Late-life depression

2017 ◽  
Author(s):  
Fabian Fußer ◽  
Tarik Karakaya ◽  
Johannes Pantel
Keyword(s):  
Cognitive Impairment ◽  
Significant Proportion ◽  
Antidepressant Drugs ◽  
Late Life ◽  
The Elderly ◽  
Behavioural Therapy ◽  
Late Life Depression ◽  
Diagnostic Challenge ◽  
Primary Care Settings ◽  
Core Symptoms

Depression is one of the most prevalent mental diseases in late life, and is a tremendous burden on patients, their families and carers, and the healthcare system. Late-life depression (LLD) often affects people with chronic somatic illnesses, cognitive impairment, and disability. In the elderly, core symptoms of depression are much less pronounced. Instead, unspecific somatic complaints and cognitive impairment may dominate the clinical presentation, and a significant proportion of individuals with LLD goes undiagnosed. This may lead to increased mortality rates, in part attributed to the deleterious consequences of LLD on comorbid somatic illnesses or increased suicide rates. In order to improve prognosis, general practitioners in primary care settings have a prominent but challenging role in recognizing LLD. The diagnostic challenge also includes the differential diagnosis between depression, dementia, and delirium. The optimal management of LLD may include antidepressant drugs, non-pharmacological interventions such as psychotherapy (e.g. cognitive-behavioural therapy), as well as physical exercise.

Depression and mild cognitive impairment – Comorbidity and/or continuum?

2016 ◽  
Vol 33 (S1) ◽  
pp. S190-S191
Author(s):  
G. Sobreira ◽  
M.A. Aleixo ◽  
C. Moreia ◽  
J. Oliveira
Keyword(s):  
Risk Factors ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Decline ◽  
Late Life ◽  
The Elderly ◽  
Late Life Depression ◽  
Pubmed Database ◽  
Competing Interest ◽  
The Relationship

IntroductionDepression and mild cognitive impairment are common among the elderly. Half the patients with late-life depression also present some degree of cognitive decline, making the distinction between these conditions difficult.ObjectivesTo conduct a database review in order to understand the relationship between these entities, and treatment approaches.AimsTo create and implement clinical guidelines at our institution, to evaluate and treat elderly patients presenting with depression and mild cognitive impairment.MethodsA PubMed database search using as keywords “late life depression”, “depression”; “cognitive impairment”; “mild cognitive impairment” and “dementia” between the year 2008 and 2015.ResultsLate-life depression and cognitive impairment are frequent among the elderly (10–20%). Depression is also common in the early stages of dementia decreasing as the cognitive decline progresses. The causal relationship between these entities is not well understood and some authors advocate a multifactorial model (genetic risk factors; neuroendocrine changes; vascular risk factors) and the cognitive impairment of said changes is dependent on the individual's cognitive reserve. Regarding treatment of depression in patients with cognitive impairment, most authors advocate a stepped approach with watchful waiting and then, if symptoms persist, the introduction of pharmacotherapy and psychosocial intervention.ConclusionsThe relationship between cognitive impairment and depression is still not clear and probably multifactorial. The diagnosis of depressive symptoms in patients with severe cognitive impairment can be difficult and most forms of pharmacological treatment in this population are not beneficial, making it important to carefully evaluate the benefits of introducing new medication.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Primary Care Physicians' Attitude Toward Diagnosis and Treatment of Late-life Depression

CNS Spectrums ◽  
2002 ◽  
Vol 7 (11) ◽  
pp. 784-790 ◽  
Author(s):  
Jeffrey S. Harman ◽  
Ellen L. Brown ◽  
Thomas Ten Have ◽  
Benoit H. Mulsant ◽  
Greg Brown ◽  
...  
Keyword(s):  
Primary Care ◽  
Medical Education ◽  
Primary Care Physicians ◽  
Late Life ◽  
The Elderly ◽  
Late Life Depression ◽  
Primary Care Settings ◽  
Care Groups ◽  
Physician Characteristics ◽  
Barrier To Care

ABSTRACTUnderdiagnosis and undertreatment of late-life depression is common, especially in primary care settings. To help assess whether physicians' attitude and confidence in diagnosing and managing depression serve as barriers to care, a total of 176 physicians employed in 18 primary care groups were administered surveys to assess attitudes towards diagnosis, treatment, and management of depression in elderly patients, (individuals over 65 years of age). Logistic regression was performed to assess the association of physician characteristics on attitudes. Nearly all of the physicians surveyed felt that depression in the elderly was a primary care problem, and 41% reported late-life depression as the most common problem seen in older patients. Physicians were confident in their ability to diagnose and manage depression, yet 45% had no medical education on depression in the previous three years. Physicians' confidence in their ability to diagnose, treat, and manage depression, and their reported adequacy of training, do not appear to correspond to the amount of continuing medical education in depression, suggesting that physician overconfidence may potentially be serving as a barrier to care.

