Predictors of Cognitive Improvement Following Treatment for Late-Life Depression

2020 ◽  
pp. 089198872091551
Author(s):  
Prabha Siddarth ◽  
Cynthia M. Funes ◽  
Kelsey T. Laird ◽  
Linda Ercoli ◽  
Helen Lavretsky
Keyword(s):  
Clinical Trials ◽  
Standard Deviation ◽  
Social Functioning ◽  
Randomized Clinical Trials ◽  
Antidepressant Treatment ◽  
Late Life ◽  
The Other ◽  
Late Life Depression ◽  
Cognitive Improvement ◽  
Severity Of Depression

Objective: Cognitive impairment is frequently comorbid with late-life depression (LLD) and often persists despite remission of mood symptoms with antidepressant treatment. Increasing understanding of factors that predict improvement of cognitive symptoms in LLD is useful to inform treatment recommendations. Methods: We used data from 2 randomized clinical trials of geriatric depression to examine the relationships between sociodemographic factors (resilience, quality of life) and clinical factors (age of depression onset, severity of depression, apathy) with subsequent cognitive outcomes. One hundred sixty-five older adults with major depression who had completed one of 2 clinical trials were included: (1) methylphenidate plus placebo, citalopram plus placebo, and citalopram plus methylphenidate or (2) citalopram combined with Tai Chi or health education. A comprehensive neuropsychiatric battery was administered; 2 measures of cognitive improvement were examined, one defined as an increase in general cognitive performance score of at least 1 standard deviation and the other 0.5 standard deviation pre–post treatment. Results: At posttreatment, 59% of participants had remitted, but less than a third of those who remitted showed cognitive improvement (29%). Cognitive improvement was observed in 18% of nonremitters. Lower baseline depression severity, greater social functioning, and depression onset prior to 60 years of age were significantly associated with cognitive improvement. None of the other measures, including baseline apathy, resilience, and depression remission status, were significantly associated with cognitive improvement. Conclusions: Lower severity of depression, earlier onset, and greater social functioning may predict improvement in cognitive functioning with treatment for depression in LLD.

scholarly journals Deep learning-based automated speech detection as a marker of social functioning in late-life depression

2020 ◽  
pp. 1-10 ◽  
Author(s):  
Bethany Little ◽  
Ossama Alshabrawy ◽  
Daniel Stow ◽  
I. Nicol Ferrier ◽  
Roisin McNaney ◽  
...  
Keyword(s):  
Deep Learning ◽  
Social Functioning ◽  
Objective Measure ◽  
Late Life ◽  
Psychomotor Retardation ◽  
Self Report ◽  
Late Life Depression ◽  
Acoustic Environment ◽  
Speech Detection ◽  
Speech Activity

Abstract Background Late-life depression (LLD) is associated with poor social functioning. However, previous research uses bias-prone self-report scales to measure social functioning and a more objective measure is lacking. We tested a novel wearable device to measure speech that participants encounter as an indicator of social interaction. Methods Twenty nine participants with LLD and 29 age-matched controls wore a wrist-worn device continuously for seven days, which recorded their acoustic environment. Acoustic data were automatically analysed using deep learning models that had been developed and validated on an independent speech dataset. Total speech activity and the proportion of speech produced by the device wearer were both detected whilst maintaining participants' privacy. Participants underwent a neuropsychological test battery and clinical and self-report scales to measure severity of depression, general and social functioning. Results Compared to controls, participants with LLD showed poorer self-reported social and general functioning. Total speech activity was much lower for participants with LLD than controls, with no overlap between groups. The proportion of speech produced by the participants was smaller for LLD than controls. In LLD, both speech measures correlated with attention and psychomotor speed performance but not with depression severity or self-reported social functioning. Conclusions Using this device, LLD was associated with lower levels of speech than controls and speech activity was related to psychomotor retardation. We have demonstrated that speech activity measured by wearable technology differentiated LLD from controls with high precision and, in this study, provided an objective measure of an aspect of real-world social functioning in LLD.

scholarly journals Cortical Thickness of the Salience Network and Change in Apathy Following Antidepressant Treatment for Late-Life Depression

2020 ◽  
Author(s):  
Monique A. Pimontel ◽  
Nili Solomonov ◽  
Lauren Oberlin ◽  
Theodora Kanellopoulos ◽  
Jennifer N. Bress ◽  
...  
Keyword(s):  
Cortical Thickness ◽  
Antidepressant Treatment ◽  
Late Life ◽  
Salience Network ◽  
Late Life Depression

scholarly journals Change in Cognitive Functioning Following Acute Antidepressant Treatment in Late-Life Depression

2009 ◽  
Vol 17 (10) ◽  
pp. 881-888 ◽  
Author(s):  
Michelle E. Culang ◽  
Joel R. Sneed ◽  
John G. Keilp ◽  
Bret R. Rutherford ◽  
Gregory H. Pelton ◽  
...  
Keyword(s):  
Cognitive Functioning ◽  
Antidepressant Treatment ◽  
Late Life ◽  
Late Life Depression

Metabolic dysregulation and late-life depression: a prospective study

2016 ◽  
Vol 47 (6) ◽  
pp. 1041-1052 ◽  
Author(s):  
R. M. Marijnissen ◽  
N. Vogelzangs ◽  
M. E. Mulder ◽  
R. H. S. van den Brink ◽  
H. C. Comijs ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Waist Circumference ◽  
Depressive Symptomatology ◽  
Hdl Cholesterol ◽  
Late Life ◽  
Late Life Depression ◽  
Metabolic Dysregulation ◽  
The Metabolic Syndrome ◽  
Co Morbidity ◽  
Severity Of Depression

