Tips for treating patients with late-life depression

When possible, get ahead of depression before it sets in

Social participation and employment help to sustain an optimistic, euthymic mood.⁴⁵ Maintaining good physical health, in part through consistent activity levels (including exercise), can help prevent depression. Since persistent sleep disturbance predicts depression among those with a depression history, optimizing sleep among geriatric adults can avoid or alleviate depression.⁴⁶

Low vitamin D levels can contribute to depression, yet vitamin D supplementation may not improve mood.

Sleep hygiene education for patients is also helpful. A regular waking time often promotes a better sleeping schedule. Restful sleep also is more likely when an individual avoids excess caffeine, exercises during the day, and uses the bed only for sleeping (not for listening to music or watching television).

Because inflammation may precede ­depression, anti-inflammatory medications have been proposed as potential treatment, but such pharmacotherapies are often ineffective. Older adults generally do not benefit from low-dose aspirin administration to prevent depression.⁴⁷ Low vitamin D levels can contribute to depression, yet vitamin D supplementation may not improve mood.⁴⁸

Offering hope. Tell your patients that if they are feeling depressed, they should make an appointment with you, their primary care physician, because there are medications they can take and counseling they can avail themselves of that could help.

CORRESPONDENCE
Steven Lippmann, MD, University of Louisville-Psychiatry, 401 East Chestnut Street, Suite 610, Louisville, KY 40202; steven.lippmann@louisville.edu.