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Chapter 12 - Principles of Geriatric Psychiatry

Published online by Cambridge University Press:  02 January 2025

By
Antonio L. Teixeira  and
Jennifer R. Gatchel
Edited by
Marsal Sanches  and
Jair C. Soares
Marsal Sanches
Affiliation:
McGovern Medical School, Texas
Jair C. Soares
Affiliation:
McGovern Medical School, Texas
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Summary

In this chapter, we discuss late-life psychiatric disorders highlighting their unique biological, clinical, and therapeutic features compared to presentations earlier in life. They are frequently overlapping and associated with dementia and other neurodegenerative diseases. The three D’s – delirium, dementia, and depression – represent common geriatric psychiatry syndromes that can pose diagnostic and therapeutic challenges. Clinical suspicion of delirium must prompt careful investigation of the underlying cause. Dementia is an umbrella term that describes progressive cognitive decline and related behavioral and functional impairments. Behavioral symptoms of dementia are a frequent reason for psychiatry referral. They have a more irregular course than the cognitive decline, and can be categorized in distinct dimensions. Late-life depression has unique features, such as the focus on somatic complaints instead of mood changes.

Keywords

AnxietyDementiaDeliriumDepressionGeriatricsPsychosisLate-Life
Type
Chapter
Information
Fundamentals of Clinical Psychiatry
A Practical Handbook
 , pp. 99 - 108
Publisher: Cambridge University Press
Print publication year: 2025

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References

Vespa, J., The U.S. Joins Other Countries with Large Aging Populations. (2021). https://www.census.gov/library/stories/2018/03/graying-america.html.Google Scholar
Husain-Krautter, S. & Ellison, J. M., Late Life Depression: The Essentials and the Essential Distinctions. Focus (Am Psychiatr Publ), 19 (2021) 282–293.Google ScholarPubMed
Marcantonio, E. R., Delirium in Hospitalized Older Adults. N Engl J Med, 377 (2017) 1456–1466.CrossRefGoogle ScholarPubMed
Neufeld, K. J., Yue, J., Robinson, T. N., Inouye, S. K., & Needham, D. M., Antipsychotic Medication for Prevention and Treatment of Delirium in Hospitalized Adults: A Systematic Review and Meta-Analysis. J Am Geriatr Soc, 64 (2016) 705–714.CrossRefGoogle ScholarPubMed
Cole, M. G., Ciampi, A., Belzile, E., & Zhong, L., Persistent Delirium in Older Hospital Patients: A Systematic Review of Frequency and Prognosis. Age Ageing, 38 (2009) 19–26.CrossRefGoogle ScholarPubMed
Scheltens, P., De Strooper, B., Kivipelto, M., Holstege, H., Chetelat, G., Teunissen, C. E., Cummings, J., & van der Flier, W. M., Alzheimer’s Disease. Lancet, 397 (2021) 1577–1590.CrossRefGoogle ScholarPubMed
Tampi, R. R. & Jeste, D. V., Dementia Is More Than Memory Loss: Neuropsychiatric Symptoms of Dementia and Their Nonpharmacological and Pharmacological Management. Am J Psychiatry, 179 (2022) 528–543.CrossRefGoogle ScholarPubMed
Kales, H. C., Gitlin, L. N., & Lyketsos, C. G., Assessment and Management of Behavioral and Psychological Symptoms of Dementia. BMJ, 350 (2015) h369.CrossRefGoogle ScholarPubMed
Jones, K. C., Update on Major Neurocognitive Disorders. Focus (Am Psychiatr Publ), 19 (2021) 271–281.Google ScholarPubMed
Alexopoulos, G. S., Mechanisms and Treatment of Late-Life Depression. Transl Psychiatry, 9 (2019) 188.CrossRefGoogle ScholarPubMed
Dias, N. S., Barbosa, I. G., Kuang, W., & Teixeira, A. L., Depressive Disorders in the Elderly and Dementia: An Update. Dement Neuropsychol, 14 (2020) 1–6.CrossRefGoogle ScholarPubMed
Kok, R. M. & Reynolds, C. F. 3rd, Management of Depression in Older Adults: A Review. JAMA, 317 (2017) 2114–2122.CrossRefGoogle ScholarPubMed
Marshe, V. S., Islam, F., Maciukiewicz, M., Bousman, C., Eyre, H. A., Lavretsky, H., Mulsant, B. H., Reynolds, C. F. 3rd, Lenze, E. J., & Muller, D. J., Pharmacogenetic Implications for Antidepressant Pharmacotherapy in Late-Life Depression: A Systematic Review of the Literature for Response, Pharmacokinetics and Adverse Drug Reactions. Am J Geriatr Psychiatry, 28 (2020) 609–629.CrossRefGoogle ScholarPubMed
Tunvirachaisakul, C., Gould, R. L., Coulson, M. C., Ward, E. V., Reynolds, G., Gathercole, R. L., Grocott, H., Supasitthumrong, T., Tunvirachaisakul, A., Kimona, K., & Howard, R. J., Predictors of Treatment Outcome in Depression in Later Life: A Systematic Review and Meta-analysis. J Affect Disord, 227 (2018) 164–182.CrossRefGoogle ScholarPubMed
Tampi, R. R., Young, J., Hoq, R., Resnick, K., & Tampi, D. J., Psychotic Disorders in Late Life: A Narrative Review. Ther Adv Psychopharmacol, 9 (2019) 2045125319882798.CrossRefGoogle ScholarPubMed
Reinhardt, M. M. & Cohen, C. I., Late-Life Psychosis: Diagnosis and Treatment. Curr Psychiatry Rep, 17 (2015) 1.CrossRefGoogle ScholarPubMed
Jazi, A. N. & Asghar-Ali, A. A., Obsessive-Compulsive Disorder in Older Adults: A Comprehensive Literature Review. J Psychiatr Pract, 26 (2020) 175–184.CrossRefGoogle ScholarPubMed
Mulchandani, M., Shetty, N., Conrad, A., Muir, P., & Mah, B., Treatment of Eating Disorders in Older People: A Systematic Review. Syst Rev, 10 (2021) 275.CrossRefGoogle ScholarPubMed
Humphreys, K. & Shover, C. L., Twenty-Year Trends in Drug Overdose Fatalities among Older Adults in the US. JAMA Psychiatry, 80 (2023) 518–520.CrossRefGoogle ScholarPubMed
Wang, L., Pan, Y., Ye, C., Guo, L., Luo, S., Dai, S., Chen, N., & Wang, E., A Network Meta-analysis of the Long- and Short-Term Efficacy of Sleep Medicines in Adults and Older Adults. Neurosci Biobehav Rev, 131 (2021) 489–496.CrossRefGoogle Scholar

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