CHALLENGES AND STRATEGIES IN THE MANAGEMENT OF MAJOR DEPRESSIVE DISORDER IN THE ELDERLY: A SYSTEMATIC REVIEW OF COMORBIDITIES AND PHARMACOLOGICAL APPROACHES

Abstract

Objective: The general objective of this study is to compile and evaluate the scientific evidence on Major Depressive Disorder (MDD) in elderly individuals, highlighting the main clinical manifestations and management strategies of this comorbidity for greater clinical elucidation. Methodology: This is a systematic review guided by the question: "What are the main comorbidities associated with depression in geriatric patients, as well as the management used to treat the clinical practice?". The searches were performed in the PubMed Central (PMC) database using the descriptors: Depressive Disorder and Elderly, and Depressive Disorder and Health Care for the Elderly, combined with the Boolean term "AND". A total of 170 articles were identified, of which 13 met the inclusion criteria, resulting in the analysis of a total of relevant studies. Results: MDD in the elderly is a significant public health challenge, with a high prevalence of comorbidities, frailty, and the impact of neurocognitive dysfunctions. Screening tools, such as the Geriatric Depression Scale, are useful but have limitations in excluding somatic symptoms. Pharmacological treatment should be administered with caution due to polypharmacy and frequent drug interactions. Nonpharmacologic interventions, such as lifestyle modifications and reduced polypharmacy, can improve depressive symptoms and quality of life in older adults. Conclusion: An in-depth understanding of MDD in older adults is critical to improving clinical practices and patient outcomes, necessitating a holistic and ongoing approach. Future studies should prioritize specific therapeutic strategies that include a comprehensive assessment of the physical, mental, and functional health of this vulnerable population.