The Natural History of Late-Life Depression

BackgroundDeterminants for undetected dementia and late-life depression have been not well studied.AimsTo investigate risk factors for undetected dementia and depression in older communities.MethodUsing the method of the 10/66 algorithm, we interviewed a random sample of 7072 participants aged ⩽60 years in six provinces of China during 2007–2011. We documented doctor-diagnosed dementia and depression in the interview. Using the validated 10/66 algorithm we diagnosed dementia (n= 359) and depression (n= 328).ResultsWe found that 93.1% of dementia and 92.5% of depression was undetected. Both undetected dementia and depression were significantly associated with low levels of education and occupation, and living in a rural area. The risk of undetected dementia was also associated with ‘help available when needed‘, and inversely, with a family history of mental illness and having functional impairment. Undetected depression was significantly related to female gender, low income, having more children and inversely with having heart disease.ConclusionsOlder adults in China have high levels of undetected dementia and depression. General socioeconomic improvement, associated with mental health education, targeting high-risk populations are likely to increase detection of dementia and depression in older adults, providing a backdrop for culturally acceptable service development.

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Relationship between progression of brain white matter changes and late-life depression: 3-year results from the LADIS study

The British Journal of Psychiatry ◽

10.1192/bjp.bp.111.098897 ◽

2012 ◽

Vol 201 (1) ◽

pp. 40-45 ◽

Cited By ~ 53

Author(s):

Michael J. Firbank ◽

Andrew Teodorczuk ◽

Wiesje M. Van Der Flier ◽

Alida A. Gouw ◽

Anders Wallin ◽

...

Keyword(s):

White Matter ◽

Depression Scale ◽

Late Life ◽

The Elderly ◽

Late Life Depression ◽

White Matter Changes ◽

Brain White Matter ◽

History Of ◽

Depressive Episodes ◽

History Of Depression

BackgroundBrain white matter changes (WMC) and depressive symptoms are linked, but the directionality of this association remains unclear.AimsTo investigate the relationship between baseline and incident depression and progression of white matter changes.MethodIn a longitudinal multicentre pan-European study (Leukoaraiosis and Disability in the elderly, LADIS), participants aged over 64 underwent baseline magnetic resonance imaging (MRI) and clinical assessments. Repeat scans were obtained at 3 years. Depressive outcomes were assessed in terms of depressive episodes and the Geriatric Depression Scale (GDS). Progression of WMC was measured using the modified Rotterdam Progression scale.ResultsProgression of WMC was significantly associated with incident depression during year 3 of the study (P = 0.002) and remained significant after controlling for transition to disability, baseline WMC and baseline history of depression. There was no significant association between progression of WMC and GDS score, and no significant relationship between progression of WMC and history of depression at baseline.ConclusionsOur results support the vascular depression hypothesis and implicate WMC as causal in the pathogenesis of late-life depression.

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Late-Life Depressive Disorder in the Community

The British Journal of Psychiatry ◽

10.1192/bjp.166.3.316 ◽

1995 ◽

Vol 166 (3) ◽

pp. 316-319 ◽

Cited By ~ 18

Author(s):

Rob Van Ojen ◽

Chris Hooijer ◽

Dick Bezemer ◽

Cees Jonker ◽

Jaap Lindeboom ◽

...

Keyword(s):

Cognitive Impairment ◽

Family History ◽

Psychiatric Illness ◽

Mental Health Problems ◽

Down's Syndrome ◽

Down’S Syndrome ◽

Late Life ◽

Late Life Depression ◽

Stratified Sample ◽

History Of

BackgroundIn previous studies, dementia was linked to a family history of dementia and Down's syndrome. This study tested the hypothesis that late-life depression accompanied by cognitive impairment in elderly individuals with no history of psychiatric illness is also associated with these family histories.MethodWe investigated an age-stratified sample of 4051 elderly people in the community aged 65–84 (AMSTEL). The relationship between family history (CAMDEX questionnaire) and depression (GMS-AGECAT diagnosis) was studied.ResultsA family history of mental health problems was associated with all subtypes of depression. Family history of dementia was associated with depression in subjects with a psychiatric history, but a family history of Down's syndrome was only associated with the combination of depression and cognitive impairment in subjects with no history of psychiatric illness.ConclusionsThe heritability pattern confirms the concept of a dementia-related subtype of late-life depression.

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11β-Hydroxylase (CYP11B1) gene variants and new-onset depression in later life

Journal of Psychiatry and Neuroscience ◽

10.1503/jpn.190177 ◽

2020 ◽

Vol 46 (1) ◽

pp. E147-E153

Author(s):

Marie-Laure Ancelin ◽

Joanna Norton ◽

Karen Ritchie ◽

Isabelle Chaudieu ◽

Joanne Ryan

Keyword(s):

