Capurso Antonio, Capurso Cristiano, Solfrizzi Vincenzo, Colacicco Anna Maria, D'Introno Alessia, Panza Francesco
Cattedra di Geriatria, Centro per lo Studio dell'Invecchiamento Cerebrale, Memory Unit, Università di Bari.
Recenti Prog Med. 2007 Jan;98(1):43-52.
In old age, depression mainly affects those with chronic medical illness, severe disability or mental decline. Depression in elderly worsens the outcomes of many medical illness and increases mortality. Age-related processes, including arteriosclerosis, inflammatory and degenerative diseases, may compromise the integrity of prefrontostriatal pathways and amygdala leading to increased vulnerability to depression. Environmental factors, such as impoverishment, isolation, relocation, caregiving and bereavement, contribute to further increase susceptibility to depression or triggering depression in already vulnerable elderly people. Suitable treatment of depression in elderly reduces the symptoms, prevents suicidal ideation, improves cognitive and functional status and helps patients to develop the skills needed to cope with their disability or psychosocial adversity. Prevention of depression in given pathological conditions may greatly improve the outcomes, mostly the recovery of function and quality of life, as well as the mortality risk. Therefore, it should be considered the opportunity of a depression prophylaxis, particularly in those circumstances in which the risk of depression is noteworthy increased, such as stroke, cancer, institutionalization, etc.
在老年人群中，抑郁症主要影响患有慢性疾病、严重残疾或智力衰退的人。老年抑郁症会使许多疾病的预后恶化并增加死亡率。与年龄相关的过程，包括动脉硬化、炎症和退行性疾病，可能会损害前额叶纹状体通路和杏仁核的完整性，从而增加患抑郁症的易感性。环境因素，如贫困、孤独、搬迁、照料和丧亲之痛，会进一步增加易患抑郁症的老年人患抑郁症的易感性或引发抑郁症。对老年抑郁症进行适当治疗可减轻症状、预防自杀念头、改善认知和功能状态，并帮助患者培养应对残疾或心理社会逆境所需的技能。在特定病理情况下预防抑郁症可大大改善预后，主要是功能恢复和生活质量，以及降低死亡风险。因此，应考虑进行抑郁症预防，特别是在抑郁症风险显著增加的情况下，如中风、癌症、住院等。
