PMID: 9434674Jan 22, 1998Paper

Pharmacologic treatment of geriatric depression: key issues in interpreting the evidence

Journal of the American Geriatrics Society
S K RiglerP W Duncan

Abstract

A framework for critical appraisal of antidepressant trial literature involving geriatric subjects is presented. Among older adults, treatment decisions are complicated by comorbid medical and cognitive illness, the variable course of recovery, and the overlap of depressive symptoms with other disease symptoms. Consumers of the literature on competing antidepressant therapies for older adults must consider disease and population-specific outcome assessment issues. An appraisal guide, adapted for geriatric depression, is developed from literature on methodological challenges of outcome assessment and published clinical trials comparing competing antidepressant therapies in older subjects. The clinical utility of pharmacologic treatment of depression can be difficult to assess because depression scales in current use provide an important but limited perspective on treatment outcome and because the scales vary in actual content and ability to detect change. The use of indicators of function, independence, and self-perceived well-being as outcomes offers additional patient relevance and should be included. Key considerations involve (1) general characteristics: whether the depression outcome measure is valid and reproducible for th...Continue Reading

References

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Citations

Sep 19, 2006·Journal of the American Medical Directors Association·Lynne E Kallenbach, Sally K Rigler
Dec 2, 2000·Atencion primaria·J Herrera Tejedor
Oct 18, 2002·Journal of the American Geriatrics Society·Beth Han
Dec 18, 2001·International Journal of Geriatric Psychiatry·D A EspirituP A Lichtenberg

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