Depression in Later Life

1995 ◽  
Vol 167 (5) ◽  
pp. 649-652 ◽  
Author(s):  
R. C. Baldwin ◽  
Barbara Tomenson
Keyword(s):  
Vascular Disease ◽  
Early Onset ◽  
Rating Scale ◽  
Late Onset ◽  
Later Life ◽  
The Elderly ◽  
Course Of Illness ◽  
Anxiety Item ◽  
History Of ◽  
Item Scores

BackgroundDepression in later life is often thought to differ from that at other times of adulthood. The evidence for this is controversial but is important to any proposed organic model of depression in the elderly. Here, early- and late-onset depressions in later life are compared.MethodFifty-seven depressed patients with a mean age of 74 were studied, 21 with an early onset (aged 59 or less) and 36 with a late onset. All were suffering from major depression according to DSM–III–R. The measures at entry included severity and symptoms, cognitive function, antecedent life events, physical health and vascular risk factors and/or vascular disease. We also recorded any family history of mood disorders, as well as the course of illness.ResultsThe anxiety item scores of the Hamilton Depression Rating Scale were significantly higher in those with an early onset, but otherwise symptoms differed little. Heritability was greater in the early-onset group. There was a striking association of vascular disease and/or risk with late-onset patients.ConclusionsVascular disease is associated with late-onset depression. This is consistent with the hypothesis that depression in later life is a more ‘biological’ disorder.

Age, Age of Onset and Course of Primary Depressive Illness in the Elderly*

1983 ◽  
Vol 28 (2) ◽  
pp. 102-104 ◽  
Author(s):  
Martin G. Cole
Keyword(s):  
Elderly Patients ◽  
Depressive Episode ◽  
Early Onset ◽  
Age Of Onset ◽  
Late Onset ◽  
The Elderly ◽  
Depressive Illness ◽  
Physical Illness ◽  
Course Of Illness

Thirty-eight elderly patients with primary depressive illness (Feighner criteria) were followed up for 7–31 months. In the absence of persistent organic signs and severe physical illness, age of onset (first depressive episode after 60) but not age was significantly related to course of illness. Compared to early onset depressives, late onset depressives were more likely to remain completely well during the follow-up period and less likely to have frequent or disabling relapses.

The natural history of late-onset epilepsy secondary to vascular disease

1989 ◽  
Vol 80 (6) ◽  
pp. 524-526 ◽  
Author(s):  
D. R. Fish ◽  
D. H. Miller ◽  
R. C. Roberts ◽  
J. D. Blackie ◽  
R. W. Gilliatt
Keyword(s):  
Natural History ◽  
Vascular Disease ◽  
Late Onset ◽  
History Of

Late-life depression

2014 ◽  
Vol 29 (S3) ◽  
pp. 577-577 ◽  
Author(s):  
K. Ritchie
Keyword(s):  
Depressive Symptomatology ◽  
Late Onset ◽  
Late Life ◽  
Later Life ◽  
The Elderly ◽  
Conclusive Evidence ◽  
First Episode ◽  
Hormonal Changes ◽  
Late Life Depression ◽  
Incident Cases

Late-life depression is highly heterogeneous in clinical presentation, and is also commonly resistant to treatment. While some cases are a continuation of the chronic course of illness beginning in early adulthood, a large number of persons will have a first episode of depression in later life following alife-time of relatively good mental health. While incident cases of major depression tend to decrease with age, the number of persons with clinically significant depressive symptomatology rises. À distinction has often been made between early-onset and late-onset depression, however, there is no conclusive evidence to suggest these are distinct clinical entities. On the other hand observations from a fifteen year prospective population study of psychiatric disorder in the elderly (the ESPRIT Study) supports the alternative idea that depression may be divided into sub-types according to postulated aetiology; for example depression with a strong genetic component, related to hormonal changes, the consequence of trauma; the result of cerebrovascular insult. Exposure to these putative causes may be more common at different points in the life span, thus suggesting age-differences. Our research further suggests that even cases of depression appearing for the first time in late-life, may be initially triggered by risk factors occurring decades before. Our findings suggest, for example, that childhood events may lead to changes in the biology of stress management, which continue throughout life, increasing vulnerability to depression and persisting even after effective treatment of symptoms. Together these observations suggest it may be more meaningful to classify depression in the elderly according to probable principle precipitating factors rather than age.

scholarly journals Atrial Fibrillation Increases the Risk of Early-Onset Dementia in the General Population: Data from a Population-Based Cohort

2020 ◽  
Vol 9 (11) ◽  
pp. 3665
Author(s):  
Dongmin Kim ◽  
Pil-Sung Yang ◽  
Gregory Y.H. Lip ◽  
Boyoung Joung
Keyword(s):  
Atrial Fibrillation ◽  
Early Onset ◽  
Late Onset ◽  
Population Data ◽  
The Elderly ◽  
Population Based ◽  
Early Onset Dementia ◽  
Increased Risk ◽  
Late Onset Dementia

