In the older adult population, it is important to rule out any medications or medical conditions that may be the underlying cause of depression, especially if the patient does not have a history of this disorder.  You should now request further laboratory tests to help determine the cause of Mrs Wood’s condition.

Blood Screening

Blood tests are often used in investigation of depressive symptoms, primarily to exclude other possible causes of a cognitive disorder. These include active infection (white cell count), hyperthyroidism, hypothyroidism, B12 deficiency, renal and liver disease. It is also useful to record folate, glucose, calcium and cholesterol levels. Review Mrs Wood's blood test results by clicking on the image below and review results before proceeding.

Cranial Imaging

It is important that an underlying brain pathology is not contributing to Mrs Wood being so depressed. In particular subclinical vascular disease can contribute to cognitive slowing (although there is no risk factor history to suggest this in Mrs Woods case).  A CT scan or MRI scan can also rule out intracranial bleeding and malignancies that may be impacting on her mood. Click on the image below to review Mrs Wood's CT scan.