THE EPIDEMIOLOGY OF AFFECTIVE-DISORDERS IN THE ELDERLY - A REVIEW

It has been suggested that elderly people are predisposed to depressio n by age-related structural and biochemical changes that may increase their vulnerability to depression and by the fact that risk factors su ch as bereavement and other psychological losses, somatic diseases and institutionalization become more common with increasing age. The elde rly also have a disproportionately high rate of suicide. Whether the p revalence of depression increases or decreases with age is, however, d ebatable. There may be a peak in the prevalence during the years befor e retirement, a low prevalence during the first 10-15 years thereafter , and an increase after the age of 75 years. Among the consequences of depression are social deprivation, loneliness, poor quality of life, increased use of health and home-care services, cognitive decline, imp airments in activities of daily living, chronicity, suicide and increa sed non-suicide mortality. However, most studies report that few depre ssives in the community are treated with antidepressants. During recen t years new antidepressants have been introduced, which are better tol erated by the elderly. At the same time, the prescription of antidepre ssants has increased in the community. It remains to be seen whether t hese changes have led to a higher rate of treatment of depression in t he elderly.