Atrial fibrillation (AF) is considered a risk factor for dementia, especially in the elderly. However, the association between the two diseases is not well identified in different age subgroups. The association of incident AF with the development of dementia was assessed from 1 January 2005, to 31 December 2013, in 428,262 participants from a longitudinal cohort (the Korea National Health Insurance Service-Health Screening cohort). In total, 10,983 participants were diagnosed with incident AF during the follow-up period. The incidence of dementia was 11.3 and 3.0 per 1000 person-years in the incident-AF and without-AF groups, respectively. After adjustment for clinical variables, the risk of dementia was significantly elevated by incident AF, with a hazard ratio (HR) of 1.98 (95% confidence interval [CI]: 1.80–2.17, p < 0.001), even after censoring for stroke (HR: 1.74, 95% CI: 1.55–1.94, p < 0.001). The HRs of incident AF for dementia onset before the age of 65 (early-onset dementia) and for onset after the age of 65 (late-onset dementia) were 2.91 (95% CI: 1.93–4.41) and 1.67 (95% CI: 1.49–1.87), respectively. Younger participants with AF were more prone to dementia development than older participants with AF (p for trend < 0.001). AF was associated with an increased risk of both early- and late-onset dementia, independent of clinical stroke.

scholarly journals Fetal Growth Restriction – Diagnostic Work-up, Management and Delivery

2020 ◽  
Vol 80 (10) ◽  
pp. 1016-1025 ◽  
Author(s):  
Dietmar Schlembach
Keyword(s):  
Early Onset ◽  
Late Onset ◽  
Fetal Monitoring ◽  
Later Life ◽  
Growth Restriction ◽  
Growth Potential ◽  
Ductus Venosus ◽  
Optimum Approach ◽  
Diagnostic Work ◽  
Genetically Determined

AbstractFetal or intrauterine growth restriction (FGR/IUGR) affects approximately 5 – 8% of all pregnancies and refers to a fetus not exploiting its genetically determined growth potential. Not only a major cause of perinatal morbidity and mortality, it also predisposes these fetuses to the development of chronic disorders in later life. Apart from the timely diagnosis and identification of the causes of FGR, the obstetric challenge primarily entails continued antenatal management with optimum timing of delivery. In order to minimise premature birth morbidity, intensive fetal monitoring aims to prolong the pregnancy and at the same time intervene, i.e. deliver, before the fetus is threatened or harmed. It is important to note that early-onset FGR (< 32 + 0 weeks of gestation [wks]) should be assessed differently than late-onset FGR (≥ 32 + 0 wks). In early-onset FGR progressive deterioration is reflected in abnormal venous Doppler parameters, while in late-onset FGR this manifests primarily in abnormal cerebral Doppler ultrasound. According to our current understanding, the “optimum” approach for monitoring and timing of delivery in early-onset FGR combines computerized CTG with the ductus venosus Doppler, while in late-onset FGR assessment of the cerebral Doppler parameters becomes more important.

scholarly journals Late-onset depression: issues affecting clinical care

2008 ◽  
Vol 14 (2) ◽  
pp. 152-158 ◽  
Author(s):  
Hannele Variend ◽  
Y. Vishnu Gopal
Keyword(s):  
Clinical Features ◽  
Cognitive Deficits ◽  
Early Onset ◽  
Late Onset ◽  
Clinical Care ◽  
Later Life ◽  
Recurrent Depression ◽  
Vascular Depression ◽  
Structural Abnormalities ◽  
First Time

A growing body of evidence suggests that late-onset depression (depression occurring for the first time in later life) differs from early-onset (recurrent) depression in terms of clinical features, aetiology, neuroanatomical substrates and prognosis. Some evidence suggests that late-onset depression is more associated with somatic symptoms, cognitive deficits, cerebral structural abnormalities, vascular disease (‘vascular depression’) and poorer treatment outcomes than is early-onset depression. Both general adult and old age psychiatrists face the challenges of managing late-onset depression. In this article we attempt to clarify specific issues relating to late-onset depression in terms of clinical features, aetiology, treatment response and prognosis.

