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13. CGA in Primary Care Settings: Patients presenting with depression | British Geriatrics Society
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CGA in Primary Care Settings: Patients presenting with depression </div> </h1> <span property="dc:title" content="13. CGA in Primary Care Settings: Patients presenting with depression" class="rdf-meta element-hidden"></span><span property="sioc:num_replies" content="0" datatype="xsd:integer" class="rdf-meta element-hidden"></span> <div class="resource-header-details"> <div class="card-resource-type-i"> <div class="card-resource-type"> Good practice guide </div> <div class="resource-type-i-icon">i</div> <div class="resource-type-info-arrow"></div> </div> <div class="resource-type-info"><div class="resource-type-info-text">Good practices guides focus on providing information on a clinical topic.</div></div> </div> <div class="node-header-details"> <div class="card-authors-wrapper"><div class="label">Authors:</div><div class="author-details">British Geriatrics Society</div></div> <div class="card-topics-wrapper"><div class="label">Topics:</div><a href="/taxonomy/term/2935">Comprehensive Geriatric Assessment (CGA) in community settings</a>, <a href="/taxonomy/term/907">Mental Health</a></div> <div class="node-header-dates"> <div class="card-date-wrapper"><div class="label">Date Published:</div><div class="card-date"> <span class="date-display-single" property="dc:date" datatype="xsd:dateTime" content="2019-01-29T00:00:00+00:00">29 January 2019</span> </div> </div> <div class="card-date-updated"> <div class="label">Last updated: </div> <span class="date-display-single" property="dc:date" datatype="xsd:dateTime" content="2019-01-29T00:06:00+00:00">29 January 2019</span> </div> </div> </div> </div> <div class="view view-sections view-id-sections view-display-id-main view-dom-id-a60cd55aba4d7f96c900635d45ef1c1a"> <div class="view-content view-content-main"> <div class="views-row views-row-1 views-row-odd views-row-first views-row-last section-row palette-default "> <div class="section-inner"> <div class="card-body"> <p>Treatment for depression, as with any co-existing physical health problems, should be optimised. General advice should include good sleep hygiene, maintaining physical activity and limiting alcohol intake. </p> <ul> <li>For mild or subthreshold symptoms, psychosocial interventions such as increasing social contact and physical exercise may be sufficient. Medication should not be offered as a first-line treatment but reserved for those who do not respond to initial measures.</li> <li>When drug treatment is required, selective serotonin re-uptake inhibitor (SSRI) should be the first-line therapy. SSRIs may cause hyponatraemia, postural hypotension, and increase the risk of gastrointestinal bleeding.</li> <li>Tricyclic antidepressants have anti-cholinergic side effects and should be avoided in older people.</li> <li>Psychological therapies are effective in older people, and in combination with drug treatment are more effective than either therapy alone.</li> <li>Those with moderate to severe symptoms are likely to require referral for specialist support.</li> <li>People who have responded to medication should continue for at least six months after recovery to reduce the risk of relapse.</li> </ul> <h6>Further information</h6> <p>Treating depression in adults generally: <a href="https://www.nice.org.uk/guidance/cg90" rel="nofollow">NICE CG 90</a>.</p> <p>Treating depression in adults with long term health issues: <a href="https://www.nice.org.uk/guidance/cg91" rel="nofollow">CG91</a>; See also an online learning module based around CG91: <a href="http://learning.bmj.com/learning/module-intro/.html?moduleId=10014085&locale=en_GB" rel="nofollow">BMJ Learning</a>.</p> <p>Depression in older people: BMJ 2011: 343:d5219.</p> </div> <div class="card-view-4"> <div class="view view-attachment view-id-attachment view-display-id-main view-dom-id-ac2af88524aafcb74906ff004cb6bdb3"> </div> </div> </div> </div> </div> </div> </article> </div> <div class="content-additional"> <div id="block-webform-client-block-227" class="block block-webform"> <h2 class="resource-feedback-toggle">Feedback on this resource?</h2> <div class="content"> <div id="webform-ajax-wrapper-227"><form class="webform-client-form webform-client-form-227" action="/resources/13-cga-in-primary-care-settings-patients-presenting-with-depression" method="post" id="webform-client-form-227" accept-charset="UTF-8"><div><div class="webform-email form-item webform-component webform-component-email webform-component--email webform-container-inline"> <label 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href="https://www.bgs.org.uk/sites/default/files/content/resources/files/2019-03-12/CGA%20Toolkit%20for%20Primary%20Care%20Practitioners_0.pdf"> <div class="file-icon file-type-pdf"><div class="file-name">CGA Toolkit for Primary Care Practitioners.pdf</div><div class="file-details"><div class="file-extension">pdf</div><div class="file-size">814.5 KB</div></div></div> </a></span> </div> </div> </div> </div></span> </div> </div> </div> </div> </div> </section> <section class="block block-views"> <div class="view view-sections view-id-sections