BackgroundDepression is associated with the metabolic syndrome (MS). We examined whether metabolic dysregulation predicted the 2-year course of clinical depression.MethodA total of 285 older persons (⩾60 years) suffering from depressive disorder according to DSM-IV-TR criteria was followed up for 2 years. Severity of depression was assessed with the Inventory of Depressive Symptomatology (IDS) at 6-month intervals. Metabolic syndrome was defined according the National Cholesterol Education Programme (NCEP-ATP III). We applied logistic regression and linear mixed models adjusted for age, sex, years of education, smoking, alcohol use, physical activity, somatic co-morbidity, cognitive functioning and drug use (antidepressants, anti-inflammatory drugs) and severity of depression at baseline.ResultsMS predicted non-remission at 2 years (odds ratioper component = 1.26, 95% confidence interval 1.00–1.58), p = 0.047), which was driven by the waist circumference and HDL cholesterol. MS was not associated with IDS sum score. Subsequent analyses on its subscales, however, identified an association with the somatic symptom subscale score over time (interaction time × somatic subscale, p = 0.005), driven by higher waist circumference and elevated fasting glucose level.ConclusionsMetabolic dysregulation predicts a poor course of late-life depression. This finding supports the concept of ‘metabolic depression’, recently proposed on population-based findings of a protracted course of depressive symptoms in the presence of metabolic dysregulation. Our findings seem to be driven by abdominal obesity (as indicated by the waist circumference) and HDL cholesterol dysregulation.

On the Evaluation of Treatments for Narcotics Addiction

1979 ◽  
Vol 9 (2) ◽  
pp. 205-211 ◽  
Author(s):  
Vincent P. Dole ◽  
Burton Singer
Keyword(s):  
Clinical Trials ◽  
Randomized Trial ◽  
Observational Data ◽  
Chronic Diseases ◽  
Drug Addiction ◽  
Randomized Trials ◽  
Randomized Clinical Trials ◽  
The Other ◽  
Domain Of Applicability

This study is concerned with the domain of applicability of randomized clinical trials. For evaluation of well-defined treatments of acute diseases over limited periods of time, the randomized trial technique is unquestionably the best. However, in the field of chronic diseases (as illustrated by drug addiction) the physician's responsibility extends over periods of years, and his judgements involve consideration of many contingent factors which vary in the course of the disease. In this domain, randomized clinical trials, however ambitious in design, give only partial guidance. Observational data therefore must be used if treatment is to be optimized for individual patients. Two randomized trials in the treatment of narcotics addiction — one testing methadone and the other naltrexone — are reviewed, with comments on their conclusions and limitations.

scholarly journals Structural Imaging in Late-Life Depression: Association with Mood and Cognitive Responses to Antidepressant Treatment

2015 ◽  
Vol 23 (1) ◽  
pp. 4-12 ◽  
Author(s):  
Christopher M. Marano ◽  
Clifford I. Workman ◽  
Christopher H. Lyman ◽  
Cynthia A. Munro ◽  
Michael A. Kraut ◽  
...  
Keyword(s):  
Antidepressant Treatment ◽  
Late Life ◽  
Cognitive Responses ◽  
Structural Imaging ◽  
Late Life Depression

scholarly journals Acupuncture for Managing Cancer-Related Insomnia: A Systematic Review of Randomized Clinical Trials

2016 ◽  
Vol 16 (2) ◽  
pp. 135-146 ◽  
Author(s):  
Tae-Young Choi ◽  
Jong In Kim ◽  
Hyun-Ja Lim ◽  
Myeong Soo Lee
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Sleep Quality ◽  
Randomized Clinical Trials ◽  
Data Extraction ◽  
Meta Analysis ◽  
Sham Acupuncture ◽  
Risk Of Bias ◽  
The Other ◽  
Level Of Evidence

Background. Insomnia is a prominent complaint of cancer patients that can significantly affect their quality of life and symptoms related to sleep quality. Conventional drug approaches have a low rate of success in alleviating those suffering insomnia. The aim of this systematic review was to assess the efficacy of acupuncture in the management of cancer-related insomnia. Methods. A total of 12 databases were searched from their inception through January 2016 without language restriction. Randomized controlled trials (RCTs) and quasi-RCTs were included if acupuncture was used as the sole intervention or as an adjunct to another standard treatment for any cancer-related insomnia. The data extraction and the risk of bias assessments were performed by 2 independent reviewers. Results. Of the 90 studies screened, 6 RCTs were included. The risk of bias was generally unclear or low. Three RCTs showed equivalent effects on the Pittsburgh Sleep Quality Index and 2 RCTs showed the similar effects on response rate to those of conventional drugs at the end of treatment. The other RCT showed acupuncture was better than hormone therapy in the numbers of hours slept each night and number of times woken up each night. The 3 weeks of follow-up in 2 RCTs showed superior effects of acupuncture compared with conventional drugs, and a meta-analysis showed significant effects of acupuncture. Two RCTs tested the effects of acupuncture on cancer-related insomnia compared with sham acupuncture. One RCT showed favourable effects, while the other trial failed to do so. Conclusion. There is a low level of evidence that acupuncture may be superior to sham acupuncture, drugs or hormones therapy. However, the number of studies and effect size are small for clinical significance. Further clinical trials are warranted.

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