Phenomenology of depression in older compared with younger adults: Meta-analysis

BackgroundLate-life depression may differ from early-life depression in its phenomenology.AimsTo investigate the effect of age on the phenomenology of major depression.MethodA systematic search was conducted in PubMed, Embase and PsycINFO for all studies examining the relation between age and phenomenology of major depression according to RDC, DSM and ICD criteria. Studies were included only if the age groups were compared at the single-item level using the 17-, 21- or 24-item versions of the Hamilton Rating Scale for Depression; a meta-analysis was done for each item of the 17-item scale.ResultsEleven papers met the inclusion criteria. Older depressed adults, compared with younger depressed adults, demonstrated more agitation, hypochondriasis and general as well as gastrointestinal somatic symptoms, but less guilt and loss of sexual interest.ConclusionsThe phenomenology of late-life depression differs only in part from that of early-life depression. Major depression in older people may have a more somatic presentation, whereas feelings of guilt and loss of sexual function may be more prevalent in younger people.

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Faculty Opinions recommendation of Late-life depression and risk of vascular dementia and Alzheimer's disease: systematic review and meta-analysis of community-based cohort studies.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.718009150.793476303 ◽

2013 ◽

Author(s):

Craig Ritchie ◽

Abel Koshy

Keyword(s):

Systematic Review ◽

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Cohort Studies ◽

Vascular Dementia ◽

Meta Analysis ◽

Late Life ◽

Late Life Depression ◽

Community Based

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Geographic Regional Variation in Patterns of Racial and Ethnic Disparities in Late-Life Depression

Innovation in Aging ◽

10.1093/geroni/igaa057.545 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 168-168

Author(s):

Chirag Vyas ◽

Charles Reynolds ◽

David Mischoulon ◽

Grace Chang ◽

Olivia Okereke

Keyword(s):

Native American ◽

Ethnic Differences ◽

Ethnic Disparities ◽

Late Life ◽

Geographic Region ◽

Omega 3 ◽

Late Life Depression ◽

Item Level ◽

Racial Ethnic ◽

Hispanic White

Abstract There is evidence of racial/ethnic disparities in late-life depression (LLD) burden and treatment in the US. Geographic region may be a novel social determinant; yet, limited data exist regarding the interplay of geographic region with racial/ethnic differences in LLD severity, item-level symptom burden and treatment. We conducted a cross-sectional study among 25,503 men aged 50+ years and women aged 55+ years in VITAL-DEP (VITamin D and OmegA-3 TriaL-Depression Endpoint Prevention), an ancillary study to the VITAL trial. Racial/ethnic groups included Non-Hispanic White, Black, Hispanic, Asian, and other groups (Native American/Alaskan Native and other/multiple/unspecified-race/ethnicity). We assessed depression status using: the Patient Health Questionnaire-8 (PHQ-8); self-reported clinician/physician diagnosis of depression; medication and/or counseling treatment for depression. In the full sample, Midwest region was significantly associated with 12% lower severity of LLD, compared to Northeast region (rate ratio (RR) (95% confidence interval (CI)): 0.88 (0.83-0.93)). However, racial/ethnic differences in LLD varied by region. For example, in the Midwest, Blacks and Hispanics had significantly higher depression severity compared to non-Hispanic Whites (RR (95% CI): for Black, 1.16 (1.02-1.31); for Hispanic, 2.03 (1.38-3.00)). Furthermore, in multivariable-adjusted logistic regression models, minority vs. non-Hispanic White adults had 2- to 3-fold significantly higher odds of several item-level symptoms across all regions, especially in the Midwest and Southwest. Finally, among those endorsing PHQ-8≥10, Blacks had 60-80% significantly lower odds of depression treatment, compared to non-Hispanic Whites, in all regions. In summary, we observed significant geographic variation in patterns of racial/ethnic disparities in LLD outcomes. This requires further longitudinal investigation.

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Physical exercise for late-life major depression

The British Journal of Psychiatry ◽

10.1192/bjp.bp.114.150516 ◽

2015 ◽

Vol 207 (3) ◽

pp. 235-242 ◽

Cited By ~ 39

Author(s):

M. Belvederi Murri ◽

M. Amore ◽

M. Menchetti ◽

G. Toni ◽

F. Neviani ◽

...