scholarly journals When Cognitive Decline and Depression Coexist in the Elderly: CSF Biomarkers Analysis Can Differentiate Alzheimer's Disease from Late-Life Depression

2018 ◽  
Vol 10 ◽  
Author(s):  
Claudio Liguori ◽  
Mariangela Pierantozzi ◽  
Agostino Chiaravalloti ◽  
Giulia M. Sancesario ◽  
Nicola B. Mercuri ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Decline ◽  
Late Life ◽  
The Elderly ◽  
Csf Biomarkers ◽  
Late Life Depression

Cognitive impairment in remitted late-life depression is not associated with Alzheimer's disease-related CSF biomarkers

2020 ◽  
Vol 272 ◽  
pp. 409-416
Author(s):  
Júlia C. Loureiro ◽  
Florindo Stella ◽  
Marcos V. Pais ◽  
Marcia Radanovic ◽  
Paulo R. Canineu ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Late Life ◽  
Csf Biomarkers ◽  
Late Life Depression

Association between physical frailty and cognition in late-life depression

2016 ◽  
Vol 33 (S1) ◽  
pp. S84-S84
Author(s):  
M. Arts ◽  
R. Collard ◽  
H. Comijs ◽  
M. Zuidersma ◽  
S. de Rooij ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Functioning ◽  
Processing Speed ◽  
Verbal Memory ◽  
Late Life ◽  
Interference Control ◽  
Late Life Depression ◽  
Physical Frailty ◽  
Cognitive Frailty ◽  
Frailty Criteria

IntroductionCognitive frailty has recently been defined as the co-occurrence of physical frailty and cognitive impairment. Late-life depression is associated with both physical frailty and cognitive impairment, especially processing speed and executive functioning.Aim and objectivesIn this study, we investigated the association between physical frailty and cognitive functioning in depressed older persons.MethodsIn a total of 378 patients (> 60 years) with depression according to DSM-IV criteria and a MMSE score of 24 points or higher, the physical frailty phenotype as well as its individual criteria (weight loss, weakness, exhaustion, slowness, low activity) was studied. Cognitive functioning was examined in 4 domains: verbal memory, working memory, interference control, and processing speed.ResultsOf the 378 depressed patients (range 60–90 years; 66.1% women), 61 were classified as robust (no frailty criteria present), 214 as prefrail (1 or 2 frailty criteria present), and 103 as frail (> 3 criteria). Linear regression analyses, adjusted for confounders, showed that the severity of physical frailty was associated with poorer verbal memory, slower processing speed, and decreased working memory, but not with changes in interference control.ConclusionIn late-life depression, physical frailty is associated with poorer cognitive functioning, although not consistently for executive functioning. Future studies should examine whether cognitive impairment in the presence of physical frailty belongs to cognitive frailty and is indeed an important concept to identify a specific subgroup of depressed older patients, who need multimodal treatment strategies integrating physical, cognitive, and psychological functioning.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Association of Subjective Cognitive Complaints and Objective Cognitive Impairment in Late Life Depression

2018 ◽  
Vol 26 (3) ◽  
pp. S90-S91
Author(s):  
Ruth Morin ◽  
David D. Bickford ◽  
Yiu Ho Au ◽  
Kelly B. Scherer ◽  
Daniel C. Catalinotto ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Late Life ◽  
Late Life Depression ◽  
Cognitive Complaints ◽  
Subjective Cognitive Complaints

Overview of Late-Life Depression

2015 ◽  
Author(s):  
Mark D. Miller
Keyword(s):  
Bipolar Disorder ◽  
Cognitive Impairment ◽  
Personality Disorders ◽  
Collaborative Care ◽  
Late Life ◽  
Medical Conditions ◽  
Late Life Depression ◽  
Alcohol Treatments

Chapter 4 outlines late-life depression. It explores the causes of depression (including medical conditions, medication, and alcohol), treatments for depression, and other diagnoses (bipolar disorder, co-occuring anxiety, and personality disorders), depression and cognitive impairment, and collaborative care.

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