Psychiatric Phenomena in Alzheimer's Disease. III: Disorders of Mood

1990 ◽  
Vol 157 (1) ◽  
pp. 81-86 ◽  
Author(s):  
Alistair Burns ◽  
Robin Jacoby ◽  
Raymond Levy
Keyword(s):  
Alzheimer’S Disease ◽  
Cognitive Impairment ◽  
Depressive Symptoms ◽  
Depressive Symptom ◽  
Previous History ◽  
Ventricular Enlargement ◽  
Trained Observer ◽  
History Of ◽  
Interhemispheric Fissure ◽  
History Of Depression

Of 178 patients with AD, at least one depressive symptom was reported by 63%, 24% were rated as being depressed by a trained observer, and 43% were considered depressed by their relatives. Ten per cent had a previous history of depression. Elevated mood was rare, occurring in only six patients (3.5%). Subjects with depressive symptoms had less cognitive impairment and less ventricular enlargement on CT compared with those without symptoms. Widening of the interhemispheric fissure was associated with symptoms of mania but was inversely related to presence of depressive symptoms.

Antidepressant use in Alzheimer's disease patients: results of the REAL.FR cohort

2009 ◽  
Vol 22 (1) ◽  
pp. 120-128 ◽  
Author(s):  
Christophe Arbus ◽  
Virginie Gardette ◽  
Eric Bui ◽  
Christelle Cantet ◽  
Sandrine Andrieu ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Depressive Symptoms ◽  
Previous History ◽  
Natural Setting ◽  
Antidepressant Prescription ◽  
History Of ◽  
Antidepressant Use ◽  
Clinically Significant ◽  
History Of Depression

ABSTRACTBackground: Psychotropic medication is widely prescribed in clinical practice for the management of behavioral and psychological symptoms of dementia (BPSD) in Alzheimer's disease (AD). However, there have been few pharmaco-epidemiological studies or studies conducted in a natural setting on the real use of antidepressants in AD. The aim of this survey was to assess the prevalence of antidepressant use in AD and to identify the clinical factors associated with antidepressant prescription.Methods: REAL.FR is a four-year, prospective, multi-center study. Baseline data including demographic characteristics, clinical variables and drug intake were obtained. Depressive symptoms were determined using the Neuropsychiatric Inventory (NPI).Results: A total of 686 AD patients were included. Antidepressant treatment was prescribed for 34.8% of patients. Clinically significant depressive symptoms (NPI ≥ 4) were observed in 20.5% of the total population. Although depressed subjects were significantly more likely to be treated with antidepressants than non-depressed subjects (p<0.0001), only 60% of depressed subjects overall were prescribed an antidepressant. In multivariate analysis, clinically significant depressive symptoms were associated with antidepressant prescription although this result was only observed in subjects without a previous history of depression.Conclusions: The available data on antidepressant efficacy in BPSD other than depression (in particular, agitation, aggression and, occasionally, psychotic symptoms) do not influence prescription choices. Depressive symptoms may be taken more seriously in the absence of a previous history of depression, leading to increased antidepressant prescription rates in individuals presenting with depression for the first time.

Gray matter characteristics associated with trait anxiety in older adults are moderated by depression

2015 ◽  
Vol 27 (11) ◽  
pp. 1813-1824 ◽  
Author(s):  
Olivier Potvin ◽  
Gwénaëlle Catheline ◽  
Charlotte Bernard ◽  
Céline Meillon ◽  
Valérie Bergua ◽  
...  
Keyword(s):  
Older Adults ◽  
Depressive Symptoms ◽  
Trait Anxiety ◽  
Cortical Thickness ◽  
Gray Matter ◽  
Previous History ◽  
Temporal Cortex ◽  
Anterior Cingulate ◽  
History Of ◽  
History Of Depression