Keyword(s):

Primary Care ◽

Major Depression ◽

Physical Exercise ◽

Primary Outcome ◽

Rating Scale ◽

Late Life ◽

Lower Intensity ◽

Progressive Exercise ◽

Primary Care Patients ◽

Hamilton Rating Scale

BackgroundInterventions including physical exercise may help improve the outcomes of late-life major depression, but few studies are available.AimsTo investigate whether augmenting sertraline therapy with physical exercise leads to better outcomes of late-life major depression.MethodPrimary care patients (>65 years) with major depression were randomised to 24 weeks of higher-intensity, progressive aerobic exercise plus sertraline (S+PAE), lower-intensity, non-progressive exercise plus sertraline (S+NPE) and sertraline alone. The primary outcome was remission (a score of $10 on the Hamilton Rating Scale for Depression).ResultsA total of 121 patients were included. At study end, 45% of participants in the sertraline group, 73% of those in the S+NPE group and 81% of those in the S+PAE group achieved remission (P = 0.001). A shorter time to remission was observed in the S+PAE group than in the sertraline-only group.ConclusionsPhysical exercise may be a safe and effective augmentation to antidepressant therapy in late-life major depression.

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Do Primary Care Physicians Have Particular Difficulty Identifying Late-Life Depression? A Meta-Analysis Stratified by Age

Psychotherapy and Psychosomatics ◽

10.1159/000318295 ◽

2010 ◽

Vol 79 (5) ◽

pp. 285-294 ◽

Cited By ~ 65

Author(s):

Alex J. Mitchell ◽

Sanjay Rao ◽

Amol Vaze

Keyword(s):

Primary Care ◽

Primary Care Physicians ◽

Meta Analysis ◽

Late Life ◽

Late Life Depression

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Time course for memory dysfunction in early-life and late-life major depression: A longitudinal study from the Juntendo university mood disorder project

Journal of Affective Disorders ◽

10.1016/j.jad.2013.05.050 ◽

2013 ◽

Vol 151 (1) ◽

pp. 66-70 ◽

Cited By ~ 9

Author(s):

Hitoshi Maeshima ◽

Hajime Baba ◽

Yoshiyuki Nakano ◽

Emi Satomura ◽

Yuki Namekawa ◽

...

Keyword(s):

Longitudinal Study ◽

Major Depression ◽

Mood Disorder ◽

Early Life ◽

Time Course ◽

Late Life ◽

Memory Dysfunction

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Neuroanatomy of Alzheimer’s Disease and Late-Life Depression: A Coordinate-Based Meta-Analysis of MRI Studies

Journal of Alzheimer s Disease ◽

10.3233/jad-142955 ◽

2015 ◽

Vol 46 (4) ◽

pp. 963-970 ◽

Cited By ~ 18

Author(s):

Maddalena Boccia ◽

Mauro Acierno ◽

Laura Piccardi

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Meta Analysis ◽

Late Life ◽

Late Life Depression ◽

Mri Studies

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Functional connectivity predictors of acute depression treatment outcome

International Psychogeriatrics ◽

10.1017/s1041610218002260 ◽

2019 ◽

Vol 31 (12) ◽

pp. 1831-1835 ◽

Cited By ~ 1

Author(s):

David C. Steffens ◽

Lihong Wang ◽

Godfrey D. Pearlson

Keyword(s):

Functional Connectivity ◽

Rating Scale ◽

Inferior Frontal Gyrus ◽

Late Life ◽

Multivariate Regression Analysis ◽

Brain Regions ◽

Frontal Eye Field ◽

Late Life Depression ◽

Madrs Score ◽

Sensorimotor Network

ABSTRACTFew studies have examined functional connectivity (FC) patterns using functional magnetic resonance imaging (fMRI) to predict outcomes in late-life depression. We hypothesized that FC within and between frontal and limbic regions would be associated with 12-week depression outcome in older depressed adults. Seventy-one subjects with major depression were enrolled in the study. A study geriatric psychiatrist performed a clinical interview and completed a Montgomery-Åsberg Depression Rating Scale (MADRS). All study participants were free of medication at baseline and had a brain fMRI scan. Using a regions of interest (ROI) atlas (including 164 ROIs), we conducted ROI-to-ROI resting-state FC analyses for each participant. In terms of treatment participants were offered sertraline initially, although in this naturalistic study, other medications were also prescribed. Subjects were evaluated every 2 weeks up to 12 weeks by the study psychiatrist, who followed a flexible, clinically based medication dosing schedule. Multivariate regression analysis was used to examine correlation between change of MADRS score over 12 weeks and baseline FC between brain regions, controlling for age, gender, mean head motion, and baseline MADRS. We found greater FC between the left inferior frontal gyrus pars triangularis and the left frontal eye field and FC of these two regions with a number of brain regions related to reward, salience, and sensorimortor function were correlated with change in MADRS score over 12 weeks. Our results highlight the important role of between inner speech-reward, attention-salience, and attention-sensorimotor network synchronization in predicting acute treatment response in late-life depression.

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