The relationship between social integration and depression in non-demented primary care attenders aged 75 years and older

[Depression in old age: challenge for aging societies]

Depression in old age is common and has severe consequences. The paper reviews the most recent results of population-based and primary care-based studies reporting the prevalence, course and risk factors for depression in old age. Consequences of late life depression for the individual and for the society in terms of costs of illness are outlined. Studies of health service utilization and costs showed homogeneously that healthcare costs for depressive elderly individuals are one third higher compared to non-depressive individuals even though most do not receive depression-specific treatment. Late life depression is underrecognized and undertreated and data from Germany are rare. Improvement strategies, such as collaborative care models are discussed; however, adaptation and implementation to the German context are still pending. Future demographic changes will facilitate mental health service research into late life depression.

[Sexuality of the elderly: a survey and management]

OBJECTIVE

To evaluate sexuality in elderly couples and have the knowledge of its specific therapeutic options.

MATERIAL AND METHODS

Review of articles published on this subject in the Medline database, selected according to their scientific relevance together with a reflexion from our own experience.

RESULTS

Due to increased life expectancy and the changes in society leading to a life with more than one consecutive partner, couples expect to continue sexual activity after the age of 65. Clinicians are asked to address this issue frequently. With age the frequency of genital sexual relations decreases. Sexual activity should be higher both for males and females. The quality of the relationship of the couple is a key element in maintaining sexual relations in this age group. Sexual satisfaction depends on the understanding, by both partners, of the physical and psychological changes due to increased age.

CONCLUSION

The sexuality of the elderly couple must be analysed using specific criteria. The clinician's task is to explain to the patients the physiological change due to aging and give them advice on how to adapt their sexual behavior accordingly. Management will, at the same time, include pharmacological treatment, notably for erectile dysfunction, in order to restore satisfactory sexual relations. For women, vaginal lubrication products are essential. This global management should allow many elderly couples wishing to continue sexual relations, to enjoy this period of their lives in harmony with what they desire.