scholarly journals The association between frontal lobe perfusion and depressive symptoms in later life

2019 ◽  
Vol 214 (4) ◽  
pp. 230-236 ◽  
Author(s):  
Robert Briggs ◽  
Daniel Carey ◽  
Paul Claffey ◽  
Triona McNicholas ◽  
Louise Newman ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Depressive Symptoms ◽  
Older People ◽  
Frontal Lobe ◽  
Saturation Index ◽  
Community Dwelling ◽  
Lower Blood Pressure ◽  
Lower Blood ◽  
Community Dwelling Older People ◽  
Clinically Significant

BackgroundDeficits in frontal lobe perfusion have been demonstrated in late-life depression; however, studies to date have generally involved small numbers, used neuroimaging rather than bedside testing and have not controlled for important covariates.AimsWe aimed to examine the association between depressive symptoms and frontal lobe perfusion during standing, in a large cohort of community-dwelling older people.MethodParticipants aged ≥50 years underwent continuous measurement of orthostatic blood pressure by finometry, and frontal lobe perfusion by near-infrared spectroscopy. Depressive symptoms were assessed by the eight-item Centre for Epidemiological Studies Depression Scale. Real-time frontal lobe cerebral oxygenation was measured by the Portalite System, detecting changes in frontal lobe perfusion and reporting a tissue saturation index score.ResultsAlmost 8% (209 out of 2616) had clinically significant depressive symptoms. Multilevel models demonstrated a significantly lower tissue saturation index in participants with depressive symptoms at both 60 and 90 s post-stand, with coefficients of −0.43 (95% CI −0.63 to −0.22) and −0.37 (95% CI −0.57 to −0.16), respectively. Controlling for relevant covariates did not significantly attenuate these associations. After addition of systolic blood pressure this association was no longer significant, suggesting lower blood pressure may modify this relationship.ConclusionsThis study demonstrates that lower frontal lobe perfusion, related to lower values of baseline systolic blood pressure, is associated with clinically significant depressive symptoms in a cohort of community-dwelling older people. Given the recognised longitudinal association between lower blood pressure and depression in older people, this may represent a potential therapeutic target for prevention of incident depression.Declaration of interestNone.

scholarly journals Ambulatory Blood Pressure Variability Increases Over a 10-Year Follow-Up in Community-Dwelling Older People

2015 ◽  
Vol 29 (5) ◽  
pp. 560-567 ◽  
Author(s):  
Claire McDonald ◽  
Mark S. Pearce ◽  
Joanna Wincenciak ◽  
Simon R.J. Kerr ◽  
Julia L. Newton
Keyword(s):  
Blood Pressure ◽  
Older People ◽  
Ambulatory Blood Pressure ◽  
Blood Pressure Variability ◽  
Community Dwelling ◽  
Community Dwelling Older People

scholarly journals Apathy is associated with incident dementia in community-dwelling older people

Neurology ◽  
2017 ◽  
Vol 90 (1) ◽  
pp. e82-e89 ◽  
Author(s):  
Jan Willem van Dalen ◽  
Lennard L. Van Wanrooij ◽  
Eric P. Moll van Charante ◽  
Edo Richard ◽  
Willem A. van Gool
Keyword(s):  
Depressive Symptoms ◽  
Older People ◽  
Cox Regression ◽  
Depression Scale ◽  
Community Dwelling ◽  
Memory Complaints ◽  
Incident Dementia ◽  
Increased Risk ◽  
Community Dwelling Older People

ObjectiveTo assess whether apathy and depressive symptoms are independently associated with incident dementia during 6-year follow-up in a prospective observational population-based cohort study.MethodsParticipants were community-dwelling older people in the Prevention of Dementia by Intensive Vascular Care trial, aged 70–78 years, without dementia at baseline. Apathy and depressive symptoms were measured using the 15-item Geriatric Depression Scale (GDS-15). Dementia during follow-up was established by clinical diagnosis confirmed by an independent outcome adjudication committee. Hazard ratios (HRs) were calculated using Cox regression analyses. Given its potentially strong relation with incipient dementia, the GDS item referring to memory complaints was assessed separately.ResultsDementia occurred in 232/3,427 (6.8%) participants. Apathy symptoms were associated with dementia (HR 1.28, 95% confidence interval [CI] 1.12–1.45; p < 0.001), also after adjustment for age, sex, Mini-Mental State Examination score, disability, and history of stroke or cardiovascular disease (HR 1.21, 95% CI 1.06–1.40; p = 0.007), and in participants without depressive symptoms (HR 1.26, 95% CI 1.06–1.49; p = 0.01). Depressive symptoms were associated with dementia (HR 1.12, 95% CI 1.05–1.19), also without apathy symptoms (HR 1.16, 95% CI 1.03–1.31; p = 0.015), but not after full adjustment or after removing the GDS item on memory complaints.ConclusionsApathy and depressive symptoms are independently associated with incident dementia in community-dwelling older people. Subjective memory complaints may play an important role in the association between depressive symptoms and dementia. Our findings suggest apathy symptoms may be prodromal to dementia and might be used in general practice to identify individuals without cognitive impairment at increased risk of dementia.

