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Geriatric Psychiatry Review: Differential Diagnosis and Treatment of the 3 D’s - Delirium, Dementia, and Depression

  • Geriatric Disorders (H Lavretsky, Section Editor)
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Abstract

The three D’s of Geriatric Psychiatry—delirium, dementia, and depression—represent some of the most common and challenging diagnoses for older adults. Delirium is often difficult to diagnose and treatment is sometimes controversial with the use of antipsychotic medications, but it is common in a variety of patient care settings and remains an independent risk factor for morbidity and mortality in older adults. Dementia may affect a significant number of older adults and is associated with delirium, depression, frailty, and failure to thrive. Treatment of dementia is challenging and while medication interventions are common, environmental and problem solving therapies may have some of the greatest benefits. Finally, depression increases with age and is more likely to present with somatic complaints or insomnia and is more likely to be reported to a primary care physician than any other healthcare provider by older adults. Depression carries an increased risk for suicide in older adults and proven therapies should be initiated immediately. These three syndromes have great overlap, can exist simultaneously in the same patient, and often confer increased risk for each other. The primary care provider will undoubtedly benefit from a solid foundation in the identification, classification, and treatment of these common problems of older adulthood.

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Conflict of Interest

Lisa J. Downing declares that she has no conflict of interest.

Thomas V. Caprio declares that he has no conflict of interest.

Jeffrey M. Lyness declares that he has no conflict of interest.

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Authors and Affiliations

  1. Department of Medicine, Division of Geriatrics and Aging, University of Rochester School of Medicine and Dentistry, Monroe Community Hospital, 435 East Henrietta Road, Rochester, NY, 14620, USA

    Lisa J. Downing & Thomas V. Caprio

  2. Department of Psychiatry, University of Rochester School of Medicine and Dentistry, 601 Elmwood Ave, Box 706, Rochester, NY, 14642, USA

    Jeffrey M. Lyness

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  1. Lisa J. Downing
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  2. Thomas V. Caprio
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  3. Jeffrey M. Lyness
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Correspondence to Thomas V. Caprio.

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This article is part of the Topical Collection on Geriatric Disorders

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Downing, L.J., Caprio, T.V. & Lyness, J.M. Geriatric Psychiatry Review: Differential Diagnosis and Treatment of the 3 D’s - Delirium, Dementia, and Depression. Curr Psychiatry Rep 15, 365 (2013). https://doi.org/10.1007/s11920-013-0365-4

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