Improvement of late life depression after therapeutic enoxaparin: two case reports

2018 ◽  
Vol 26 (5) ◽  
pp. 534-536 ◽  
Author(s):  
David Graham ◽  
Qi Xuan Wu ◽  
Ian Gilligan ◽  
Raiz Ismail ◽  
Mark Walker
Keyword(s):  
Pulmonary Embolism ◽  
Elderly Patients ◽  
Inpatient Treatment ◽  
Case Reports ◽  
Late Life ◽  
Organic Basis ◽  
Late Life Depression ◽  
Treatment Of Depression ◽  
Significant Clinical Improvement ◽  
Vascular Component

Objective: Late life depression (LLD) may have a significant vascular component. While this organic basis remains controversial it would explain the refractory nature of LLD. Moreover, depression is a risk factor for venous thrombus embolism (VTE). This paper aims to describe two elderly patients with LLD who developed and were treated for pulmonary embolism (PE). Methods: Two cases of elderly patients who developed PE while they were undergoing inpatient treatment for depression are presented. This is discussed using the vascular and the cytokine hypotheses of depression as an explanatory framework. Results: Both patients showed significant clinical improvement in their mental state following therapeutic enoxaparin despite no other changes to their management of depression. This observed benefit of enoxaparin can be explained by the vascular hypothesis of LLD, and possibly the cytokine hypothesis of major depression. Conclusion: Enoxaparin may be a novel adjunct to the treatment of depression in elderly patients. The possible benefit of enoxaparin would require further study to exclude a coincidence in these clinical cases.

scholarly journals Clinical applicability of D-dimer assay in the diagnosis of pulmonary embolism reduces with aging

2007 ◽  
Vol 1 (4) ◽  
pp. 153-164
Author(s):  
Luca Masotti ◽  
Giancarlo Landini ◽  
Fabio Antonelli ◽  
Elio Venturini ◽  
Roberto Cappelli ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Elderly Patients ◽  
Case Reports ◽  
High Morbidity ◽  
Clinical Probability ◽  
Clinical Applicability ◽  
Diagnostic Management ◽  
Diagnostic Work ◽  
Work Up ◽  
D Dimer

Despite modern algorithms have been proposed for diagnosis of pulmonary embolism (PE), it remains understimed and often missed in clinical practice, especially in elderly patients, resulting in high morbidity and mortality when early and correctly untreated. One of the main controversial issue is represented by the role and applicability of D-dimer in the diagnostic work up of geriatric patients. Most recent guidelines in young-adult patients suggest to perform D-dimer assay by ELISA or immunoturbidimetric methods only in non high pre-test clinical probability (PTP) patients; in these patients negative D-dimer can safely rule out the diagnosis of PE. This strategy is safe also in elderly patients; however the percentage of patients with non high PTP and negative D-dimer reduces progressively with age, making difficult its clinical applicability. The Authors, starting from two case reports, up date the diagnostic management of PE underling the limitations of D-dimer assay in elderly patients.

Increased Mortality Rates in Late-life Depression

1988 ◽  
Vol 152 (3) ◽  
pp. 347-353 ◽  
Author(s):  
Elaine Murphy ◽  
Rae Smith ◽  
James Lindesay ◽  
Jim Slattery
Keyword(s):  
Elderly Patients ◽  
Physical Health ◽  
Late Life ◽  
Mortality Rates ◽  
Physical Illness ◽  
Late Life Depression ◽  
Depressed Patients ◽  
Depressed Group ◽  
First Interview

Physical illness at referral and subsequent mortality were studied in a group of elderly patients with depression, and compared with age/sex-matched controls. The depressed group was significantly less well at first interview, and had a significantly higher 4–year mortality. When the effect of physical illness was controlled, the depressed patients (particularly the men) still had a significantly higher 4–year mortality, suggesting that the greater mortality in the depressed group was not due to differences in physical health alone.

Oral health-related quality of life in late-life depression patients treated prosthetically

2017 ◽  
Vol 67 (1) ◽  
pp. 58-64
Author(s):  
Małgorzata Gałczyńska-Rusin ◽  
Ryszard Koczorowski
Keyword(s):  
Quality Of Life ◽  
Oral Health ◽  
Elderly Patients ◽  
Life Quality ◽  
Late Life ◽  
Health Related Quality ◽  
Late Life Depression ◽  
Related Quality ◽  
Health Related

Introduction. Due to the ageing of the human population, dentists provide care for an increasing number of elderly patients suffering from depression. Aim of the study. To examine the relationship between depression signs, oral health-related quality of life and adaptation to new prosthetic restorations in elderly patients. The study involved 150 patients of the Gerodontology Clinic after prosthetic rehabilitation with removable dentures. The Geriatric Depression Scale (GDS) and the General Oral Health Assessment Index (GOHAI) were used in questionnaire examinations. Results. Signs of depression were found in 24.6% of the patients. This group showed a significantly lower level of satisfaction with their life quality compared to individuals without depression signs and were less adaptable to new prosthetic restorations. Conclusions. Late-life depression (LLD) may considerably affect the outcome of prosthetic treatment, regardless of the type and quality of the restoration provided, by lowering the level of perceived life quality connected with adaptation to new dentures.

