Epidemiology and diagnosis of depression in late life

Depression is a significant concern in elderly patients. Reported prevalenc e rates differ greatly depending on the definition of depression and the po pulation of interest, with increases reported in settings where comorbid ph ysical illnesses are more common. In community-dwelling elderly patients, p revalences of depressive symptoms and major depressive disorder are 15% and 1% to 3%, respectively. Factors associated with depression in the elderly include female gender, alcohol and substance abuse, pharmaceuticals, family history, and medical conditions such as stroke, Alzheimer's disease, cance r, and heart disease. Recognition of depression is complex because patients often deny their depression, present with somatic complaints, or may have comorbid anxiety or cognitive impairment. Depression is underrecognized and undertreated in the elderly, despite evidence that the benefits of treatme nt outweigh potential risks.