Major Depression ◽

Major Gene ◽

Depression Scale ◽

Late Life ◽

Later Life ◽

Cumulative Exposure ◽

Late Life Depression ◽

Recurrent Depression ◽

History Of ◽

New Onset

Background: Cumulative exposure to high glucocorticoid levels is detrimental for the brain and may have particular implications in later life. A feature of late-life depression is increased cortisol secretion. Variants in the CYP11B1 gene, which codes for the enzyme responsible for cortisol synthesis, could influence risk of late-life depression, but this hypothesis has not been examined. We investigated the associations between variants in the CYP11B1 gene and late-life depression, taking into account history of depression and potential sexspecific effects. Methods: We assessed depression in 1007 community-dwellers aged 65 years or older (60% women) at baseline and over a 14-year follow-up. A clinical level of depression was defined as a score of ≥ 16 on the Centre for Epidemiology Studies Depression scale or a diagnosis of current major depression based on the Mini-International Neuropsychiatric Interview and according to the criteria of the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV). We examined incident and recurrent depression in participants without or with a history of major depression, respectively. We genotyped 5 single-nucleotide polymorphisms (SNPs) spanning CYP11B1. We used multivariable analyses to adjust for age, body mass index, cardiovascular ischemic pathologies, hypertension, cognitive impairment and anxiety. Results: In women, rs6471580 and rs7016924 were associated with a 50% lower rate of incident (new-onset) late-life depression, and rs11783855 was associated with a 2.4-fold higher rate of late-life depression. These associations remained after correction for multiple testing, but we found no associations for recurrent depression in women or men. Limitations: This study focused on the major gene involved in corticosteroid biosynthesis, but other genes may also be implicated in this pathway. Conclusion: Variants of the CYP11B1 gene appear to be susceptibility factors for late-life depression in a sex-specific manner.

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The Natural History of Psychiatric Disorders: Early-onset Disease in Late Life and Late-onset Illness

Principles and Practice of Geriatric Psychiatry ◽

10.1002/0470846410.ch18 ◽

2003 ◽

pp. 99-102

Author(s):

Judith Hays

Keyword(s):

Natural History ◽

Psychiatric Disorders ◽

Early Onset ◽

Late Onset ◽

Late Life ◽

History Of

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Twelve-Year History of Late-Life Depression and Subsequent Feelings to God

American Journal of Geriatric Psychiatry ◽

10.1016/j.jagp.2013.04.016 ◽

2014 ◽

Vol 22 (11) ◽

pp. 1272-1281 ◽

Cited By ~ 13

Author(s):

Arjan W. Braam ◽

Hanneke Schaap-Jonker ◽

Marleen H.L. van der Horst ◽

Bas Steunenberg ◽

Aartjan T.F. Beekman ◽

...

Keyword(s):

Late Life ◽

Late Life Depression ◽

History Of

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Association of Serotonin Genes with History of Suicide Attempt in Late Life Depression

American Journal of Geriatric Psychiatry ◽

10.1016/j.jagp.2017.01.135 ◽

2017 ◽

Vol 25 (3) ◽

pp. S116 ◽

Cited By ~ 1

Author(s):

Ali Bani Fatemi ◽

Vincenzo de Luca ◽

James Kennedy ◽

Benoit H. Mulsant ◽

Eric Lenze ◽

...

Keyword(s):

Suicide Attempt ◽

Late Life ◽

Late Life Depression ◽

History Of

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White matter integrity and late-life depression in community-dwelling individuals: diffusion tensor imaging study using tract-based spatial statistics

The British Journal of Psychiatry ◽

10.1192/bjp.bp.113.142109 ◽

2014 ◽

Vol 205 (4) ◽

pp. 315-320 ◽

Cited By ~ 28

Author(s):

Simone Reppermund ◽

Lin Zhuang ◽

Wei Wen ◽

Melissa J. Slavin ◽

Julian N. Trollor ◽

...

Keyword(s):

Depressive Symptoms ◽

White Matter ◽

Spatial Statistics ◽

Late Life ◽

White Matter Integrity ◽

Late Life Depression ◽

White Matter Changes ◽

History Of ◽

Tract Based Spatial Statistics ◽

History Of Depression

BackgroundLate-life depression has been associated with white matter changes in studies using the regions of interest approach.AimsTo investigate the cross-sectional and longitudinal relationship between white matter integrity and depression in community-dwelling individuals using diffusion tensor imaging with tract-based spatial statistics.MethodThe sample comprised 381 participants aged between 72 and 92 years who were assessed twice within 2 years. Depressive symptoms were measured with the Geriatric Depression Scale. Tract-based spatial statistics were applied to investigate white matter integrity in currently depressed v. non-depressed elderly people and in those with a history of depression v. no history of depression. The relationship between white matter integrity and development of depressive symptoms after 2 years were analysed with logistic regression.ResultsIndividuals with current depression had widespread white matter integrity reduction compared with non-depressed elderly people. Significant fractional anisotropy reductions were found in 45 brain areas with the most notable findings in the frontal lobe, association and projection fibres. A history of depression was not associated with reduced fractional anisotropy. White matter changes in the superior frontal gyrus, posterior thalamic radiation, superior longitudinal fasciculus and in the body of corpus callosum predicted depression at follow-up.ConclusionsReduced white matter integrity is associated with late-life depression and predicts future depressive symptoms whereas a history of depression is not related to white matter changes. Disruption to white matter integrity may be a biomarker to predict late-life depression.

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