[Diagnosis and management of depression in the elderly]. / Diagnostic et prise en charge de la dépression chez le sujet âgé.

Depression in the elderly is common, and associated with major functional impact, impaired quality of life and significant risk of suicide. Often undetected, it may also be insufficiently treated when diagnosed. Few therapeutic trials have specifically addressed depression in the elderly and guidelines for screening and management are most often based on expert opinion or extrapolation of data from younger patients. The objective of this article is to provide a synthesis of current knowledge on depression in the elderly and to recall, on the one hand, the importance of a targeted screening, and, on the other hand, the importance of a personalized management resulting from a global and multidisciplinary assessment.

Direct oral anticoagulants in non-valvular atrial fibrillation in elderly: for a treatment adapted to patient profile.

Atrial fibrillation is the most frequent rhythm disorder in elderly patients. Moreover, the risk of stroke and the bleeding risk under anticoagulant treatment are the highest in this population. Vitamin K antagonists were until now the reference treatment of the anticoagulant treatment and they demonstrated a net benefit, including in elderly patients. The availability of the new oral anticoagulants, which do not require biological monitoring, simplified the anticoagulant treatment. However, data for the use of these molecules in elderly population remain limited. The benefit-risk ratio must not be assessed for this therapeutic class taken as a whole but for each molecule and according to the patient profile.