scholarly journals The ‘Wish to Die’ in later life: prevalence, longitudinal course and mortality. Data from TILDA

2021 ◽  
Author(s):  
Robert Briggs ◽  
Mark Ward ◽  
Rose Anne Kenny
Keyword(s):  
Depressive Symptoms ◽  
Older People ◽  
Later Life ◽  
Community Dwelling ◽  
Mortality Data ◽  
Individual Level ◽  
Longitudinal Course ◽  
Wish To Die ◽  
Community Dwelling Older People

Abstract Background ‘Wish to Die’ (WTD) involves thoughts of or wishes for one’s own death or that one would be better off dead. Objective To examine the prevalence, longitudinal course and mortality-risk of WTD in community-dwelling older people. Design Observational study with 6-year follow-up. Setting The Irish Longitudinal Study on Ageing, a nationally representative cohort of older adults. Subjects In total, 8,174 community-dwelling adults aged ≥50 years. Methods To define WTD, participants were asked: ‘In the last month, have you felt that you would rather be dead?’ Depressive symptoms were measured using the CES-D. Mortality data were compiled by linking administrative death records to individual-level survey data from the study. Results At Wave 1, 3.5% of participants (279/8,174) reported WTD. Both persistent loneliness (OR 5.73 (95% CI 3.41–9.64)) and depressive symptoms (OR 6.12 (95% CI 4.33–8.67)) were independently associated with WTD. Of participants who first reported WTD at Wave 1 or 2, 72% did not report WTD when reassessed after 2 years, and the prevalence of depressive symptoms (−44%) and loneliness (−19%) was more likely to decline in this group at follow-up. Fifteen per cent of participants expressing WTD at Wave 1 died during a 6-year follow-up. Conclusions WTD amongst community-dwelling older people is frequently transient and is strongly linked with the course of depressive symptoms and loneliness. An enhanced focus on improving access to mental health care and addressing social isolation in older people should therefore be a public health priority, particularly in the current context of the Covid-19 pandemic.

scholarly journals Components of the metabolic syndrome and depressive symptoms in community-dwelling older people: the Bambuí Cohort Aging Study

2016 ◽  
Vol 38 (3) ◽  
pp. 183-189 ◽  
Author(s):  
Luiz Gustavo Ruas ◽  
Breno S. Diniz ◽  
Josélia O. Firmo ◽  
Sérgio V. Peixoto ◽  
Juliana V. Mambrini ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Depressive Symptoms ◽  
Older People ◽  
Community Dwelling ◽  
The Metabolic Syndrome ◽  
Aging Study ◽  
Community Dwelling Older People

scholarly journals Medication use in community-dwelling older people: pharmacoepidemiology of psychotropic utilisation

2014 ◽  
Vol 6 (4) ◽  
pp. 269 ◽  
Author(s):  
Anna Schäfers ◽  
Nataly Martini ◽  
Simon Moyes ◽  
Karen Hayman ◽  
Monica Zolezzi ◽  
...  
Keyword(s):  
Older Adults ◽  
Depressive Symptoms ◽  
New Zealand ◽  
Older People ◽  
Psychotropic Medication ◽  
Medication Use ◽  
Community Dwelling ◽  
Drug Event ◽  
Community Dwelling Older People ◽  
Community Dwelling Older Adults

INTRODUCTION: Psychotropic medications have a significant adverse drug event profile, particularly in older adults, and appropriate use is paramount. Patterns of prescribing in community-dwelling older adults in New Zealand remain unknown. AIM: This study aimed to determine the prevalence and the pattern of psychotropic use amongst community-dwelling older people in New Zealand and to identify any association between depressive symptomatology and psychotropic medication use. METHODS: Data were collected on the demographics, medication use and mood status of community-dwelling older adults from two New Zealand studies: the BRIGHT trial, which recruited potentially disabled participants (N=141) and the DeLLITE trial, which recruited potentially depressed participants (N=193). The prevalence and the pattern of psychotropic use were established and the gender, age and level of depression assessed using regression analysis. RESULTS: The use of any psychotropic medication was 28.9% in the BRIGHT trial and 43.5% in the DeLLITE trial. Antidepressants were the most commonly used psychotropic medication in the two studies, followed by hypnotics and sedatives. Psychotropic use was highly correlated with the presence of depressive symptoms in the BRIGHT trial and with female gender in the DeLLITE trial. Age was not associated with psychotropic medication use. In both studies, there is possible underdiagnosed, undertreated and inappropriately treated depression. DISCUSSION: The prevalence of psychotropic medication use is high in community-dwelling older people with disability and very high in community-dwelling older people with depressive symptoms, but varies by gender and level of depression. KEYWORDS: Aged; depression; independent living; New Zealand; psychotropic drugs

scholarly journals THE ASSOCIATION OF BLOOD PRESSURE WITH FRAILTY AMONG COMMUNITY-DWELLING OLDER PEOPLE

2017 ◽  
Vol 1 (suppl_1) ◽  
pp. 1129-1129
Author(s):  
M. Kabayama ◽  
K. Kamide ◽  
Y. Gondo ◽  
K. Sugimoto ◽  
Y. Masui ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Older People ◽  
Community Dwelling ◽  
Community Dwelling Older People
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