ABSTRACTBackground:Structural gray matter characteristics of anxiety remain unclear. The aim of this study was to assess the influence of current depressive symptoms and history of depression on the gray matter characteristics of trait anxiety.Methods:Structural magnetic resonance imaging (MRI) data from 393 individuals aged 65 years or older were used. Regions of interest (ROIs) included the amygdala, anterior cingulate cortex (ACC), insula, orbitofrontal cortex (OFC), and temporal cortex. Trait anxiety was measured by the State-Trait Anxiety Inventory (STAI). Depression and depressive symptoms were measured using DSM-IV criteria and the Center for Epidemiological Studies Depression Scale (CESD).Results:After adjustments for sociodemographics and health-related variables, anxiety had a significant influence on the gray matter characteristics in all cortical ROIs. First, in participants without depression antecedents, higher trait anxiety was associated with a larger cortical thickness in all cortical ROIs. Second, in participants with a previous history of depression, higher trait anxiety was associated with a smaller cortical thickness in all cortical ROIs.Conclusions:These results suggest that anxiety is related to cortical thickness differently in healthy older adults and in older adults with psychiatric antecedents. Anxiety associated with thinner cortical areas could reflect symptoms of a specific type of depression or a vulnerability to develop depression.

#3041 High prevalence of lifetime depressive symptoms in patients referred for clinical amyloid-PET: a retrospective study

2021 ◽  
Vol 92 (8) ◽  
pp. A9.1-A9
Author(s):  
Anna Fitzgerald ◽  
Flavia Loreto ◽  
Mara Golemme ◽  
Zarni Win ◽  
Neva Patel ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Depressive Symptoms ◽  
Amyloid Pet ◽  
Onset Age ◽  
Appropriate Use Criteria ◽  
Memory Clinic ◽  
Appropriate Use ◽  
History Of ◽  
History Of Depression

Objectives/AimsDepression has been reported as a possible risk factor for Alzheimer’s Disease, but also as one of the clinical features of Alzheimer’s as well as other dementias. Further, depression has long been associated with cognitive impairment in the absence of neurodegeneration (Connors et al. 2018). Here we sought to ascertain the prevalence of clinical depression in patients meeting widely accepted Appropriate Use Criteria for Amyloid PET Imaging (API). We examined the prevalence of lifetime depression in patients undergoing clinical API in a real-world clinical setting and compared our findings with population data from community-dwelling older adults. We also examined whether rates of depression were higher in amyloid positive or negative groups.MethodsOne-hundred-and-eighty-five older adults (mean age 67.079.37, 49% females) underwent diagnostic workup, including API, at the Imperial Memory Clinic between January 2017 and June 2019. API was performed in line with appropriate use criteria after multidisciplinary team discussion. History of depressive symptoms and features of depression were evaluated through a review of hospital records and clinical correspondence. Patients were defined as having a history of depression if there was evidence of previous or current depressive symptoms and/or of a formal diagnosis of depression in their clinical records.ResultsBased on visual reads, 83 individuals had positive Amyloid-PET scans and 102 were negative. Overall, 102 (55%) patients(mean age=66.758.99, 56% females) had a history of lifetime depressive symptoms, compared with just 12 and 19% of elderly individuals in the general population (McDougall et al. 2007; Biddulph et al. 2014). Of the 92 patients for whom further information regarding depression onset were available, 54 (58.7%) had early symptom onset (age <60), and 38 (41.3%) had late symptom onset (age ≥s60). At the time of the clinical assessment at the Imperial Memory Clinic, 71 of those 102 (69.6%) were on active treatment for depression. Finally, depression was not associated with amyloid status (χ2(1) =1.12p=.26), with 42 (41.2%) amyloid-positive and 60 (58.8%) amyloid-negative patients reporting a history of depression.ConclusionsOver half of patients with suspected cognitive impairment and meeting appropriate use criteria for clinical API had a history of depression, regardless of amyloid status. Depression is an important but incompletely understood factor in referral for evaluation with Amyloid-PET.

scholarly journals The contribution of depressive ‘disorder characteristics’ to determinations of prognosis for adults with depression: an individual patient data meta-analysis

2021 ◽  
pp. 1-14
Author(s):  
Joshua E. J. Buckman ◽  
Rob Saunders ◽  
Zachary D. Cohen ◽  
Phoebe Barnett ◽  
Katherine Clarke ◽  
...  
Keyword(s):  
Primary Care ◽  
Depressive Symptoms ◽  
Depressive Symptom ◽  
Panic Disorder ◽  
Symptom Severity ◽  
Individual Patient Data ◽  
Antidepressant Treatment ◽  
Patient Data ◽  
History Of ◽  
Depressive Symptom Severity

