St. Luke's Hospital, Duluth, MN, USA.
Am Fam Physician. 2011 Nov 15;84(10):1149-54.
The diagnosis of depression in older patients is often complicated by comorbid conditions, such as cerebrovascular disease or dementia. Tools specific for this age group, such as the Geriatric Depression Scale or the Cornell Scale for Depression in Dementia, may assist in making the diagnosis. Treatment decisions should consider risks associated with medications, such as serotonin syndrome, hyponatremia, falls, fractures, and gastrointestinal bleeding. Older white men with depression are at high risk of suicide. Depression is common after stroke or myocardial infarction, and response to antidepressant treatment has been linked to vascular outcomes. Depression care management is an important adjunct to the use of antidepressant medications. Structured psychotherapy and exercise programs are useful treatments for select patients.
老年患者的抑郁症诊断通常因合并症而变得复杂，如脑血管疾病或痴呆。针对该年龄组的特定工具，如老年抑郁量表或痴呆症中的康奈尔抑郁量表，可能有助于做出诊断。治疗决策应考虑与药物相关的风险，如血清素综合征、低钠血症、跌倒、骨折和胃肠道出血。患有抑郁症的老年白人男性自杀风险很高。中风或心肌梗死后抑郁症很常见，抗抑郁治疗的反应与血管结局有关。抑郁护理管理是使用抗抑郁药物的重要辅助手段。结构化心理治疗和运动计划对某些患者有用。
