Depression in the elderly: risk factors, comorbidity, treatment and prognosis

Late-life depression is defined as the depressive syndrome that occurs in people older than 65 and it often arises in the context of medical or psychiatric disorders. There is evidence that depression in the elderly plays an important role in developing alcoholism. Most commonly reported comorbidities, which influence the course and the outcome of depression, are anxiety disorders, alcoholism and cluster B and C personality disorders. Moreover, depression seems to be associated with an increased risk of developing Alzheimer's disease, where the age of onset correlates positively with the risk for dementia. There's a strict link between depression and "medical burden" too. The most important psychosocial risk factors are stressful events, mourning and disability. With respect to pharmacotherapy, SSRIs and SNRIs are preferred; there's evidence that combined therapy (pharmacotherapy and psychotherapy) is appropriate and it is recommended in older patients suffering from depression. According to data, the main factors influencing the outcome of late-life depression are the age of onset, response to treatment and maintainance therapy.