scholarly journals What to Do When there is Nothing to Do: The psychotherapeutic value of Meaning Therapy in the treatment of late life depression

2013 ◽  
Vol 5 (1) ◽  
pp. 324-330
Author(s):  
J. H. Morgan
Keyword(s):  
Elderly Patient ◽  
Late Life ◽  
The Elderly ◽  
Late Life Depression ◽  
Healthy Living ◽  
Psychotherapeutic Treatment ◽  
The Future ◽  
Full Life ◽  
The Moment ◽  
Meaning Therapy

Psychotherapeutic treatment with the goal of cure, of course, is the standard within the healing professions but when we are dealing with late life depression where there is no hope for longevity, the agenda necessarily must shift from cure to care, from treatment with the goal of renewed healthy living to a focus upon the palliative aspects of a limited prognosis. Here, then, the clinician is faced with the challenge of existential intervention with an emphasis upon the “moment” rather than the future. The encroachment of ennui upon the elderly, particularly and especially those who have been actively engaged in a full life of service such as the clergy, physicians, teachers, and attorneys, can be a traumatic and debilitating experience.When hope for the future is not being sought but rather an effective and celebrative address to the existential realities confronting the elderly patient who is facing decline and death, the quest for those “happy moments” conjured in the patient’s memory constitute a promising field of treatment.Geriatric logotherapy is uniquely constructed to do just that.

scholarly journals When Cognitive Decline and Depression Coexist in the Elderly: CSF Biomarkers Analysis Can Differentiate Alzheimer's Disease from Late-Life Depression

2018 ◽  
Vol 10 ◽  
Author(s):  
Claudio Liguori ◽  
Mariangela Pierantozzi ◽  
Agostino Chiaravalloti ◽  
Giulia M. Sancesario ◽  
Nicola B. Mercuri ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Decline ◽  
Late Life ◽  
The Elderly ◽  
Csf Biomarkers ◽  
Late Life Depression

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.

Depression and mild cognitive impairment – Comorbidity and/or continuum?

2016 ◽  
Vol 33 (S1) ◽  
pp. S190-S191
Author(s):  
G. Sobreira ◽  
M.A. Aleixo ◽  
C. Moreia ◽  
J. Oliveira
Keyword(s):  
Risk Factors ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Decline ◽  
Late Life ◽  
The Elderly ◽  
Late Life Depression ◽  
Pubmed Database ◽  
Competing Interest ◽  
The Relationship

IntroductionDepression and mild cognitive impairment are common among the elderly. Half the patients with late-life depression also present some degree of cognitive decline, making the distinction between these conditions difficult.ObjectivesTo conduct a database review in order to understand the relationship between these entities, and treatment approaches.AimsTo create and implement clinical guidelines at our institution, to evaluate and treat elderly patients presenting with depression and mild cognitive impairment.MethodsA PubMed database search using as keywords “late life depression”, “depression”; “cognitive impairment”; “mild cognitive impairment” and “dementia” between the year 2008 and 2015.ResultsLate-life depression and cognitive impairment are frequent among the elderly (10–20%). Depression is also common in the early stages of dementia decreasing as the cognitive decline progresses. The causal relationship between these entities is not well understood and some authors advocate a multifactorial model (genetic risk factors; neuroendocrine changes; vascular risk factors) and the cognitive impairment of said changes is dependent on the individual's cognitive reserve. Regarding treatment of depression in patients with cognitive impairment, most authors advocate a stepped approach with watchful waiting and then, if symptoms persist, the introduction of pharmacotherapy and psychosocial intervention.ConclusionsThe relationship between cognitive impairment and depression is still not clear and probably multifactorial. The diagnosis of depressive symptoms in patients with severe cognitive impairment can be difficult and most forms of pharmacological treatment in this population are not beneficial, making it important to carefully evaluate the benefits of introducing new medication.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Relationship between progression of brain white matter changes and late-life depression: 3-year results from the LADIS study

