Mood Disorders in Late Life

2016 ◽  
pp. 298-310
Author(s):  
Pat Arean ◽  
Eric Lenze ◽  
Joaquin A. Anguera
Keyword(s):  
Major Depression ◽  
Access To Care ◽  
Mood Disorders ◽  
Late Life ◽  
Later Life ◽  
Standardized Assessment ◽  
Younger Adults ◽  
Assessment Scores ◽  
Assessment And Treatment

This chapter discusses how clinicians will need to prepare for a worldwide exponentially growing aging community by describing the current scope of practices with respect to the assessment and treatment mood disorders, including minor and major depression. Particularly for those in later life, the meaningful interpretation of standardized assessment scores requires consideration of medical and neurological complexities. Clinicians must be flexible not only with respect to characterization, but especially with respect to treatment, given the inherent challenges associated with access to care and the range of disability amongst these individuals. Indeed, these late-life individuals are typically assessed in a similar fashion to younger adults (which may obscure meaningful interpretations), making understanding the nuances underlying existing behavioral and pharmaceutical approaches an essential endeavor.

Origins of depression in later life

2005 ◽  
Vol 35 (9) ◽  
pp. 1241-1252 ◽  
Author(s):  
DAN G. BLAZER ◽  
CELIA F. HYBELS
Keyword(s):  
Older Adults ◽  
Stressful Life Events ◽  
Cognitive Distortions ◽  
Late Life ◽  
Later Life ◽  
Late Life Depression ◽  
Younger Adults ◽  
Social Risks ◽  
Clinically Significant ◽  
The Many

Background. Despite the burden of depression in late life, its origins present a paradox to investigators and clinicians alike.Method. We review biological (genetics and heredity factors, neurotransmitter dysfunction, endocrine changes, vascular disorders, and medical co-morbidities), psychological (personality attributes, neuroticism, cognitive distortions, and the lack of emotional control and self-efficacy) and social (stressful life events, bereavement, chronic stress or strain, socio-economic disadvantage and impaired social support) origins of late-life depression based upon an extensive though not exhaustive review of the extant literature. In addition, modifying psychological and social factors are discussed.Results. Older adults appear to be at greater risk for major depression biologically, such as depression resulting from vascular changes, yet the frequency of depression is lower compared to younger adults. Older adults may be protected psychologically due to factors such as socio-emotional selectivity and wisdom, compared to younger adults, and perhaps relatively protected from social risks.Conclusions. A biopsychosocial approach to evaluating the origins of late-life depression is heuristically valuable, a continual reminder of the many factors that contribute to the onset and persistence of clinically significant symptoms in late life.

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

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.

Mood disorders in the elderly

2012 ◽  
pp. 1550-1558
Author(s):  
Robert Baldwin
Keyword(s):  
Bipolar Disorder ◽  
Mood Disorders ◽  
Late Life ◽  
Later Life ◽  
The Elderly ◽  
Clinical Syndrome ◽  
Late Life Depression ◽  
Increased Risk

This chapter considers some of the commonly asked questions about mood disorders in later life. Is depression in later life a distinct clinical syndrome? How common is it? Is there an organic link, for example to cerebral changes, and if so, is there an increased risk of later dementia? Is it more difficult to diagnose and treat late-life depression, and once treated, is the outcome good, bad, or indifferent? The emphasis will be on depression but bipolar disorder and mania will also be considered.

scholarly journals Body size throughout the life-course and incident benign prostatic hyperplasia-related outcomes and nocturia

BMC Urology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Saira Khan ◽  
K. Y. Wolin ◽  
R. Pakpahan ◽  
R. L. Grubb ◽  
G. A. Colditz ◽  
...  
Keyword(s):  
Body Size ◽  
Benign Prostatic Hyperplasia ◽  
Life Course ◽  
Early Life ◽  
Prostate Volume ◽  
Late Life ◽  
Later Life ◽  
Normal Weight ◽  
Prostatic Hyperplasia ◽  
The Life Course

