and treatment (Papalia & Olds, 1995).
Another problem for older and elderly people is depression. Indeed, Skipwith (1994) reports that depression is one of the most common health problems confronting the aged. However, she notes that the condition often goes undiagnosed or is incorrectly diagnosed because it is masked by other complaints and problems. Signs of depression in older people include sadness, insomnia, anorexia, weight loss, and constipation. Unfortunately, these complaints are often undervalued and labeled as normal complains of old age or even hypochondria (Skipwith, 1994).
In his discussion of the fact that depression can often go unrecognized in older and elderly people, Reynolds (1996) states that the primary reasons for under-diagnosis of the conditions include its atypical presentation and the comorbid medical conditions in older and elderly population. He further notes that depression may coexist with dementia or Alzheimer's disease and is more often seen in patients with certain medical illnesses, including central nervous system diseases, endocrine disorders, infectious diseases, nutritional deficiencies, electrolyte imbalances, systemic diseases, cardiovascular disease, and cancer.
Depressed older patients with comorbid medical conditions tend to have a poorer prognosis than otherwise healthy depressed older patients. The current armamentarium of antidepressants includes SSRIs, tricyclic antidepressants (TCAs), monoamine oxidase inhibitors (MAOIs), heterocyclic antidepressants, and atypical antidepressants. While the problem of depression is widespread in older populations, Reynolds (1996) reports that the correct use of these agents produces clinical improvement in 65 75 percent of patients with acute depression.
As to the correct use of the agents, Reynolds (1996) states that SSRIs are often chosen for older patients because of their proven efficacy, safety, and tolerability. The most comm...