Gc06-6 - Maria D Llorente MD Professor Dept of Psychiatry Behavioral Sciences Miller School of Medicine at the University of Miami

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The Association between Late-life  The Association between Late-life  Depression and Medical Illness Depression and Medical Illness Maria D. Llorente MD Professor Dept. of Psychiatry & Behavioral Sciences Miller School of Medicine at the University of Miami
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The “Graying” of America The “Graying” of America By the year 2025, the world’s older  population  (60 and older) will approach 1.2 billion . By the year 2030, 1 of every 5 people in the  U.S. will be 65 or older. Older Americans will number more than 65  million  
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U.S. Dept of Health and Human Services. Mental Health: A Report of the Surgeon General . Rockville, MD: U.S. Dept of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, NIH, NIMH, 1999. Late-Life Depression Late-Life Depression Incidence of major depression declines with age, but minor depression is much more common Depressive symptoms occur in 15% 25% of older adults (>65 years) that fail to meet criteria but cause distress and interfere with functioning Fewer than half of depressed seniors are recognized as being depressed and of those who are identified fewer than half receive treatment
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Primary Care is the De Facto Primary Care is the De Facto Mental Health System (in the Mental Health System (in the United States) responsible for the United States) responsible for the care of more patients with mental care of more patients with mental disorders than the specialty disorders than the specialty mental health sector. mental health sector. Regier et al. Arch Gen Psychiatry 1993; 50:85-94
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Depression Guideline Panel. Depression in Primary Care: Vol 1. Detection and Diagnosis. Clinical Practice Guideline No. 5. Rockville, MD: US Dept of Health and Human Services. Public Health Service, Agency for Health Care Policy and Research; no. 93-0550; 1993. Kessler RC et al. J Affect Disord. 1993;29:85-96. Kessler et al., JAMA 2003; Evans et al., J Clin Psych 1999; Astrom et al., Stroke, 1993; Tiller et al., Psychopharm 1992; Meaf et al., Neurology 1994; Cumming Am J Psych 1992. 16.2% of US population report at least one lifetime episode More than half of patients have first episode by age 40 25% of older cancer patients 25-50% of post-stroke patients 1/3 of Alzheimer’s patients 50% of Parkinson’s patients 30% of post-MI Patients     Epidemiology of Major Depression Epidemiology of Major Depression
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Minority Elderly Minority Elderly and Depression and Depression HISPANIC >65 will increase by more than 450% by 2050 Depressive disorder prevalence in primary care increased from 4.5% to 8.6% between 1992-97 Higher prevalence of depressive symptoms (11- 40%) Higher depression-associated mortality from both suicide and medical disorders AFRICAN-AMERICAN >65 will increase by 131% by 2030 Lower rates of depression recognition and treatment
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Gc06-6 - Maria D Llorente MD Professor Dept of Psychiatry Behavioral Sciences Miller School of Medicine at the University of Miami

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