Suicide in later life: A comparison between cases with early-onset and late-onset depression

2011 ◽  
Vol 132 (1-2) ◽  
pp. 185-191 ◽  
Author(s):  
Richard C. Oude Voshaar ◽  
Nav Kapur ◽  
Harriet Bickley ◽  
Alyson Williams ◽  
Nitin Purandare
Keyword(s):  
Early Onset ◽  
Late Onset ◽  
Later Life

scholarly journals Deliberate Self-Harm and the Elderly: A Volatile Combination—An Overview from the Plastic Surgery Perspective

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
J. Packer ◽  
M. A. Hussain ◽  
S. H. A. Shah ◽  
J. R. Srinivasan
Keyword(s):  
Plastic Surgery ◽  
Protective Factor ◽  
Previous History ◽  
Later Life ◽  
The Elderly ◽  
Elderly Group ◽  
History Of ◽  
Group A ◽  
Almost All ◽  
Surgery Department

Aims. To study the factors associated with the DSH in the elderly group of 60 years and above and to recommend changes to be implemented in order to improve the management in this specific group. Materials and Methods. Five-year retrospective study was undertaken from July 2005 to July 2010 in the Plastic Surgery Department of the Royal Preston Hospital, NHS Trust. A Performa was designed to collect data about the inpatient admission and included certain areas of key information. The case notes for all patients were extensively analysed in order to gather adequate information for the devised Performa. Results. DSH is getting more common in the elderly group, and males are more affected than females. 60% of the patients had a previous history of DSH. A large number (80%) of patients had a previous history of mental illness. 60% of those DSH patients were living with family. Almost all patients (90%) were reviewed by the Psychiatry Liaison Team. The timing of patients being assessed was highly variable. Conclusions. Marriage is not a protective factor in the prevention of the DSH in the elderly group. A mental health team referral in the early phases of the management would be of huge benefit and a likely step to prevent possible future admissions. The Department would benefit from the creation of a protocol for the management of these patients. There should be a joint effort of the professionals in the management of DSH in the elderly, and GPs play a very important role in the prevention of DSH in the later life.

Suicide in Later Life: Psychological Autopsy Findings

1991 ◽  
Vol 3 (1) ◽  
pp. 59-66 ◽  
Author(s):  
Yeates Conwell ◽  
Kurt Olsen ◽  
Eric D. Caine ◽  
Catherine Flannery
Keyword(s):  
Major Depression ◽  
Preliminary Data ◽  
Late Onset ◽  
Later Life ◽  
The Elderly ◽  
Psychological Autopsy ◽  
Autopsy Study ◽  
Autopsy Findings ◽  
Completed Suicide ◽  
Viable Method

The authors report preliminary data from a psychological autopsy study of completed suicide in late life. Sixteen of 18 victims had diagnosable psychopathology, most commonly major depression of late onset. Symptoms manifest prior to death are described and directions for future investigation discussed. The psychological autopsy is shown to be a viable method for studying suicide in the elderly.

Clinical and neurocognitive characteristics associated with treatment-resistant depression

2017 ◽  
Vol 41 (S1) ◽  
pp. S542-S542 ◽  
Author(s):  
G. Serafini ◽  
G. Adavastro ◽  
G. Canepa ◽  
C. Conigliaro ◽  
M. Pompili ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Early Onset ◽  
Rating Scale ◽  
Color Word ◽  
Late Onset ◽  
Anxiety Symptoms ◽  
Treatment Resistant Depression ◽  
Treatment Resistant ◽  
Interference Test ◽  
Resistant Depression

IntroductionTreatment resistant depression (TRD) is a disabling condition associated with a relevant psychosocial impairment worldwide.ObjectivesThis exploratory study is aimed to evaluate the main clinical and neurocognitive characteristics in a sample of 21 subjects admitted to the Psychiatric Clinic of University of Genoa as inpatients between 2015 and 2016 and diagnosed with TRD according to Thase and Rush staging method.MethodsPatients have been assessed using the Hamilton Depression Rating Scale (HDRS), Hamilton Anxiety Rating Scale, and Clinical Global Impression (CGI). The Continuous Performance Test (CPT), Trial Making Test (TMT-A/B), Stroop Color Word Interference Test, Verbal Fluency Test, and Rey auditory-verbal learning test (RAVLT) have been administered as well.ResultsSubjects with early-onset (< 50 years) depression had a longer illness duration, higher depressive episodes and more impaired performance at RAVLT while individuals with late-onset (> 50 years) depression showed a higher severity of depressive symptoms and more anxiety symptoms. Depressive symptoms were positively associated with anxiety (r = 0.82; P = 0.00) and negatively with TMT-A/B (r = −0.56, P = 0.01), Stroop Color Word Interference Test (r = −0.72, P = 0.005 and r = −0.616, P = 0.008), and RAVLT (r = −0.60; P = 0.02) performances. According to regression analyses, anxiety symptoms were the only significant predictor of depression severity (P = 0.02).ConclusionsEarly-onset depression is associated with more disability and worse neurocognitive performance whereas late-onset depression is linked to more anxiety symptoms and more depressive symptoms severity. Clinicians should closely monitor patients with TRD for the presence of anxiety symptoms that may represent a significant risk factor of poorer long-term outcome.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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