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  • Print publication year: 2018
  • Online publication date: September 2018

Chapter 11 - Mental Health Problems in Older People

from Section 2 - Clinical Issues



  • Royal College of General Practitioners Mental Health Toolkit (Mental Health in Older Adults)

  • Baldwin R, Anderson D, Black S, et al. (2003) Guideline for the management of late-life depression in primary care. International Journal of Geriatric Psychiatry, 18, 829–838. For those with access rights (e.g. some forms of Athens passwords) this can be downloaded in PDF format.

  • The Old Age Psychiatry Faculty of the Royal College of Psychiatrists has published guidance specifically for older people.


  • The National Institute for Health and Care Excellence in 2006 published extensive guidance for the management of dementia. It emphasizes person-centred care and the use of individual care plans, and makes evidence-based recommendations for the diagnosis and management of patients with dementia, including the role of care managers and the need for integrated health and social care:

  • The National Service Framework for Older People (2001) recommended specialist training for those working in primary care on the diagnosis and management of dementia. The Framework suggested that primary and secondary care should work together to draw up protocols and guidelines for the identification of appropriate referral pathways for patients, including the use of rating scales:

Age Concern England (2007) Improving Services and Support for Older People with Mental Health Problems. Second Report from the UK Inquiry into Mental Health and Wellbeing in Later Life. Age Concern England.
Alzheimer’s Society (2014b) Assessment and Diagnosis. Fact sheet 426LP. Downloadable from
Alzheimer’s Society (2016) Driving and Dementia. Fact sheet 439LP. Downloadable from
This reference should be Alzheimer’s Society (2015) What is mild cognitive impairment (MCI)? Fact sheet 470LP. Downloadable from
Alzheimer’s Society (2014a) Dementia UK: Update (Second Edition). Downloadable from
Baldwin, R, Anderson, D, Black, S, et al. (2003) Guideline for the management of late-life depression in primary care. International Journal of Geriatric Psychiatry, 18, 829838.
Barry, LC, Abou, JJ, Simen, AA, et al. (2012) Under-treatment of depression in older persons. Journal of Affective Disorders, 136, 789796.
Brodaty, H, Pond, D, Kemp, NM, et al. (2002) The GPCOG: a new screening test for dementia designed for general practice. Journal of the American Geriatric Society, 50, 530534.
Brooke, P, Bullock, R (1999) Validation of the 6 item Cognitive Impairment Test. International Journal of Geriatric Psychiatry, 14, 936940.
Chew-Graham, C, Baldwin, R, Burns, A (2008) The Integrated Management of Depression in the Elderly. Cambridge University Press.
Chew-Graham, CA, Lovell, K, Roberts, C, et al. (2007) A randomised controlled trial to test the feasibility of a collaborative care model for the management of depression in older people. British Journal of General Practice, 57, 364370.
Clayton, PJ (2004) Bereavement and depression. In Late-Life Depression (ed. Roose, RP, Sackeim, HA). Pp. 107114. Oxford University Press.
Copeland, JR, Beekman, AT, Dewey, AT, et al. (1999) Depression in Europe: geographical distribution among older people. British Journal of Psychiatry, 174, 312321.
Crausman, RS (2004) The four ‘I’s of delirium (letter). Journal of the American Geriatrics Society, 52, 645.
Cullen, B, O’Neill, B, Evans, JJ, et al. (2007) A review of screening tests for cognitive impairment. Journal of Neurology, Neurosurgery and Psychiatry, 78, 790799.
Department of Health (2000) The NHS Plan: A Plan for Investment, a Plan for Reform. The Stationery Office.
Department of Health (2004) The NHS Improvement Plan. Cm 6268. The Stationery Office.
Folstein, MF, Folstein, SE, McHugh, PR (1975) ‘Mini-Mental State’: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 185198.
Gatz, M, Fiske, A, Fox, LS, et al. (1998) Empirically validated psychological treatments for older adults. Journal of Mental Health and Aging, 4, 946.
Hodkinson, HM (1972) Evaluation of a mental test score for assessment of mental impairment in the elderly. Age and Ageing, 1, 233238.
Inouye, SK, van Dyck, CH, Alessi, CA, et al. (1990) Clarifying confusion: the confusion assessment method. A new method for detection of delirium. Annals of Internal Medicine, 113, 941948.
Katzman, R, Brown, T, Fuld, P, et al. (1983) Validation of a short Orientation–Memory Concentration Test of cognitive impairment. American Journal of Psychiatry, 140, 734739.
Mitchell, AJ, Subramaniam, H (2005) Prognosis of depression in old age compared to middle age: a systematic review of comparative studies. American Journal of Psychiatry, 162, 15881601.
National Institute for Health and Care Excellence (2006) Dementia: Supporting People with Dementia and Their Carers in Health and Social Care. NICE Clinical Guideline 42. NICE. Downloadable from
National Institute for Health and Care Excellence (2009) Depression in Adults: Recognition and Management. NICE Clinical Guideline CG90. NICE. Downloadable from
National Institute for Health and Care Excellence (2011) Donepezil, Galantamine, Rivastigmine and Memantine for the Treatment of Alzheimer’s Disease. NICE technology appraisal guidance (TA217). Downloadable from
Petersen, RC, Knopman, DS, Boeve, BF, et al. (2009) Mild cognitive impairment: ten years later. Archives of Neurology, 66, 14471455.
Pinquart, M, Sorensen, S (2001) How effective are psychotherapeutic and other psychosocial interventions with older adults? A meta-analysis. Journal of Mental Health and Aging, 7, 207243.
Reynolds, CF III, Miller, MD, Pasternak, RE, et al. (1999a) Treatment of bereavement-related major depressive episodes in later life: a controlled study of acute and continuation treatment with nortriptyline and interpersonal psychotherapy. American Journal of Psychiatry, 156, 202208.
Reynolds III, CF, Frank, E, Perel, JM, et al. (1999b) Nortriptyline and interpersonal psychotherapy as maintenance therapies for recurrent major depression: a randomized controlled trial in patients older than 59 years. JAMA, 281, 3945.
Shulman, KI (2000) Clock-drawing: is it the ideal cognitive screening test? International Journal of Geriatric Psychiatry, 15, 548561.
Taylor, WD (2014) Clinical practice: depression in the elderly New England Journal of Medicine, 43, 4, 411431.
Unützer, J, Katon, W, Callahan, CM, et al. (2002) Collaborative care management of late-life depression in the primary care setting: a randomized controlled trial. JAMA, 288, 28362845.
World Health Organization (1992) International Classification of Diseases (10th revision) (ICD–10). World Health Organization.