You are here: Los Angeles Health Baltimore Health Examiner

Dr. Delia Chiaramonte

Baltimore Health Examiner
Dr. Delia Chiaramonte is the founder and president of Insight Medical Consultants, a private medical advising and patient advocacy company. She is board certified in family medicine and is Medical Director for Hospice of Baltimore.

  

Examiner Feeds

These websites were picked by the Baltimore Health Examiner as useful resources.

Diabetes Awareness Month

The State of the Healthcare System

Patient Advocacy Resources

Cancer Resources

Alternative Medicine Resources

Baltimore Examiners

Steve DeClue
Baltimore Football Examiner
Most Recent Post
Ravens vs. Eagles preview
Tom Flynn
Navy Midshipmen Examiner
Most Recent Post
Navy Overwhelms Pitt, 4-1
Adam Meister
Baltimore Politics Examiner
Most Recent Post
Section 8 rentals in your neighborhood
Craig Meister
Baltimore College Prep Examiner
Most Recent Post
Early Decision ‘08: Hope for the Best, Prepare for the Worst
Dining Dish
Baltimore Dining Examiner
Most Recent Post
Inaugural Fever - for just $200,900
 
 

(i.e. Los Angeles hiking, Los Angeles parenting)

Depression in Older People - Common and Often Missed

August 1, 1:04 AM
by Dr. Delia Chiaramonte, Baltimore Health Examiner
 
 


Depression in older people often goes undiagnosed. The patients don’t often bring it up, maybe because of a perceived social stigma, and doctors may miss it. Some may even consider it a normal part of aging. It isn’t.

The general older population actually has a lower rate of depression compared with people at mid life. However, rates of depression are higher for older adults with medical illnesses such as heart disease, chronic pain and insomnia. Other risk factors include being female, socially isolated, or a widow or divorcee.

Being depressed can be dangerous. One study of depression in people who’d had heart attacks showed that being depressed made you four times more likely to die.

I once had a woman admitted to hospice who seemed to be near death. She slept 20 hours a day and didn’t eat. Her family assumed that she’d be gone within a month. But what was wrong with her? She didn’t have cancer or heart disease, so why did she sleep all day and refuse food? We thought she might be depressed so we started her on an anti-depressant. It was a miracle. Within 3 weeks she was up and about and lunching with her friends.

Depression tends to hang with other illnesses like anxiety and, sometimes, even psychosis. If you only treat the anxiety or psychosis, but neglect the depression the patient just won't get better. This is a common mistake made with elderly people; I saw it just this week. Using Xanax or Ativan to treat nervousness in an elderly patient who has an anxious depression creates a person who is dependent on anxiety medicines but doesn’t feel all that much better.

Some people who are depressed self-medicate with alcohol, pain pills or sleeping medicines. This phenomenon is easily missed by busy primary care doctors, but can be tragic if it leads to a broken hip, a household accident, or memory deficits. Actually confusion in older people can actually be caused by depression. It is often worth a trial of antidepressants when dementia first appears.

“Sure, Grandpa gets a little cranky and blue sometimes, but he’d never do anything stupid”, you might think. Wrong.  Elderly people account for 13% of the US population, but make up nearly 24% of completed suicides. Older men are the most at risk with a rate of 29 per 100,000 people.

A simple 2 question screening test can be used to help diagnose depression. The questions are:
1. During the past month, have you been bothered by feeling down, depressed or hopeless?
2. During the past month, have you been bothered by little interest or pleasure in doing things?
Anyone who answers yes to both of these questions is likely to be suffering from depression.

Does this sound like anyone you know?

Be well,

Dr. C
www.insightmedicalconsultants.com

(photo courtesy of elderlycareservices.org)

For more info: click here to learn more about depression in the elderly.

Topics: geriatrics
   Subscribe   Feed
 
 

Comments

Name:  
Email Address:  
Comments:  

More from Baltimore Health Examiner

Do you need a patient advocate?

November 21, 2:15 AM
Do you need a patient advocate?Some people sail through the medical system with no trouble at all but others, particularly those with serious illnesses, find themselves navigating a bumpy road. Perhaps your two doctors are telling you different things... Read More
Topics: patient advocate , medical consultant

To Stuff or Not to Stuff?

November 13, 12:40 PM
To stuff or not to stuff…Friends of mine have this argument every year about this time, as they begin to contemplate their thanksgiving turkey. HE wants to let the bird stand alone and leave stuffing for a casserole dish while SHE wants to let... Read More

Using Your Thoughts to Improve your Mood

November 2, 11:27 PM
Emails to check, voice mails to listen to, appointments to keep and errands to run.Life can be stressful.A little stress is good – it helps you get your reports in on time or your house clean before company comes. But too much stress is harmful.... Read More
Topics: stress reduction

Hope for the Healthcare System?

October 25, 6:25 PM
Today I was inspired.As doctors often do, I was grousing about the state of the healthcare system with a colleague, family physician Adam Dimitrov. He told me the story of a recent patient encounter and he shared his enthusiasm and commitment to changing... Read More
Topics: doctor-patient communication

When The Tables Turn: what to do as your parents age

October 13, 9:14 PM
Sometimes, the tables turn slowly. Other times, an abrupt change in your parents’ health makes you suddenly switch roles. No matter how quickly it happens, you may one day be in the position of needing to help your parents when they can no longer... Read More
Topics: geriatrics

Flu Facts

October 7, 8:48 AM
 Have you ever been in bed with the “flu”? People throw that word around lightly, using it to describe various symptoms from sniffles to cough to diarrhea. But the real flu packs a punch. If you’ve ever had it you would know... Read More
Topics: infectious disease

Baltimore's Best Healthcare Gems

September 29, 11:21 PM
Baltimore is filled with healthcare gems.  Of course we have Hopkins and the University of Maryland, but that’s not all.  There are many dedicated, passionate healthcare providers in town who don’t toot their own horns nearly as... Read More
Topics: Best of Baltimore

Food Allergy Wars

September 24, 12:05 AM
There is a lot of talk about food allergy these days.  There are peanut-free classrooms and cupcake-free school birthdaycelebrations.  It may seem as though every other kid in your child’s school has a food allergy.Food allergy, particularly... Read More
Topics: allergies

Rational Use of Herbal Therapies: the 5 most commonly used herbs

September 18, 11:26 PM
Americans love herbs. Consumer use of herbal therapies increased 380% from 1990-1997, and it continues to rise. Many people, especially those wary of pharmaceuticals, believe that herbs are safe and free of side effects. Others appreciate the control... Read More
Topics: alternative medicine