Increased Mortality Rates in Late-life Depression

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.

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The Art of Clinical Management in Pharmacologic Trials With Depressed Elderly Patients: Lessons from the Pittsburgh Study of Maintenance Therapies in Late-Life Depression

American Journal of Geriatric Psychiatry ◽

10.1097/00019442-199908000-00007 ◽

1999 ◽

Vol 7 (3) ◽

pp. 228-234 ◽

Cited By ~ 15

Author(s):

Mark D. Miller ◽

Ellen Frank ◽

Charles F. Reynolds

Keyword(s):

Elderly Patients ◽

Clinical Management ◽

Late Life ◽

Late Life Depression

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Which elderly depressed patients remain well on maintenance interpersonal psychotherapy alone?: Report from the Pittsburgh Study Of Maintenance Therapies in Late-Life Depression

Depression and Anxiety ◽

10.1002/(sici)1520-6394(1999)10:2<55::aid-da3>3.0.co;2-f ◽

1999 ◽

Vol 10 (2) ◽

pp. 55-60 ◽

Cited By ~ 14

Author(s):

Matthew P. Taylor ◽

Charles F. Reynolds ◽

Ellen Frank ◽

Cleon Cornes ◽

Mark D. Miller ◽

...

Keyword(s):

Late Life ◽

Interpersonal Psychotherapy ◽

Late Life Depression ◽

Depressed Patients

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

Australasian Psychiatry ◽

10.1177/1039856218797441 ◽

2018 ◽

Vol 26 (5) ◽

pp. 534-536 ◽

Cited By ~ 1

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.

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Does the Framingham Stroke Risk Profile predict white-matter changes in late-life depression?

International Psychogeriatrics ◽

10.1017/s1041610211002183 ◽

2011 ◽

Vol 24 (4) ◽

pp. 524-531 ◽

Cited By ~ 16

Author(s):

Charlotte L. Allan ◽

Claire E. Sexton ◽

Ukwuori G. Kalu ◽

Lisa M. McDermott ◽

Mika Kivimäki ◽

...

Keyword(s):

White Matter ◽

Corpus Callosum ◽

Stroke Risk ◽

Late Life ◽

Risk Profile ◽

The Body ◽

White Matter Integrity ◽

Late Life Depression ◽

White Matter Changes ◽

Depressed Group

ABSTRACTBackground: Cardiovascular risk factors and diseases are important etiological factors in depression, particularly late-life depression. Brain changes associated with vascular disease and depression can be detected using magnetic resonance imaging. Using diffusion tensor imaging (DTI), we investigated whether the Framingham Stroke Risk Profile (FSRP), a well-validated risk prediction algorithm, is associated with changes in white-matter connectivity. We hypothesized that depressed participants would show reduced white-matter integrity with higher FSRP, and non-depressed controls (matched for mean vascular risk) would show minimal co-variance with white-matter changes.Methods: Thirty-six participants with major depression (age 71.8 ± 7.7 years, mean FSRP 10.3 ± 7.6) and 25 controls (age 71.8 ± 7.3 years, mean FSRP 10.1 ± 7.7) were clinically interviewed and examined, followed by 60-direction DTI on a 3.0 Tesla scanner. Image analysis was performed using FSL tools (www.fmrib.ox.ac.uk/fsl) to assess the correlation between FSRP and fractional anisotropy (FA). Voxelwise statistical analysis of the FA data was carried out using Tract Based Spatial Statistics. The significance threshold for correlations was set at p < 0.05 using threshold-free cluster-enhancement. Partial correlation analysis investigated significant correlations in each group.Results: Participants in the depressed group showed highly significant correlations between FSRP and FA within the body of corpus callosum (r = −0.520, p = 0.002), genu of corpus callosum (r = −0.468, p = 0.005), splenium of corpus callosum (r = −0.536, p = 0.001), and cortico-spinal tract (r = −0.473, p = 0.005). In controls, there was only one significant correlation in the body of corpus callosum (r = −0.473, p = 0.023).Conclusions: FSRP is associated with impairment in white-matter integrity in participants with depression; these results suggest support for the vascular depression hypothesis.

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

Prosthodontics ◽

10.5604/00331783.1233262 ◽

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.

