Lacro, and Dilip V. Jeste
21. Electroconvulsive Therapy in Late-Life Depression, Harold A. Sackeim
22. Pharmacologic Treatment of Depression in Alzheimer's Disease, John L. Beyer and P. Murali Doraiswamy
23. Psychotherapy in Old-Age Depression: Progress and Challenges, Charles F. Reynolds III, Patricia A. Arean, Thomas R. Lynch, and Ellen Frank
24. Treatment of Depression in Residential Settings, Ira R. Katz and Joel Streim
25. Depression co-Morbid with Ischemic Heart Disease, Steven P. Roose and Alexander H. Glassman
26. Vascular Disease and Late-Life Depression: Stroke, Robert G. Robinson
27. Substance Abuse and Co-Morbidity, David W. Oslin
28. Basal Ganglia Disease and Depression, Anjan Chatterjee and Karen Marder
29. Major Depressive Disorder in Alzheimer's Disease, George S. Zubenko

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