Abstract Background Existing evidence suggests that there is an association between body size and prevalent Benign Prostatic Hyperplasia (BPH)-related outcomes and nocturia. However, there is limited evidence on the association between body size throughout the life-course and incident BPH-related outcomes. Methods Our study population consisted of men without histories of prostate cancer, BPH-related outcomes, or nocturia in the intervention arm of the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO) (n = 4710). Associations for body size in early- (age 20), mid- (age 50) and late-life (age ≥ 55, mean age 60.7 years) and weight change with incident BPH-related outcomes (including self-reported nocturia and physician diagnosis of BPH, digital rectal examination-estimated prostate volume ≥ 30 cc, and prostate-specific antigen [PSA] concentration > 1.4 ng/mL) were examined using Poisson regression with robust variance estimation. Results Men who were obese in late-life were 25% more likely to report nocturia (Relative Risk (RR): 1.25, 95% Confidence Interval (CI): 1.11–1.40; p-trendfor continuous BMI < 0.0001) and men who were either overweight or obese in late-life were more likely to report a prostate volume ≥ 30 cc (RRoverweight: 1.13, 95% CI 1.07–1.21; RRobese: 1.10, 95% CI 1.02–1.19; p-trendfor continuous BMI = 0.017) as compared to normal weight men. Obesity at ages 20 and 50 was similarly associated with both nocturia and prostate volume ≥ 30 cc. Considering trajectories of body size, men who were normal weight at age 20 and became overweight or obese by later-life had increased risks of nocturia (RRnormal to overweight: 1.09, 95% CI 0.98–1.22; RRnormal to obese: 1.28, 95% CI 1.10–1.47) and a prostate volume ≥ 30 cc (RRnormal to overweight: 1.12, 95% CI 1.05–1.20). Too few men were obese early in life to examine the independent effect of early-life body size. Later-life body size modified the association between physical activity and nocturia. Conclusions We found that later-life body size, independent of early-life body size, was associated with adverse BPH outcomes, suggesting that interventions to reduce body size even late in life can potentially reduce the burden of BPH-related outcomes and nocturia.

Lack of Medical Support in HIV Infection and Unstable Mood States

1997 ◽  
Vol 81 (2) ◽  
pp. 635-639
Author(s):  
Motoko Hayashi ◽  
Isao Fukunishi
Keyword(s):  
Social Support ◽  
Depressive Symptoms ◽  
Major Depression ◽  
Hiv Infection ◽  
Mood Disorders ◽  
Early Stage ◽  
Mood States ◽  
Hiv Positive ◽  
Medical Support ◽  
Hiv Patients

This study examined what kinds of social support are related to mood states in a sample of 50 HIV-positive patients without AIDS (46 men and 4 women; M age 36.5 yr., SD = 9.8). In the early stage of HIV infection, HIV patients without AIDS may be prone to depressive symptoms although none of these HIV-positive patients' symptoms fulfilled the DSM-III-R Mood Disorders including Major Depression. The depressive symptoms were not significantly related to lack of ordinary social support such as friends and family but were significantly associated with dissatisfaction with HIV/AIDS-related medical support

scholarly journals Mania in late life

2011 ◽  
Vol 17 (5) ◽  
pp. 357-364
Author(s):  
Felicity Richards ◽  
Martin Curtice
Keyword(s):  
Older People ◽  
Old Age ◽  
Specific Treatment ◽  
Late Life ◽  
Aging Population ◽  
Age Group ◽  
Treatment Algorithms ◽  
Assessment And Treatment ◽  
Old Age Psychiatry ◽  
Older Populations

SummaryMania in late life is a serious disorder that demands specialist assessment and management. However, it is greatly under-researched, with only a paucity of studies specifically analysing older populations. The mainstay of the old age psychiatry workload will inevitably be concerned with assessing and managing dementia and depression, but the steady rise in the aging population with longer survival means that there will be an increase in absolute numbers of older people presenting with mania. There are no specific treatment algorithms available for mania in late life. This article reviews mania and hypomania in late life and concentrates on diagnosis, assessment and treatment, as well as on the management considerations associated with this important age group.

scholarly journals Castelli risk indexes 1 and 2 are higher in major depression but other characteristics of the metabolic syndrome are not specific to mood disorders

Life Sciences ◽  
2014 ◽  
Vol 102 (1) ◽  
pp. 65-71 ◽  
Author(s):  
Heber Odebrecht Vargas ◽  
Sandra Odebrecht Vargas Nunes ◽  
Décio Sabbatini Barbosa ◽  
Mateus Mendonca Vargas ◽  
Ariane Cestari ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Major Depression ◽  
Mood Disorders ◽  
The Metabolic Syndrome

scholarly journals Kleptomania, mood disorder and lithium

1992 ◽  
Vol 50 (4) ◽  
pp. 543-546 ◽  
Author(s):  
Fábio Lopes Rocha ◽  
Maria Elizabete Guimarães Rocha
Keyword(s):  
Major Depression ◽  
Mood Disorder ◽  
Mood Disorders ◽  
Pharmacological Treatment ◽  
Lithium Therapy ◽  
Bipolar Mood Disorder

Kleptomania has been found in association with major depression in a fairly large number of reports in recent years. We describe a patient with concurrent DSM-III-R Bipolar Mood Disorder and Kleptomania, whose symptoms remitted completely, apparently in response to lithium therapy, which raised the possibility that pharmacological treatment may benefit kleptomania. Further studies are needed to establish the possible relationship between kleptomania, mood disorders and lithium therapy.

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