2012 ◽  
Vol 201 (1) ◽  
pp. 40-45 ◽  
Author(s):  
Michael J. Firbank ◽  
Andrew Teodorczuk ◽  
Wiesje M. Van Der Flier ◽  
Alida A. Gouw ◽  
Anders Wallin ◽  
...  
Keyword(s):  
White Matter ◽  
Depression Scale ◽  
Late Life ◽  
The Elderly ◽  
Late Life Depression ◽  
White Matter Changes ◽  
Brain White Matter ◽  
History Of ◽  
Depressive Episodes ◽  
History Of Depression

BackgroundBrain white matter changes (WMC) and depressive symptoms are linked, but the directionality of this association remains unclear.AimsTo investigate the relationship between baseline and incident depression and progression of white matter changes.MethodIn a longitudinal multicentre pan-European study (Leukoaraiosis and Disability in the elderly, LADIS), participants aged over 64 underwent baseline magnetic resonance imaging (MRI) and clinical assessments. Repeat scans were obtained at 3 years. Depressive outcomes were assessed in terms of depressive episodes and the Geriatric Depression Scale (GDS). Progression of WMC was measured using the modified Rotterdam Progression scale.ResultsProgression of WMC was significantly associated with incident depression during year 3 of the study (P = 0.002) and remained significant after controlling for transition to disability, baseline WMC and baseline history of depression. There was no significant association between progression of WMC and GDS score, and no significant relationship between progression of WMC and history of depression at baseline.ConclusionsOur results support the vascular depression hypothesis and implicate WMC as causal in the pathogenesis of late-life depression.

Loneliness in late-life depression: structural and functional connectivity during affective processing

2016 ◽  
Vol 46 (12) ◽  
pp. 2485-2499 ◽  
Author(s):  
N. M. L. Wong ◽  
H.-L. Liu ◽  
C. Lin ◽  
C.-M. Huang ◽  
Y.-Y. Wai ◽  
...  
Keyword(s):  
Functional Connectivity ◽  
Emotion Dysregulation ◽  
Diffusion Tensor ◽  
Structural Connectivity ◽  
Late Life ◽  
The Elderly ◽  
Affective Processing ◽  
Late Life Depression ◽  
Processing Task ◽  
Affective Stimuli

BackgroundLate-life depression (LLD) in the elderly was reported to present with emotion dysregulation accompanied by high perceived loneliness. Previous research has suggested that LLD is a disorder of connectivity and is associated with aberrant network properties. On the other hand, perceived loneliness is found to adversely affect the brain, but little is known about its neurobiological basis in LLD. The current study investigated the relationships between the structural connectivity, functional connectivity during affective processing, and perceived loneliness in LLD.MethodThe current study included 54 participants aged >60 years of whom 31 were diagnosed with LLD. Diffusion tensor imaging (DTI) data and task-based functional magnetic resonance imaging (fMRI) data of an affective processing task were collected. Network-based statistics and graph theory techniques were applied, and the participants’ perceived loneliness and depression level were measured. The affective processing task included viewing affective stimuli.ResultsStructurally, a loneliness-related sub-network was identified across all subjects. Functionally, perceived loneliness was related to connectivity differently in LLD than that in controls when they were processing negative stimuli, with aberrant networking in subcortical area.ConclusionsPerceived loneliness was identified to have a unique role in relation to the negative affective processing in LLD at the functional brain connectional and network levels. The findings increas our understanding of LLD and provide initial evidence of the neurobiological mechanisms of loneliness in LLD. Loneliness might be a potential intervention target in depressive patients.

