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Geriatric Psychiatry

Mental health care for older adults with attention to medical and cognitive complexity

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Psikiyatri department. Book Appointment →

What is Geriatric Psychiatry?

Geriatric psychiatry focuses on the assessment and treatment of mental disorders in adults over sixty-five. Late-life depression often presents with cognitive complaints, somatic symptoms, and reduced engagement rather than typical sadness; it carries higher suicide risk than depression at younger ages, and structured screening with the Geriatric Depression Scale (GDS) is recommended.

The differential is broader. Delirium, dementia, and depression can overlap and need careful separation; thyroid dysfunction, B12 and folate deficiency, sleep apnea, and medications such as steroids, beta-blockers, or anticholinergics may all mimic or worsen psychiatric symptoms. Pseudodementia from depression improves with treatment.

Treatment requires careful attention to drug interactions, falls, and cognition. Sertraline and citalopram (with QTc-aware dosing) are commonly preferred. Benzodiazepines and tricyclics are usually avoided. Psychotherapy (CBT, problem-solving therapy) and behavioral activation work well. Late-life psychosis or severe agitation in dementia is treated cautiously with low-dose atypical antipsychotics, accepting the boxed mortality warning.

Symptoms

Reduced interest, energy, or appetite
Cognitive complaints or slowed thinking
Sleep changes, especially early morning awakening
Withdrawal from family and activities
Suspiciousness, paranoia, or hallucinations
New behavioral changes in patients with dementia

Risk Factors

Recent loss of spouse or social network
Chronic pain or chronic medical illness
Polypharmacy (especially anticholinergics, benzodiazepines)
Mild cognitive impairment or early dementia
Hearing or vision loss

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • New depression or anxiety in an older adult
  • Sudden change in mental status (delirium)
  • Suicidal thoughts or expressions of hopelessness
  • New psychotic symptoms
  • Severe agitation in dementia

Treatment Methods

01
SSRIs (sertraline, citalopram) with cardiac and electrolyte monitoring
02
Avoid benzodiazepines, tricyclics, and high anticholinergic burden
03
Cognitive behavioral therapy and problem-solving therapy
04
Behavioral activation and social engagement
05
Comprehensive medication review at every visit
06
Treatment of contributing medical conditions
07
Multidisciplinary team including geriatrician and social worker

Which Department to Visit?

You can visit our Psikiyatri department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.