Abstract Background This study aimed to investigate general factors associated with prognosis regardless of the type of treatment received, for adults with depression in primary care. Methods We searched Medline, Embase, PsycINFO and Cochrane Central (inception to 12/01/2020) for RCTs that included the most commonly used comprehensive measure of depressive and anxiety disorder symptoms and diagnoses, in primary care depression RCTs (the Revised Clinical Interview Schedule: CIS-R). Two-stage random-effects meta-analyses were conducted. Results Twelve (n = 6024) of thirteen eligible studies (n = 6175) provided individual patient data. There was a 31% (95%CI: 25 to 37) difference in depressive symptoms at 3–4 months per standard deviation increase in baseline depressive symptoms. Four additional factors: the duration of anxiety; duration of depression; comorbid panic disorder; and a history of antidepressant treatment were also independently associated with poorer prognosis. There was evidence that the difference in prognosis when these factors were combined could be of clinical importance. Adding these variables improved the amount of variance explained in 3–4 month depressive symptoms from 16% using depressive symptom severity alone to 27%. Risk of bias (assessed with QUIPS) was low in all studies and quality (assessed with GRADE) was high. Sensitivity analyses did not alter our conclusions. Conclusions When adults seek treatment for depression clinicians should routinely assess for the duration of anxiety, duration of depression, comorbid panic disorder, and a history of antidepressant treatment alongside depressive symptom severity. This could provide clinicians and patients with useful and desired information to elucidate prognosis and aid the clinical management of depression.

Abstract P543: Association Of Tanning Bed Use With Depression In A Preventive Medicine Cohort: The Cooper Center Longitudinal Study

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Katie Kinser ◽  
Beth B Wright ◽  
David Leonard ◽  
Laura F Defina
Keyword(s):  
Depressive Symptoms ◽  
Preventive Medicine ◽  
Personal History ◽  
Healthy Population ◽  
Cross Sectional ◽  
Tanning Beds ◽  
Increased Risk ◽  
Tanning Bed ◽  
History Of ◽  
History Of Depression

Importance: The use of tanning beds continues despite evidence of increased skin cancer risk among users. In the US, the prevalence of indoor tanning ranges from 35% of adults to 59% of college students. Objective: To investigate the association between depressive symptoms and tanning bed use. Design: Cross-sectional study. Setting: A preventive medicine clinic in Dallas, Texas. Participants: Between September 2013 and June 2019, a total of 11,823 generally healthy men and women presented for preventive medical examinations. Exposure: Self-reported tanning bed use. Main Outcome and Measures: Depressive symptoms as indicated by a score of greater than or equal to 10 on the Center for Epidemiologic Studies Depression (CES-D) Scale. Results: Fifteen percent of participants had used a tanning bed prior to their examination. For men, tanning bed use was associated with an increased risk of depressive symptoms (OR: 1.86; 95% CI:1.41-2.44). For women, the association between the use of tanning beds and depressive symptoms was significant in an unadjusted model, but was no longer significant after adjustment for confounders (OR: 1.26; 95% CI:0.99-1.61). However, the odds ratio was still in the direction of increased risk. Women with a personal history of depression were more likely to tan frequently and have higher CES-D scores than women with no personal history of depression ( p = .003). Conclusions and Relevance: In a generally healthy population, depressive symptoms were associated with the use of a tanning bed. This association was more evident in those with a history of depression, although remained true for those without a history of depression. As recurrent tanning bed use is known to contribute to the diagnosis of melanoma, it is critical to help patients identify other options to treat depression as well as to educate them on the risks of routine tanning bed use.

