The Carlat Psychiatry Podcast
3 D's of Geriatric Psychiatry
Oct 9, 2023
Learn how to distinguish between depression, dementia, and delirium in older adults. Explore treatment options including medication, psychotherapy, and exercise. Discover the effectiveness of TMS and ECT in treating depression and get an overview of dementia. Find out about non-pharmacological treatments for dementia and delirium, and the cautious use of antipsychotics. Explore management options for sleep, delirium, depression, and dementia in geriatric psychiatry.
16:24
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Quick takeaways
- Depression in older adults can present without sadness and may manifest as anhedonia, fatigue, malaise, and apathy, and screening for depression in older adults should include basic labs to rule out reversible causes and assessment of suicide risk factors.
- Dementia is characterized by cognitive decline that impacts daily activities, and assessments for dementia include the MMSE, MOCA, or SLUMS, and non-pharmacological treatments are the first line of management.
Deep dives
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.
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