Depression in Older Adults: Clinical Implications and Current Lines of Intervention in Professional Counseling
Keywords:
Geriatric Depression, Healthy Aging, Professional Counseling, Collaborative Care, Mental HealthAbstract
Major depression in older adults is one of the mental disorders with the greatest impact on the
global burden of disease, functional impairment, and premature mortality, representing a
priority challenge for health systems (Beekman, Penninx, & Deeg, 2019; World Health
Organization, 2023). Its diagnostic complexity is increased by its frequent coexistence with
medical multimorbidity and cognitive impairment, conditions that can mask or modify the
clinical expression of the disorder (Taylor, 2014). The purpose of this study was to critically
analyze recent international and Latin American scientific evidence on geriatric depression,
identifying etiological foundations, therapeutic trends, and current lines of intervention
relevant to professional counseling. An integrative narrative review was conducted with a
systematic search in PubMed, Scopus, and Web of Science between 2015 and 2025. Of 214
initial records, after screening and applying inclusion criteria (meta-analyses, systematic
reviews, randomized controlled trials, and relevant Latin American studies), 78 articles were
integrated for qualitative analysis. The evidence confirmed a complex biopsychosocial
etiology. At the biological level, vascular and inflammatory mechanisms associated with
alterations in fronto-subcortical circuits stand out (Alexopoulos, 2019). In the psychosocial
sphere, loneliness and social isolation show consistent associations with higher risk and
poorer prognosis (Holt-Lunstad, Smith, & Baker, 2015). The most widely supported
interventions include cognitive behavioral therapy, behavioral activation, and collaborative
care models in primary care (Cuijpers et al., 2020; Unützer et al., 2002). It is concluded that
the culturally adapted implementation of integrated models can contribute to reducing the
therapeutic gap in Latin America. As a contribution, an integrative model applicable in
primary care and professional counseling is proposed, aimed at timely detection and
evidence-based interventions that promote healthy aging.
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