view-display-id-sidebar view-dom-id-121ac9a43d25e8c3755f1744873234b1"> <div class="view-content view-content-main"> <div class="views-row views-row-1 views-row-odd views-row-first side-row "> <div class="section-inner"> <div class="card-title"> <h2 class="field-content">Section 1: CGA in Primary Care</h2> </div> <div class="side-row-wrapper"> <div class="card-body"> <p><a href="/resources/1-cga-in-primary-care-settings-introduction">Introduction</a><br /> <a href="/resources/2-cga-in-primary-care-settings-the-elements-of-the-cga-process">The elements of CGA</a>:<br /> - <a href="/resources/3-cga-in-primary-care-settings-physical-assessment">Physical assessment</a><br /> - <a href="/resources/4-cga-in-primary-care-settings-functional-and-social-assessment">Functional, social and environmental assessment</a><br /> - <a href="/resources/5-cga-in-primary-care-settings-psychological-components">Psychological components</a><br /> - <a href="/resources/6-cga-in-primary-care-settings-medication-review">Medication review</a><br /> - <a href="/resources/7-cga-in-primary-care-settings-creating-a-problem-list">Creating a problem list</a><br /> <a href="/resources/8-cga-in-primary-care-settings-care-and-support-planning">Care and support planning</a><br /> <a href="/resources/9-cga-in-primary-care-settings-involving-social-services">Involving Social Services</a></p> 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href="/resources/16-cga-in-primary-care-settings-patients-presenting-with-urinary-incontinence">Urinary incontinence</a><br /> <a href="/resources/17-cga-in-primary-care-settings-weight-loss-and-nutrition-issues">Weight loss and nutrition</a><br /> <a href="/resources/18-cga-in-primary-care-settings-end-of-life-care-issues">End of life care</a></p> </div> </div> </div> </div> </div> </div> </section> </div> </aside> </div> </main> <section class="postscript-first"> <div class="postscript_first"> <section class="block block-views postscript-section-row-block"> <h2 class="block-title">Other resources in this series</h2> <div class="view view-resource-series view-id-resource_series view-display-id-block section-row row-max-4 view-card-default-palette view-dom-id-fc1c1fa1430834802eb95f30bb66d559"> <div class="view-content view-content-main"> <div class="views-row views-row-1 views-row-odd views-row-first"> <a class="card resource-card" href="/cgatoolkit"><div class="card-text"><div class="card-content"> <div class="card-title"> <h3>1. CGA in Primary Care Settings: Introduction</h3> </div> <div class="card-date-display-override"> <span class="date-display-single" property="dc:date" datatype="xsd:dateTime" content="2019-01-28T00:00:00+00:00">28 Jan 2019</span> </div> <div class="card-summary"> <div class="card-summary-wrapper"> <div class="card-summary"> An introduction to CGA in primary care settings. This toolkit was developed by the British Geriatrics Society and has been endorsed by the ANCD for Older People and Integrated Person-Centred Care and by the Council of British Geriatrics Society, Scotland. </div> </div> </div> </div><div class="card-footer"> <div class="card-resource-series"> In a series </div> <div class="card-resource-type"> Good practice guide </div> </div></div></a> </div> <div class="views-row views-row-2 views-row-even"> <a class="card resource-card" href="/resources/2-cga-in-primary-care-settings-the-elements-of-the-cga-process"><div class="card-text"><div class="card-content"> <div class="card-title"> <h3>2. CGA in Primary Care Settings: The elements of the CGA process</h3> </div> <div class="card-date-display-override"> <span class="date-display-single" property="dc:date" datatype="xsd:dateTime" content="2019-01-28T00:00:00+00:00">28 Jan 2019</span> </div> <div class="card-summary"> <div class="card-summary-wrapper"> <div class="card-summary"> An overview of how Comprehensive Geriatric Assessment (CGA) is done in the primary care setting, and what to consider when conducting the assessment. </div> </div> </div> </div><div class="card-footer"> <div class="card-resource-series"> In a series </div> <div class="card-resource-type"> Good practice guide </div> </div></div></a> </div> <div class="views-row views-row-3 views-row-odd"> <a class="card resource-card" href="/resources/3-cga-in-primary-care-settings-physical-assessment"><div class="card-text"><div class="card-content"> <div class="card-title"> <h3>3. CGA in Primary Care Settings: Physical Assessment </h3> </div> <div class="card-date-display-override"> <span class="date-display-single" property="dc:date" datatype="xsd:dateTime" content="2019-01-28T00:00:00+00:00">28 Jan 2019</span> </div> <div class="card-summary"> <div class="card-summary-wrapper"> <div class="card-summary"> Examination of older patients incorporates all the typical aspects of clinical examination, although there are some general considerations and emphases that should be borne in mind, and specific examinations that may be more relevant in older people. </div> </div> </div> </div><div class="card-footer"> <div class="card-resource-series"> In a series </div> <div class="card-resource-type"> Good practice guide </div> </div></div></a> </div> <div class="views-row views-row-4 views-row-even views-row-last"> <a class="card