Depression in Older Adults

Depression in older adults can present without sadness and may manifest as anhedonia, fatigue, malaise, and apathy. Psychotic symptoms, including delusions and auditory hallucinations, are common in older adults with depression. Apathy, a lack of motivation, is a frequent early symptom of dementia but can be mistaken for depression. Screening for depression in older adults should include basic labs to rule out reversible causes and assessment of suicide risk factors. Treatment options include SSRIs, SNRIs, mertazapine, cognitive-behavioral therapy, problem-solving therapy, interpersonal therapy, bright light therapy, and exercise.