History of depression, depressive symptoms, and medial temporal lobe atrophy and the risk of Alzheimer disease

Neurology ◽  
2008 ◽  
Vol 70 (15) ◽  
pp. 1258-1264 ◽  
Author(s):  
M. I. Geerlings ◽  
T. den Heijer ◽  
P. J. Koudstaal ◽  
A. Hofman ◽  
M.M.B. Breteler
Keyword(s):  
Depressive Symptoms ◽  
Alzheimer Disease ◽  
Temporal Lobe ◽  
Medial Temporal Lobe ◽  
Medial Temporal Lobe Atrophy ◽  
History Of ◽  
History Of Depression ◽  
Lobe Atrophy

scholarly journals LO57: Validation of the Ottawa 3DY in community seniors in the ED

CJEM ◽  
2017 ◽  
Vol 19 (S1) ◽  
pp. S47 ◽  
Author(s):  
C. Bédard ◽  
P. Voyer ◽  
D. Eagles ◽  
V. Boucher ◽  
M. Pelletier ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Dysfunction ◽  
Mental Status ◽  
Medical Condition ◽  
Previous History ◽  
Altered Mental Status ◽  
Initial Interview ◽  
Nursing Facility ◽  
Trained Research Assistant ◽  
History Of

Introduction: Cognitive dysfunction is getting more common in geriatric emergency department (ED) patients, as the number of seniors visiting our EDs is increasing. ED guidelines recommend a systematic mental status screening for seniors presenting to the ED. As the existing tools are not suitable for the busy ED environment, we need quicker and easier ways to assess altered mental status, such as the O3DY. The purpose of this study is to assess the effectiveness of the French version of the O3DY to screen for cognitive dysfunction in seniors presenting to the ED. Methods: This is a planned sub-study of the INDEED project, which was conducted between February and May 2016 in 4 hospitals across the province of Québec. Inclusion criteria were: patients aged ≥65, with an 8-hour ED stay, admitted on a care unit, independent or semi-independent in their activities of daily living. Exclusion criteria were: patient living in a long-term nursing facility, with an unstable medical condition, pre-existing psychiatric condition or severe dementia, a delirium within the 8-hour exposure to the ED. A trained research assistant collected the following data upon initial interview: socio-demographic information, cognitive assessment (TICS-m), functional assessment (OARS) and delirium screening (CAM). The O3DY was also administered at initial interview and during patient follow-ups, as well as the CAM. Results: This study population was composed of 305 participants, of which 47.7% were men. Mean age was 76 years old (SD: 10.8). Nine of these participants had a previous history of dementia. 151 of these participants (47,04%) had a negative O3DY and 154 (47,98%) a positive O3DY at the initial encounter. When compared to the CAM, the O3DY presents a sensitivity of 85.0% (95% CI [62.1, 96.8]) and a specificity of 57.7% (95% CI [51.8, 63.6]) for prevalent delirium. When compared to the TICS, the O3DY presents a sensitivity of 76.7% (95% CI [66.4, 85.2]) and a specificity of 68.1% (95% CI [61.3, 74.3]) for cognitive impairment. The combined measure presents a sensitivity of 76.7% (95% CI [66.6, 84.9]) and a specificity of 68.4% (95% CI [61.7, 74.5]). Conclusion: A negative result to the O3DY indicates the absence of prevalent delirium or undetected cognitive impairment. The O3DY could be a useful tool for the triage nurses in the ED.

Increased Cerebrospinal Fluid Concentration of ZnT3 Is Associated with Cognitive Impairment in Alzheimer’s Disease

2020 ◽  
Vol 77 (3) ◽  
pp. 1143-1155
Author(s):  
Daniela Enache ◽  
Joana B. Pereira ◽  
Vesna Jelic ◽  
Bengt Winblad ◽  
Per Nilsson ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cerebrospinal Fluid ◽  
Cognitive Impairment ◽  
Depressive Symptoms ◽  
Cognitive Decline ◽  
Lewy Bodies ◽  
Lewy Body Dementia ◽  
Synaptic Proteins ◽  
Subjective Cognitive Decline

