This Publication Is Searchable The Merck Manual of Diagnosis and Therapy Section 21. Special Subjects Chapter 293. Depression is the most common affective disorder in the elderly but is no more common than in younger persons. Depression is more common in institutionalized elderly.
Thyrotoxicosis is uncommon in the elderly.
One explanation of the lack of classic findings in the elderly is that their diminished physiologic reserve is depleted quickly by hypermetabolic stress. Symptoms and signs referable to one organ system, most often the heart, dominate the clinical picture. Heart failure poorly responsive to digitalis, atrial fibrillation with slow ventricular response, other fixed or paroxysmal arrhythmias, cardiomegaly, and palpitations are common. GI involvement can include constipation, weight loss with anorexia, and hepatomegaly. Ca turnover is reflected by elevated serum Ca, bone pain, osteoporosis, and frequent fracture.