ORLANDO — Depression in elderly patients is easily missed by primary care physicians, according to a new study.
“Sometimes family doctors don't have time to screen for depression, and patients don't put it out on the table,” said Dr. Irene Mangani, who presented her findings in a poster at the annual meeting of the Gerontological Society of America.
“These people can be helped with a lot of interventions for depression, not just pharmacological interventions but also psychotherapy and exercise. And we miss these opportunities by not screening them for depression,” said Dr. Mangani, who is a geriatrician at the University of Florence, Italy.
Her investigation included data from the ICARe Dicomano Study, which enrolled two waves of community-dwelling individuals, aged 65 years and older. The first group was enrolled in 1995, the second in 1999.
A total of 656 participants (mean age 74 years) completed the 30-item Geriatric Depression Scale (GDS), and their scores were compared with evaluations by primary care physicians who assessed the participants for depressive symptoms.
Using a GDS cutoff of 14 or higher to identify depression, the investigators found that the prevalence of depressive symptoms was 24% in the 1995 wave of participants and 31% in the 1999 wave. However, primary care physicians identified only a 14% prevalence in the first wave and 11% in the second wave.
“The GDS is not a diagnosis of depression. It is a screening tool that identifies depressive symptoms. But if someone has a GDS score higher than 14, they should be asked about other symptoms of depression because if they are depressed, this condition can be cured and can be dangerous if not taken care of,” Dr. Mangani said in an interview.
She said that depression in this population has been linked with higher disability and mortality rates. For this reason, screening is worthwhile, even in the primary care setting where there is so little time.
“Just asking a simple question like 'have you lost interest in things you usually like?' is something that doesn't take much time but can be important. If they answer yes, you can ask more questions or even give them the GDS screen,” she said.