Improvement of functional abilities after treatment of depression in the elderly]

During one year all patients with a diagnosis of depression in accordance with ICD-10, referred to a psychogeriatric department, were assessed at admission and discharge with a number of rating scales: The Brief Geriatric Depression Scale, Katz' ADL-index, the Multidimensional Dementia Assessment Scale, the Mini-Mental State Examination and the Functional Ambulation Classification. The department has an active stepwise treatment strategy: SSRI (selective serotonin reuptake inhibitor), potentiation with mianserin, lithium potentiation, ECT. The 87 depressive patients had a median age of 79 and most had one or more severe somatic conditions. Fifty-nine were severely depressed at admission, 19 at discharge; the number of functionally disabled dropped from 22 to seven and the number of cognitively impaired from 35 to 19. In conclusion, a nihilistic approach to treatment in the very old is unfounded.