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Depressed Elderly (depressed + elderly)

Distribution by Scientific Domains
Medical Sciences100%

Terms modified by Depressed Elderly

  • depressed elderly patient
    		•

    Selected Abstracts

    Outcome of late-life depression after 3 years of sequential treatment

    ACTA PSYCHIATRICA SCANDINAVICA, Issue 4 2009
    R. M. Kok
    Objective:, To study the outcome of a sequential treatment protocol in elderly, severely depressed in-patients. Method:, All 81 patients from a 12-week double-blind randomized controlled trial (RCT) comparing venlafaxine with nortriptyline were asked to participate in a 3 year follow-up study. Thirty-two patients who did not achieve remission during the RCT, entered an open sequential treatment protocol and were treated with augmentation with lithium, switch to a monoamine oxidase inhibitor or ECT. Results:, Seventy-eight of the 81 patients (96.3%) achieved a response [,50% reduction in Montgomery Åsberg Depression Rating Scale score) and 68 patients (84%) a complete remission (final MADRS score , 10) within 3 years of treatment. Greater severity and longer duration of the depressive episode at baseline predicted poor recovery. Augmentation with lithium may be the best treatment option in treatment resistant depressed elderly. Only few patients dropped-out due to side-effects. Conclusion:, Our study demonstrates the importance of persisting with antidepressant treatment in elderly patients who do not respond to the first or second treatment. [source]

    A controlled evaluation of monthly maintenance interpersonal psychotherapy in late-life depression with varying levels of cognitive function

    INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 11 2008
    Kristen Carreira
    Abstract Objective To evaluate the effect of maintenance Interpersonal Psychotherapy (IPT) on recurrence rates and time to recurrence of major depression in elderly patients with varying levels of cognitive function. Methods/Design Two-year maintenance study of monthly maintenance IPT vs supportive clinical management (CM) in remitted depressed elderly who were participants in a previously reported placebo-controlled study of maintenance paroxetine and IPT (Reynolds et al., 2006). We used Cox regression analysis to test interactions between cognitive status (Dementia Rating Scale score) and treatment (IPT, CM) with respect to recurrence of major depression. Results We observed a significant interaction between cognitive status and treatment: lower cognitive performance was associated with longer time to recurrence in IPT than in CM (58 weeks vs 17 weeks) (HR,=,1.41 [95% CI,=,1.04, 1.91], p,=,0.03). Subjects with average cognitive performance showed no effect of maintenance IPT vs CM on time to recurrence (38 vs 32 weeks, respectively). Conclusion Monthly maintenance IPT confers protection against recurrence of major depression in elders with lower cognitive functioning. Copyright © 2008 John Wiley & Sons, Ltd. [source]

    The effects of ECT on cognitive functioning in the elderly: a review

    INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 8 2008
    Caroline E. M. Tielkes
    Abstract Background Electroconvulsive therapy (ECT) as a single course or in maintenance form (M-ECT) is an effective treatment in depressed elderly. However, ECT may have adverse effects on cognition. Objective To review all studies from 1980,2006 on ECT and cognition in the elderly with a minimum age of 55 years or a mean age of 55 years, and with valid measurements of cognition before and after ECT. Results Nine out of the 15 eligible studies were focused exclusively on the elderly. Three studies reported verbal learning- and recall problems post ECT, while three studies found positive effects of ECT on memory, speed of processing and concentration. Global cognitive functioning in patients with cognitive impairment improved in all studies. At follow up, most studies reported improvement of cognitive functions. Learning verbal information and executive functioning were impaired in M-ECT patients whereas global cognition remained stable after M-ECT over a year. Conclusions To date research of ECT on cognitive functioning in the elderly is very limited. Small sample size, lack of controls, use of a single screening instrument and a short follow up period may explain the conflicting results. Given the clinical importance, more extensive research on cognition in elderly treated with ECT is urgently needed. Copyright © 2008 John Wiley & Sons, Ltd. [source]

    The clock drawing test in primary care: sensitivity in dementia detection and specificity against normal and depressed elderly

    INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 10 2001
    Michael Kirby
    Abstract Objectives The aim of this study was to examine the sensitivities and specificities of the clock drawing test (CDT) in the detection of dementia among older people in primary care, with particular emphasis on the effect of depression on CDT specificity. Most previous studies have been sited in specialist settings and few have addressed the issue of specificity aginst depression. Methods Comparison of cohorts identified from community-based screening with GMS-AGECAT. The CDT and the Mini-Mental State Examination (MMSE) were administered to 41 elderly subjects with organic disorder (dementia), 84 elderly subjects with case level depression and 523 normal elderly subjects. Sensitivities and specificities of the CDT were calculated. Results The sensitivity of the CDT in the detection of dementia in the general community was 76%. The specificities of the CDT against normal elderly and depressed elderly was 81% and 77% respectively. Higher sensitivity and specificity were achieved by the MMSE. Conclusions The use of the CDT in the detection of dementia syndromes is likely to be more relevant in the primary care context than in specialist settings. The CDT provides good sensitivity and specificity but may not be as sensitive or specific in the general community as previous studies have suggested, particularly in mild dementia. Community-based late life depression does not appear to alter the specificity of the CDT. Copyright © 2001 John Wiley & Sons, Ltd. [source]