A nurse is teaching a wellness class about depression for a group of older adult clients. Which of the following information should the nurse include in the teaching?

A. Older adults often have multiple chronic medical conditions such as diabetes, cardiovascular disease, or chronic pain, and these comorbidities actually increase the risk of developing depression. Chronic illness can contribute to functional decline, social isolation, and decreased quality of life, all of which are known risk factors for depression in older adults. B. Older adults typically require lower starting doses of antidepressants due to age-related changes in metabolism, decreased renal and hepatic function, and increased sensitivity to medications. Treatment usually follows a “start low, go slow” approach to reduce the risk of adverse effects such as falls, confusion, and orthostatic hypotension. C. Depression in older adults can present with symptoms that closely mimic dementia or other neurocognitive disorders, such as memory impairment, decreased concentration, apathy, and slowed thinking. This presentation is sometimes referred to as “pseudodementia.” Because of this overlap, careful assessment is needed to differentiate between depression and true neurocognitive decline, as treatment approaches differ significantly. D. Electroconvulsive therapy (ECT) is not considered first-line treatment for depression in older adults. It may be used in severe cases, such as treatment-resistant depression, psychotic depression, or when there is a high risk of suicide or when rapid symptom relief is needed. First-line treatment typically includes psychotherapy and antidepressant medications, with careful monitoring in older adults.