resource-card" href="/resources/4-cga-in-primary-care-settings-functional-and-social-assessment"><div class="card-text"><div class="card-content"> <div class="card-title"> <h3>4. CGA in Primary Care Settings: Functional and social assessment</h3> </div> <div class="card-date-display-override"> <span class="date-display-single" property="dc:date" datatype="xsd:dateTime" content="2019-01-28T00:00:00+00:00">28 Jan 2019</span> </div> <div class="card-summary"> <div class="card-summary-wrapper"> <div class="card-summary"> Functional assessment examines factors like mobility and daily living activities, and social assessment looks at social circumstances. Asking what the older person does and what environment they live in adds context to any Comprehensive Geriatric Assessment. </div> </div> </div> </div><div class="card-footer"> <div class="card-resource-series"> In a series </div> <div class="card-resource-type"> Good practice guide </div> </div></div></a> </div> </div> <div class="view-footer"> <div class="card-feed-link"><a href="/resources/resource-series/comprehensive-geriatric-assessment-toolkit-for-primary-care-practitioners">See all resources in this series</a></div> </div> </div> </section> </div> </section> <footer id="site-footer" role="contentinfo"> <section class="footer-first"> <div class="outer-wrapper"> <section class="block block-views"> <div class="view view-footer-sections view-id-footer_sections view-display-id-orgs view-display-grid view-dom-id-95a0291697a853a261f8bbe5604f540b"> <div class="view-header"> <script> if(jQuery('#Main.CRM_Contribute_Form_Contribution_Main').length > 0){ jQuery('#Main.CRM_Contribute_Form_Contribution_Main').on('submit',function(e){ setTimeout(function(){ e.preventDefault(); let firstInvalidElement = jQuery('label.crm-inline-error:visible:first'); if(firstInvalidElement){ let fid=firstInvalidElement.attr('for'); let originalDisplay = jQuery('#'+fid).css('display'); jQuery('#'+fid).css('display', 'block'); jQuery('#'+fid).focus(); jQuery('#'+fid).css('display', originalDisplay); } },100) }); } </script> </div> <div class="view-content view-content-main"> <div class="views-row views-row-1 views-row-odd views-row-first section-row palette-default "> <div class="card-title"> <h2 class="field-content">Contact us</h2> </div> <div class="card-body"> <h6>British Geriatrics Society</h6> <p>Marjory Warren House<br /> 31 St John’s Square<br /> London EC1M 4DN</p> <p><a class="arrow" href="/about/contact">Visit us</a></p> <p><strong>Tel:</strong> +44 (0)20 7608 1369</p> <p><a href="/about/contact">Email us</a></p> <p class="smaller-text">Charity No 268762<br /> Company No 1189776 (England and Wales)</p> </div> </div> <div class="views-row views-row-2 views-row-even section-row palette-default "> <div class="card-title"> <h2 class="field-content">Quick links</h2> </div> <div class="card-body"> <p><a href="/media-enquiries">Media enquiries</a></p> <p><a href="/AGENDA">AGENDA</a></p> <p><a href="/about/what-we-do/age-and-ageing"><em>Age and Ageing</em> Journal</a></p> <p><a href="/about/make-a-donation">Donate</a></p> <p><a href="/blog">Our blog</a></p> <p><a href="/about/what-we-do/research-opportunities-and-cpd">BGS Grants</a></p> <p><a href="/about/bgs-vacancies">Jobs/Vacancies</a></p> </div> </div> <div class="views-row views-row-3 views-row-odd section-row "> <div class="card-title"> <h2 class="field-content">Follow us</h2> </div> <div class="card-follow-us-on"> <div class="item-list"><ul><li class="first"><div class='card-links'><a href="https://facebook.com/BGS1947" rel="nofollow" target="_blank">Facebook</a> </div></li> <li><div class='card-links'><a href="https://twitter.com/GeriSoc" rel="nofollow" target="_blank">Twitter</a> </div></li> <li class="last"><div class='card-links'><a href="http://linkedin.com/company/british-geriatrics-society" rel="nofollow" target="_blank">LinkedIn</a> </div></li> </ul></div> </div> </div> <div class="views-row views-row-4 views-row-even views-row-last section-row palette-default "> <div class="card-title"> <h2 class="field-content">Sign up for our e-bulletin</h2> </div> <div class="card-body"> <a href="/user/register" class="button">Sign up</a> <style> .webform-container-inline.webform-datepicker div, .webform-container-inline.webform-datepicker input { display: inline-block !important; margin-top: 1em; } select { padding-right: 39px; background-size: 29px; } #multiple_block > input { display: inline-block; } </style> </div> </div> </div> </div> </section> </div> </section> <section class="footer-third"> <div class="outer-wrapper"> <section class="block block-menu"> <ul class="menu"><li class="first leaf"><a href="/terms-of-use">Website Terms of use</a></li> <li class="leaf"><a href="/privacy-statement">Privacy Statement</a></li> <li class="leaf"><a href="/membership-terms-and-conditions" title="ToC governing membership of the BGS">Membership Terms and Conditions</a></li> <li class="last leaf"><a href="/event-booking-terms-and-conditions" title="">Event Booking Terms and Conditions</a></li> </ul> </section> <div id="manta-ray-media">Built by <a href="http://www.mantaraymedia.co.uk/" target="_blank">Manta Ray Media</a></div> </div> </section> </footer> </div> <!-- Root element of PhotoSwipe. 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