Diagnostic and therapeutic approaches to depression in geriatric patients – a literature review

Abstract

Introduction: Depression in older adults is a highly prevalent and complex disorder, significantly compromising quality of life. Diagnostic assessment is challenging due to symptom overlap with medical comorbidities, requiring validated screening tools and detailed clinical evaluation. Regarding interventions, a multifactorial approach is recommended, combining pharmacological and non-pharmacological strategies. Objective: To analyze diagnostic and therapeutic approaches in geriatric depression, aiming to improve quality of life and patient well-being. Methods: A literature review was conducted through systematic searches in PubMed, Web of Science, Scopus, and Google Scholar, considering publications from the last 15 years. Inclusion criteria covered studies in English, Portuguese, or Spanish that addressed diagnostic or therapeutic strategies for depression in older adults. Case reports, commentaries, and editorials were excluded. Results and Discussion: Depression in the elderly affects 7–10% of this population and is associated with chronic illness, social isolation, bereavement, and functional decline. Early diagnosis is essential but often underestimated due to somatic symptoms and comorbidities. Pharmacological options, particularly SSRIs and SNRIs, remain central, while non-pharmacological interventions such as psychotherapy, physical activity, and integrative therapies are effective. Novel strategies including community-based interventions and telepsychiatry have expanded care delivery in recent Years. Conclusion: Comprehensive management of geriatric depression requires an integrated diagnostic approach, multidisciplinary treatment, and health policies that improve access to mental health services. Promotion of positive mental health and preventive strategies are essential.