Diagnosis and Management of Depression in the Elderly

The poster presentation will provide a review of the literature concerning the diagnosis and management of depression in elderly populations, focusing on challenges in diagnostics, approaches to treatment, and needs for individualized care plans.

After this poster presentation, the learner should be able to:

1. Describe the challenges of diagnosing depression in older adults, including symptom overlap with other conditions.
2. Compare and contrast pharmacological with non-pharmacological treatments for elderly depression.
3. Recognize the importance of patient-centered care in improving mental health outcomes for older adults: Diagnosis and Management of Depression in the Elderly.

Depression among the elderly is common, deteriorating quality of life and placing a heavy burden on healthcare systems. Overlapping symptoms with age-related diseases, such as dementia and chronic illness, and possible side effects of medications complicate accurate diagnosis. In addition, stigma and reluctance to seek mental health care contribute to delayed or missed diagnoses. Untreated depression in this population accelerates physical decline, increases the likelihood of hospitalization, and leads to greater mortality.

Recent studies show that the Geriatric Depression Scale (GDS) and the Patient Health Questionnaire-9 (PHQ-9) are screening tools that can be used. These are specifically designed to address the different ways in which depressive symptoms manifest in this age group (Tack et al., 2023). Emerging technologies, such as ANN, provide new ways of improving diagnostic accuracy, especially in settings where resources are limited. Emerging technologies also have challenges, including equitable access and appropriate validation for widespread use.

Subsequently, management of depression in elderly patients often requires a complex approach. Pharmacological treatments are common, such as the use of second-generation antidepressants, but they do carry risks of adverse effects, especially among the frail elderly. Each of these risks calls for careful use of the drugs, proper monitoring, and dose adjustment.

CBT, physical activity, and social support are accepted as complementary non-pharmacological management methods that do not mediate risks of complications. For instance, one of the clearly stated benefits is the effect of physical activity on daily depressive symptoms and the cardiovascular and musculoskeletal statuses of individuals.

The best results were generally achieved by combining pharmacological treatments with psychotherapy. Specific evidence-based guidelines suggest that the treatment should be as patient-centered as possible with regard to the patient’s comorbidity, physical disability, or mental state (Pinho et al., 2021). Social interventions, such as structured group activities, have been shown not only to reduce the severity of depression but also to reduce isolation, often experienced by elderly populations.

Despite these strides, challenges persist. One of the most contentious areas relates to the balance between pharmacological and non-pharmacological treatments. On one side, medications help reduce discomfort in the shortest time but do not consider the role of psychosocial factors in depression. In contrast, non-pharmacological methods of intervention frequently take longer and cost more to be utilized successfully.

Another critical area of debate involves the integration of digital technologies, which holds great promise but faces important barriers related to access, training, and cost, especially in rural or underserved areas. The final diagnosis and management of depression in older populations should be patient-centered, with consideration for the individual’s preferences and needs. The care plans must be tailored to address the biological, psychological, and social determinants of health. These comprise accurate diagnosis, cross-sectorial coordination, and re-assessment, which are essential to achieving the highest outcomes and improving aging patients’ quality of life.

This presentation provides healthcare practitioners with practical interventions to improve the mental health and well-being of older adults. It takes a holistic approach to the diagnosis and treatment of depression in the elderly, drawing on findings from primary research, meta-analyses, and clinical guidelines. 

References

Pinho, L. G. de, Lopes, M. J., Correia, T., Sampaio, F., Arco, H. R. do, Mendes, A., Marques, M. do C., & Fonseca, C. (2021). Patient-Centered Care for Patients with Depression or Anxiety Disorder: An Integrative Review. Journal of Personalized Medicine, 11(8), 776. https://doi.org/10.3390/jpm11080776

Tack, L., Maenhoudt, A.-S., Ketelaars, L., De Zutter, J., Pinson, S., Keunebrock, L., Haaker, L., Deckmyn, K., Gheysen, M., Kenis, C., Wildiers, H., Depoorter, L., Geerts, P.-J., Chandler, R., Boterberg, T., Schofield, P., Parris, C. N., & Debruyne, P. R. (2023). Diagnostic Performance of Screening Tools for Depressive Symptoms in Vulnerable Older Patients with Cancer Undergoing Comprehensive Geriatric Assessment (CGA): Results from the SCREEN Pilot Study. Current Oncology, 30(2), 1805–1817. https://doi.org/10.3390/curroncol30020140

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Guidelines for Developing an Abstract

An abstract is used to provide information about a presentation you want to give at a conference.  In spring semester for NSG 6697 you will share information about the topic you have researched in NSG 6696.  These guidelines are for a “generic” abstract, typical for most conferences; however, the conference to which you choose to submit may vary in requirements, and your “generic” abstract may require some minor revisions.

The sponsors of a conference announce a “call for abstracts”, usually several months before the conference and include the deadline to submit.   People who want to present at a conference develop an abstract describing content they want to present.  Usually 2-3 learning objectives are required and then a summary of the content to be presented.

A limit on the number of words in the abstract is often specified.   The sponsors of a conference usually give specific instructions on how to present the abstract.

Presentations may be either poster presentations or paper (podium) presentations.  For a poster presentation, you will develop a professional poster that will be printed by a professional printer.  The poster must be approved by your mentor.   For a podium presentation, you will be giving an oral presentation using a PowerPoint slide presentation to those attending the conference.

The instructions for preparing the abstract will state whether the “call for abstracts” is for posters or podium presentations or if you have a choice.  You can specify your preference at the beginning of the abstract.  The instructions will also specify the deadline for abstract submission.

For this assignment, you are developing an abstract with a “generic” (common) format:

Page 1: Title page:  give title of presentation,

state:             Abstract for Poster Presentation at

the _______________________  (to be filled in when you decide)

on (DATE)

your name with credentials (e.g., BSN, RN)

Troy University MSN Student

Troy email

Your phone number

Page 2: Title of presentation:

Purpose:

Learning Objectives:

Summary:

Last page: References if instructed to include

Most abstracts undergo “blind review”.  Your name, contact information (email and phone number), and title of your presentation should be included on a title page.  Do not use a running head, and do not include your name on any of the following pages.  When your abstract is reviewed, the title page will be removed so that reviewers will not know who submitted the abstract.

On the second page of the abstract, give the title of your presentation at the top of the page.  The following introduction is recommended:

The purpose of this poster (or paper) presentation [specify one or use “or” to indicate you would do either a poster or paper] is to present a review of literature on (your topic).

Next give objectives:

After viewing this poster (or attending this presentation, if paper), the learning should be able to:

1. Objective 1
2. Objective 2       (can do 3, but no more)

Next, in one or two paragraphs summarize your presentation.  Don’t discuss your topic; use your literature synthesis to summarize what you learned about your topic.  Do not cite any sources in your abstract.

Body of the Abstract

A typical word limit for an abstract is 300-400 words and would include the title, the opening statement, and your summary paragraph(s), but not a reference list or the title page.

In NSG 6697 you will submit an abstract to be considered for presentation at a professional nursing conference.  Available conferences will be posted as dates and information become available under Modules.

Your abstract is due to your mentor by December 2.  Submit through the Assignment Link in the NSG 6696 Blackboard shell.  Your mentor will give you feedback.  Often there is a short time period between the call for abstracts and the deadline date, so it is important that you complete the abstract as much as possible this semester.

See the sample abstract posted in this module.