DIAGNOSIS AND TREATMENT OF DEPRESSION IN LATE-LIFE - CONSENSUS STATEMENT UPDATE

Objective.-To reexamine the conclusions of the 1991 National Institute s of Health Consensus Panel on Diagnosis and Treatment of Depression i n Late Life in light of current scientific evidence, Participants.-Par ticipants included National institutes of Health staff and experts dra wn from the Planning Committee and presenters of the 1991 Consensus De velopment Conference, Evidence.-Participants summarized relevant data from the world scientific literature on the original questions posed f or tile conference. Process.-Participants reviewed the original consen sus statement and identified areas for update, The list of issues was circulated to all participants and amended to reflect group agreement, Selected participants prepared first drafts of the consensus update f or each issue, All drafts were read by all participants and were amend ed and edited to reflect group consensus, Conclusions.-The review conc luded that, although the initial consensus statement still holds, ther e is important new information in a number of areas, These areas inclu de the onset and course of late-life depression; comorbidity and disab ility; sex and hormonal issues; newer medications, psychotherapies, an d approaches to long-term treatment; impact of depression on health se rvices and health care resource use; late-life depression as a risk fa ctor for suicide; and the importance of the heterogeneous forms of dep ression, Depression in older people remains a significant public healt h problem. The burden of unrecognized or inadequately treated depressi on is substantial, Efficacious treatments are available. Aggressive ap proaches to recognition, diagnosis, and treatment are warranted to min imize suffering, improve overall functioning and quality of life, and limit inappropriate use of health care resources.