scholarly journals Review of treatment for late-life depression

2013 ◽  
Vol 19 (4) ◽  
pp. 302-309 ◽  
Author(s):  
Charlotte L. Allan ◽  
Klaus P. Ebmeier
Keyword(s):  
Selective Serotonin Reuptake Inhibitors ◽  
Treatment Options ◽  
Treatment Strategies ◽  
Late Life ◽  
Line Treatment ◽  
Late Life Depression ◽  
Nonpharmacological Treatment ◽  
Augmentation Strategies ◽  
Treatment Of Depression ◽  
Favourable Side Effect Profile

SummaryDepressive disorder in those over the age of 60 has many clinical similarities to depression in younger adults, but biological changes related to ageing may necessitate a different approach to treatment. We present an evidence-based review of treatment for late-life depression, focusing on pharmacological approaches, including monotherapy, combination and augmentation strategies. Selective serotonin reuptake inhibitors such as sertraline and citalopram are well tolerated, have the advantage of a favourable side-effect profile, and are good options for first-line treatment. Second-line treatment options include combination therapy with a second antidepressant, or treatment augmentation with an antipsychotic or lithium. We also consider evidence for nonpharmacological treatment strategies, including psychological therapy and neurostimulation. Finally, we summarise evidence for treatment of depression in patients in dementia.

Change in Disability Follows Inpatient Treatment for Late Life Depression

2000 ◽  
Vol 48 (4) ◽  
pp. 357-362 ◽  
Author(s):  
David W. Oslin ◽  
Joel Streim ◽  
Ira R. Katz ◽  
William S. Edell ◽  
Thomas TenHave
Keyword(s):  
Inpatient Treatment ◽  
Late Life ◽  
Late Life Depression

scholarly journals Late-life depression in sub-Saharan Africa: lessons from the Ibadan Study of Ageing

2020 ◽  
Vol 29 ◽  
Author(s):  
A. Ojagbemi ◽  
T. Bello ◽  
O. Gureje
Keyword(s):  
Mental Health ◽  
Mental Health Problems ◽  
Late Life ◽  
Sub Saharan Africa ◽  
Social Changes ◽  
Late Life Depression ◽  
Treatment Of Depression ◽  
The World ◽  
Sub Saharan ◽  
Health Service Challenges

Abstract The population surviving to old age in sub-Saharan Africa (SSA) is increasing rapidly in consonance with the rest of the world. Nevertheless, the sub-region offers unique challenges to survival across the lifespan. The determinants of health and ageing in SSA are thus likely different from those in higher income countries. The need to explore pressing epidemiological and health service challenges of older people living in SSA in the context of multiple social changes and rapid ageing of the population provided the rationale for the Ibadan Study of Ageing (ISA). This article appraises ISA findings in relation to late-life depression. It concludes that healthcare policies in SSA need to deliberately prioritise the treatment of depression and other mental health problems in late-life in order to stem the neglect of older people's mental health in the region.

Diagnosis and Management of Late Life Depression: A Guide for the Primary Care Physician

1997 ◽  
Vol 27 (3) ◽  
pp. 269-281 ◽  
Author(s):  
David K. Conn ◽  
Allan B. Steingart
Keyword(s):  
Primary Care ◽  
Elderly Patients ◽  
Empirical Evidence ◽  
Primary Care Physician ◽  
Care Physician ◽  
Geriatric Depression ◽  
Late Life Depression ◽  
Diagnosis And Management ◽  
Treatment Of Depression ◽  
Primary Care Patients

Objective: The purpose of this article is to provide a brief and practical approach for the primary care physician regarding the recognition, diagnosis, and management of depression in elderly patients. Method: Empirical evidence and current recommendations regarding the recognition, diagnosis, and treatment of depression are reviewed as the basis for this approach. Appropriate modifications for geriatric depression are added where indicated. Results: The recommendations are listed by category and briefly explained. Conclusions: It is important to be vigilant for the variety of depressive presentations that occur in older primary care patients. Neurological causes of depression (such as stroke), suicide, and a longer time to recovery are all more frequent concerns in older depressed patients.

scholarly journals Association between self-rated physical performance and late-life depression in elderly patients

2017 ◽  
Vol 81 (0) ◽  
pp. 1B-071-1B-071
Author(s):  
Mio Shinozaki ◽  
Masayo Kakiya ◽  
Shigemi Yamamoto ◽  
Chikako Kajita ◽  
Naoki Ito ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Physical Performance ◽  
Late Life ◽  
Late Life Depression

Research Directions for Treatment of Depression

1995 ◽  
Vol 7 (S1) ◽  
pp. 139-142 ◽  
Author(s):  
Sanford I. Finkel
Keyword(s):  
Major Depression ◽  
Nursing Home Residents ◽  
Public Health Problem ◽  
Late Life ◽  
The Elderly ◽  
The United States ◽  
Late Life Depression ◽  
Treatment Interventions ◽  
Treatment Of Depression ◽  
Average Longevity

Late-life depression is an immense public health problem for which research on treatment interventions is very much needed. Between 1950 and 1990, average longevity worldwide increased from 46.6 years to 64.7 years (United Nations, 1993). With this surge in the elderly population has come an increased prevalence of late-life depression and its sometimes severe consequences. Older people with depressive symptoms have a threefold increase in mortality (Ashby et al., 1991). As many as 15% to 25% of nursing home residents in the United States have major depression (NIH Consensus Development Panel, 1992), and between 50% and 80% of elderly people who commit suicide have major depression (Clark, 1991; Conwell et al., 1991; Finkel & Rosman, 1995).

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