Martin L M, Fleming K C, Evans J M
Department of Psychiatry and Psychology, Mayo Clinic Rochester, Minnesota, USA.
Mayo Clin Proc. 1995 Oct;70(10):999-1006. doi: 10.4065/70.10.999.
To describe important aspects of the recognition and management of anxiety and depression in elderly patients.
We reviewed pertinent recent articles in the medical literature and compiled guidelines for diagnosing and treating anxiety and depression in the geriatric population.
Depression and anxiety are common in the elderly population. The development of depression in elderly subjects is associated with a higher risk of death from suicide than for any other age-group. Recognition of depression in elderly patients is often hampered by an inability or reluctance on the part of these patients to report depressive symptoms. In addition, anxiety and depression are often attributed to organic illness in this age-group. Pharmacotherapy is effective; however, older patients are probably more likely than young patients to experience adverse effects. Using medications at lower doses, choosing drugs with shorter half-lives, and avoiding drugs with potent anticholinergic side effects are often advisable.
Anxiety and depression are common conditions among the elderly population. Correct recognition, attention to underlying precipitating factors, and compassionate, supportive care can vastly improve the quality of the lives of these patients.
描述老年患者焦虑和抑郁的识别与管理的重要方面。
我们回顾了医学文献中近期的相关文章，并编制了老年人群焦虑和抑郁的诊断与治疗指南。
抑郁和焦虑在老年人群中很常见。老年受试者发生抑郁与自杀死亡风险高于其他任何年龄组有关。老年患者对抑郁症状的报告能力不足或不愿报告常常妨碍对他们抑郁的识别。此外，该年龄组的焦虑和抑郁常被归因于器质性疾病。药物治疗是有效的；然而，老年患者可能比年轻患者更易出现不良反应。通常建议使用较低剂量的药物，选择半衰期较短的药物，并避免使用具有强效抗胆碱能副作用的药物。
焦虑和抑郁是老年人群中的常见病症。正确识别、关注潜在的诱发因素以及给予同情、支持性护理可极大地改善这些患者的生活质量。