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Early-onset and late-onset depression in older adults: psychological perspectives

Reviews in Clinical Gerontology ◽

10.1017/s0959259800000265 ◽

2000 ◽

Vol 10 (2) ◽

pp. 149-159 ◽

Cited By ~ 6

Author(s):

Jemma Boyd ◽

Fionnuala McKiernan ◽

Glen Waller

Keyword(s):

Mental Health ◽

Older Adults ◽

Late Onset ◽

Late Life ◽

Mortality Rates ◽

Late Life Depression ◽

Significant Challenge ◽

Common Mental Health Problem ◽

Further Development ◽

Growing Population

Depression is the most common mental health problem in old age, presenting a significant challenge to mental health services for older adults. The high chronicity, relapse and mortality rates associated with late-life depression suggest that existing treatments for late-life depression are insufficient. Therefore, current theoretical understandings may require further development. Given the growing population of older adults, the need to improve our understanding of late-life depression is increasingly urgent.

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Gender differences in elderly patientswith depression

European Psychiatry ◽

10.1016/s0924-9338(11)72537-8 ◽

2011 ◽

Vol 26 (S2) ◽

pp. 832-832

Author(s):

H. Dessoki ◽

F. Moussa ◽

M. Nasr

Keyword(s):

Gender Differences ◽

Elderly Patients ◽

Elderly Women ◽

Past History ◽

Control Group ◽

Depressed Patients ◽

Depressed Group ◽

Psychological Gender ◽

Index Comparison ◽

And Control

ObjectiveTo detect phenomenological gender differences in elderly patients with depression for better understanding. In addition to illustrate neuro- psychological gender differences in elderly patients with depression for better management.SubjectsA case/control, comparative study with consecutive sample. 80 elderly Egyptian subjects of both sexes aged 60 years or above recruited from psychiatry outpatient clinic in Kasr Al Aini and Beni Suef hospitals with no obvious cognitive impairment or substance related psychiatric disorders. The subjects were classified into 2 groups (depressed patients and control groups) 40 subjects each.The MethodsDiagnostic criteria of the DSM-IV TR, Symptom checklist, MMSE, GDS,WAIS and STAI were used.ResultsComparison between the depressed patients and the control group revealed that the depressed group has affected cognitively than the control group as assessed by MMSE and also showed deterioration of intellectual abilities (deterioration index). Comparison between the depressed males and females subgroups revealed that the characteristics of the patients and correlates of depression are similar in both sexes except for some significant findings e.g, depression in elderly women is more associated with widowhood, more suffering of sense of worthlessness, more affection of attention and more disturbance in reasoning and costructional abilities.ConclusionDepression in older patients is related to widowhood, presence of family conflicts an positive past history of depression. There were no gender differences in elderly depressed patients except for that depression in elderly women is more associated with widowhood, sense of worthlessness, more affection of attention and more disturbance in reasoning.

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The immunhistochemical examination of GABAergic interneuron markers in the dorsolateral prefrontal cortex of patients with late-life depression

International Psychogeriatrics ◽

10.1017/s1041610210001444 ◽

2010 ◽

Vol 23 (4) ◽

pp. 644-653 ◽

Cited By ~ 21

Author(s):

Ahmad Khundakar ◽

Christopher Morris ◽

Alan J. Thomas

Keyword(s):

Prefrontal Cortex ◽

Calcium Binding ◽

Dorsolateral Prefrontal Cortex ◽

Late Life ◽

Projection Neuron ◽

Gabaergic Interneuron ◽

Gamma Aminobutyric Acid ◽

Late Life Depression ◽

Depressed Patients ◽

Dorsolateral Prefrontal

ABSTRACTBackground: The “vascular depression” hypothesis has sought to explain differences in etiology between early and late life depression, and has been reinforced by recent imaging and morphometric studies. Gamma-aminobutyric acid (GABA) is thought to play a major role in the neurobiology of depression. However, it is unclear whether there is an effect on GABA neuronal subpopulations in an elderly depressed cohort. This study therefore examined immunohistochemically two calcium-binding proteins, calretinin and parvalbumin, which have been demonstrated to bind to two distinct GABAergic interneuron subpopulations, within the dorsolateral prefrontal cortex (DLPFC) of elderly depressed patients, against age-matched controls.Methods: Post-mortem tissue was obtained from nine controls and 11 depressed patients for the parvalbumin study and seven controls and 14 depressed patients in the calretinin study, and the mean percentage per area of immunohistochemical staining of the two antibodies was measured in individual layers and across the whole of the DLPFC.Results: The study found a reduction in parvalbumin immunostaining in layer 6 (p = 0.05) of the DLFPC in elderly depressed patients. However, no significant changes were found in parvalbumin or calretinin immunostaining in the any other layer of the DLPFC in elderly depressed patients.Conclusion: The study does not suggest any change in GABA interneuron subpopulations, though significant reductions in layer 6 may represent subtle disturbance in GABA parvalbumin-expressing interneuron and glumatatergic pyramidal projection neuron regulation in late-life depression.

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