Background: Cognitive deficits arising in the course of Alzheimer’s disease (AD), dementia with Lewy bodies (DLB), and Parkinson’s disease with dementia (PDD) are directly linked to synaptic loss. Postmortem studies suggest that zinc transporter protein 3 (ZnT3), AMPA glutamate receptor 3 (GluA3), and Dynamin1 are associated with cognitive decline in AD and Lewy body dementia patients. Objective: We aimed to evaluate the diagnostic value of ZnT3, GluA3, and Dynamin 1 in the cerebrospinal fluid (CSF) of patients with dementia due to AD, DLB, and PDD compared to cognitively normal subjective cognitive decline (SCD) patients in a retrospective study. In addition, we assessed the relationship between synaptic markers and age, sex, cognitive impairment, and depressive symptoms as well as CSF amyloid, phosphorylated tau (p-tau), and total tau (T-tau). Methods: Commercially available ELISA immunoassay was used to measure the levels of proteins in a total of 97 CSF samples from AD (N = 24), PDD (N = 18), DLB (N = 27), and SCD (N = 28) patients. Cognitive impairment was assessed using the Mini-Mental State Examination (MMSE). Results: We found a significant increase in the concentrations of ZnT3, GluA3, and Dynamin1 in AD (p = 0.002) and of ZnT3 and Dynamin 1 in DLB (p = 0.001, p = 0.002) when compared to SCD patients. Changes in ZnT3 concentrations correlated with MMSE scores in AD (p = 0.011), and with depressive symptoms in SCD (p = 0.041). Conclusion: We found alteration of CSF levels of synaptic proteins in AD, PDD, and DLB. Our results reveal distinct changes in CSF concentrations of ZnT3 that could reflect cognitive impairment in AD with implications for future prognostic and diagnostic marker development.

scholarly journals Acceptability and feasibility of two interventions in the MooDFOOD Trial: a food-related depression prevention randomised controlled trial in overweight adults with subsyndromal symptoms of depression

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e034025
Author(s):  
Matthew Owens ◽  
Edward Watkins ◽  
Mariska Bot ◽  
Ingeborg Annemarie Brouwer ◽  
Miquel Roca ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Randomised Controlled Trial ◽  
Controlled Trial ◽  
Secondary Outcome ◽  
Depression Prevention ◽  
History Of ◽  
Randomised Controlled ◽  
Subsyndromal Symptoms ◽  
Overweight Adults ◽  
History Of Depression

ObjectivesWe report on the acceptability, feasibility, dose-response relationship and adherence of two nutritional strategies to improve mood (multinutrient supplements; food-related behavioural activation (F-BA)) studied in a randomised controlled depression prevention trial (the Multi‐country cOllaborative project on the rOle of Diet, Food‐related behaviour, and Obesity in the prevention of Depression (MooDFOOD) Trial). We also assessed baseline determinants of adherence and assessed whether better adherence resulted in lower depressive symptoms.DesignRandomised controlled trial with a 2×2 factorial design conducted between 2015 and 2017.SettingGermany, the Netherlands, UK and Spain.ParticipantsCommunity sample of 1025 overweight adults with elevated depressive symptoms without a current episode of major depressive disorder. Main eligibility criteria included age (18–75 years), being overweight or obese, and having at least mild depressive symptoms, shown by a Patient Health Questionnaire Score of ≥5. A total of 76% of the sample was retained at the 12-month follow-up.InterventionsDaily nutritional supplements versus pill placebo or an F-BA therapy, delivered in individual and group sessions versus no behavioural intervention over a 1-year period.Primary and secondary outcome measuresPrimary outcome: self-reported acceptability of the interventions. Secondary outcomes: adherence and self-reported depressive symptoms.ResultsMost participants reported that the F-BA was acceptable (83.61%), feasible to do (65.91%) and would recommend it to a friend (84.57%). Individual F-BA sessions (88.10%) were significantly more often rated as positive than group F-BA sessions (70.17%) and supplements (28.59%). There were statistically significant reductions in depressive symptoms for those who both adhered to the F-BA intervention and had a history of depression (B=−0.08, SE=0.03, p=0.012) versus those who had no history of depression. Supplement intake had no effect on depressive symptoms irrespective of adherence.ConclusionsF-BA may have scope for development as a depression prevention intervention and public health strategy but further refinement and testing are needed.Trial registration numberNCT02529423.

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