Mood disorders in the elderly

2012 ◽  
pp. 1550-1558
Author(s):  
Robert Baldwin
Keyword(s):  
Bipolar Disorder ◽  
Mood Disorders ◽  
Late Life ◽  
Later Life ◽  
The Elderly ◽  
Clinical Syndrome ◽  
Late Life Depression ◽  
Increased Risk

This chapter considers some of the commonly asked questions about mood disorders in later life. Is depression in later life a distinct clinical syndrome? How common is it? Is there an organic link, for example to cerebral changes, and if so, is there an increased risk of later dementia? Is it more difficult to diagnose and treat late-life depression, and once treated, is the outcome good, bad, or indifferent? The emphasis will be on depression but bipolar disorder and mania will also be considered.

scholarly journals Sleep Disorders in Late-Life Depression

2020 ◽  
Vol 9 (1) ◽  
pp. 1
Author(s):  
Katharina Merry Apriliani ◽  
Dr. Soetjipto
Keyword(s):  
Mental Health ◽  
Sleep Disorders ◽  
Independent Risk Factor ◽  
Depressive Disorders ◽  
Late Life ◽  
The Elderly ◽  
Biological Factors ◽  
Late Life Depression ◽  
Pharmacological Management ◽  
Younger Age

Depression is an important mental health problem in developed societies, and as many as 50%-90% of patients with depression complain of sleep disorders. In the elderly, sleep disorders comorbid depressive disorders are getting worse. Late-life Depression (LLD) is often not detected because the symptoms are less specific than younger age. It even provides an independent risk factor impact on suicide ideas and behaviour. Causative risk factors of sleep disorders in Late-life Depression are biological and non-biological factors that form the basic of pharmacological and non- pharmacological management.

Late-life depression

2017 ◽  
Author(s):  
Fabian Fußer ◽  
Tarik Karakaya ◽  
Johannes Pantel
Keyword(s):  
Cognitive Impairment ◽  
Significant Proportion ◽  
Antidepressant Drugs ◽  
Late Life ◽  
The Elderly ◽  
Behavioural Therapy ◽  
Late Life Depression ◽  
Diagnostic Challenge ◽  
Primary Care Settings ◽  
Core Symptoms

Depression is one of the most prevalent mental diseases in late life, and is a tremendous burden on patients, their families and carers, and the healthcare system. Late-life depression (LLD) often affects people with chronic somatic illnesses, cognitive impairment, and disability. In the elderly, core symptoms of depression are much less pronounced. Instead, unspecific somatic complaints and cognitive impairment may dominate the clinical presentation, and a significant proportion of individuals with LLD goes undiagnosed. This may lead to increased mortality rates, in part attributed to the deleterious consequences of LLD on comorbid somatic illnesses or increased suicide rates. In order to improve prognosis, general practitioners in primary care settings have a prominent but challenging role in recognizing LLD. The diagnostic challenge also includes the differential diagnosis between depression, dementia, and delirium. The optimal management of LLD may include antidepressant drugs, non-pharmacological interventions such as psychotherapy (e.g. cognitive-behavioural therapy), as well as physical exercise.

scholarly journals Recent advances in the use of imaging in psychiatry: functional magnetic resonance imaging of large-scale brain networks in late-life depression

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 1366
Author(s):  
Kevin Manning ◽  
Lihong Wang ◽  
David Steffens
Keyword(s):  
Psychiatric Disorders ◽  
Cognitive Processing ◽  
Large Scale ◽  
Clinical Symptoms ◽  
Late Life ◽  
The Elderly ◽  
Symptom Presentation ◽  
Late Life Depression ◽  
Default Mode ◽  
Multiple Networks

Advances in neuroimaging have identified neural systems that contribute to clinical symptoms that occur across various psychiatric disorders. This transdiagnostic approach to understanding psychiatric illnesses may serve as a precise guide to identifying disease mechanisms and informing successful treatments. While this work is ongoing across multiple psychiatric disorders, in this article we emphasize recent findings pertaining to major depression in the elderly, or late-life depression (LLD), a common and debilitating neuropsychiatric illness. We discuss how neural functioning of three networks is linked to symptom presentation, illness course, and cognitive decline in LLD. These networks are (1) an executive control network responsible for complex cognitive processing, (2) a default mode network normally deactivated during cognitive demanding when individuals are at rest, and a (3) salience network relevant to attending to internal and external emotional and physiological sensations. We discuss how dysfunction in multiple networks contributes to common behavioral syndromes, and we present an overview of the cognitive control, default mode, and salience networks observed in LLD.

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