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Atypical Presentations of Depression


James L. Silvius, MD, FRCPC, Calgary Health Region, Clinical Associate Professor, Department of Medicine; Head and Chief, Division of Geriatric Medicine, University of Calgary, Calgary, AB.

Depression is common in older adults. This condition is often under-recognized and undertreated in this patient segment as it may present differently than in younger individuals. A number of risk factors for depression have been identified and may help increase recognition. Altered presentations include generalized anxiety/worry, somatisation, presence of a disability gap, subjective but not objective memory complaints, pseudodementia, hopelessness, change in adherence to medical regimens or change in function not otherwise explained. For individuals with dementia syndromes, excess disability may indicate depression. A high index of suspicion, recognition of risk factors, and asking about specific aspects of depression may increase diagnosis.
Key words: depression presentation, risk factors, function, dementia.