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Overview
We live in an aging world. Illnesses that are prevalent and cause significant morbidity and mortality in older people will consume an increasing share of health care resources. One such illness is depression. This illness has a particularly devastating impact in the elderly because it is often undiagnosed or inadequately treated. Depression not only has a profound impact on quality of life but it is associated with an increased risk of mortality from suicide and vascular disease. In fact for every medical illness studied, e.g. heart disease, diabetes, cancer, individuals who are depressed have a worse prognosis. Research has illuminated the physiological and behavioral effects of depression that accounts for these poor outcomes. The deleterious relationship between depression and other illnesses has changed the concept of late-life depression from a "psychiatric disorder" that is diagnosed and treated by a psychiatrist to a common and serious disorder that is the responsibility of all physicians who care for patients over the age of 60.
This is the first volume devoted to the epidemiology, phenomenology, psychobiology, treatment and consequences of late-life depression. Although much has been written about depressive disorders, the focus has been primarily on the illness as experienced in younger adults. The effects of aging on the brain, the physiological and behavioral consequences of recurrent depression, and the impact of other diseases common in the elderly, make late-life depression a distinct entity. There is a compelling need for a separate research program, specialized treatments, and a book dedicated to this disorder. This book will be invaluable to psychiatrists, gerontologists, clinical psychologists, social workers, students, trainees, and others who care for individuals over the age of sixty.
Editorials
From The Critics
Reviewer: Ellyn M. Lee, MD(Rush University Medical Center)Description: "This comprehensive review of depression in the elderly covers the diagnosis, treatment, and nuances of depression in the geriatric population and how it varies from depression at other stages of life. "
Purpose: This book increases awareness of an underdiagnosed and undertreated problem and gives a detailed account of all aspects of depression in older patients.
Audience: "This publication targets clinicians, researchers, students, educators, academic faculty, clinical and research fellows, residents and graduate students. It is appropriate for everyone involved in the clinical setting and those specifically researching the field of psychiatry. Healthcare practitioners have, and will continue to have, more elderly patients so increasing awareness of health in this population is pertinent to virtually all generalists and specialists. "
Features: The authors make a point of why late-life depression is an important topic and how much impact on society it has as well as the quality of life of each patient. This is iterated in the epidemiology section of the book. The biologic abnormalities that exist with depression in late life are many and some theories about the basis of this disease are not yet proven. The diagnostic process is often difficult due to a muddled picture of somatic and cognitive symptoms, which are prevalent in the aging population, and because depressive symptoms do not always equate to major depression. Treatment is largely the same as in younger adults but often a challenge due to issues with noncompliance, polypharmacy, and the high rate of adverse reactions in older patients. A whole chapter is dedicated to electroconvulsive therapy, which signifies its importance in the elderly population.
Assessment: The book provides concrete facts from current literature that are easily applicable in the clinical setting. The graphs and tables offer concise data. The breakdown of the chapters and sections are well thought out. It is written by some of the foremost authorities in their respective areas of expertise.