Psychiatry and the oldest old.

Journal Article (Journal Article;Review)

OBJECTIVE: This article reviews the assessment and management of psychiatric problems among the oldest old. METHOD: The author reviewed the English-language literature pertinent to the characteristics of people 85 years old or older and the assessment and management of psychiatric disorders in this age group with a special focus on depression in the oldest old. RESULTS: Much of the current literature in geriatric psychiatry ignores the oldest old, focusing instead on the treatment of specific psychiatric disorders with unimodal or bimodal therapies. In contrast, geriatric medicine has focused on geriatric syndromes, functional status, comprehensive geriatric assessment, and multimodal intervention. The author describes an approach to treating the oldest old that incorporates depression as an example. This approach is based on the philosophy that has worked well in geriatric medicine but has been increasingly abandoned by psychiatry over recent years. CONCLUSIONS: Comprehensive, interdisciplinary assessment and therapy were the cornerstones of geriatric psychiatry 30 years ago. As psychiatry has moved toward a medical model and emphasized pharmacological therapies, it has moved away from the mainstream of geriatric practice. The time has come for geriatric psychiatry to rejoin geriatric medicine so that psychiatry can recapture its roots and deliver optimal care to the oldest old.

Full Text

Duke Authors

Cited Authors

  • Blazer, DG

Published Date

  • December 2000

Published In

Volume / Issue

  • 157 / 12

Start / End Page

  • 1915 - 1924

PubMed ID

  • 11097951

International Standard Serial Number (ISSN)

  • 0002-953X

Digital Object Identifier (DOI)

  • 10.1176/appi.ajp.157.12.1915


  • eng

Conference Location

  • United States