gc08-5 - Late Life Depression Maria T. Caserta MD, PhD...

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1 Late Life Depression Maria T. Caserta MD, PhD Professor and Chief Division of Geriatric Psychiatry Dept. of Psychiatry and Behavioral Medicine University of South Florida Sponsored by the University of South Florida and the State of Florida Department of Elder Affairs
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2 Geriatric Statistics: U.S. Bureau of the Census: • Life expectancy: 1950 = 68 years; 1991 = 79 years for women/72 years for men* • In the year 2000 = 12.4% of the U.S. population - 35 million Americans - were 65 years or older* • By 2030 = percentage increases to 20% -1 in 5 people will be older than 65; 2025 in Florida – 1 in 4 people • People age 85 and older: are the fastest growing segment of our population – from 4 M today to 20 M by 2050;* constitute 10% of those 65 years and older; there are 39 men for every 100 women 85 years old or older *Administration on Aging. Statistics on the Aging Population, Rockville, MD; US Department of Health and Human Services; 2003; U.S. Bureau of the Census. Geriatric Statistics: Mental Health • 20% of the US population over the age of 65 has a mental illness** • As the population ages, the number of people with mental illness will double to 15 million by 2030 • Number of people over age 65 years with mental illness will equal the number of people with mental illness in ALL other age groups* • Older adults are less likely to seek mental health: only 4% of non-institutionalized US population seek mental health treatment*** • Older adults are more likely to be identified, diagnosed and receive treatment from their primary care physician**** *Bartels SJ (in press). **Jeste, DV, Consensus statement on the upcoming crisis in geriatric mental health, Arch. Gen. Psychiatry 1999: 56(9): 848-53. ** * Olfson M, Outpatient mental health care in non-hospital settings. Am. J Psychiatry 1996; 153(10): 1353-6. * ** * Kaplan MS, et al, Managing depressed and suicidal geriatric patients. Gerontologist 1999; 39(4): 417-25.
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3 Psychiatric Disorders in the elderly Mood D/O (Depressive D/O and Bipolar D/O)* Adjustment D/O* Anxiety D/O* Somatoform/Factitious/Dissociative D/O Impulse Control D/O Paraphilias/Sexual and Gender Identity D/O Eating D/O Sleep D/O* Delirium, Dementia, Amnestic and other Cognitive D/O* Alcohol and Substance Related D/O* Schizophrenia and other Psychotic D/O (such as Delusional D/O) Late Life Stressors that place older adults at risk of mental health disorders • Chronic physical health condition(s) • Death of a loved one • Caregiving • Social isolation/lack or loss of social support • Significant loss of independence • History of mental health problems
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4 1. NIH Consensus Development Panel on Depression in Late Life. JAMA. 1992;268:1018–1024. 2. Fernandez F et al. J Clin Psychiatry . 1995;56(suppl 2):20–29. Diagnostic Considerations in the Elderly Population – Perception and stigma of psychiatric illness 1 – Variable clinical presentation 2 – Concomitant drug therapy 2 – Comorbid medical conditions 2 – Co-existing neurologic/psychiatric disorders 2 Adverse Life Events & Aging Multiple Losses •Jobs • Money • Homes • Friends • Abilities • Health • Hopes and dreams • Bereavement
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gc08-5 - Late Life Depression Maria T. Caserta MD, PhD...

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