Presentation
In this report, a late onset depression was the initial presentation of SREAT in a middle aged patient, something rarely described before, indicating the need to suspect SREAT as a possible etiology for depression in this age group. [ncbi.nlm.nih.gov]
The aim of the present study was to examine whether LOD exhibits more prominent hypofrontality than EOD during performance of the word fluency task (WFT) under multichannel near-infrared spectroscopy (NIRS), a newly developed non-invasive functional neuroimaging [keio.pure.elsevier.com]
The Oxford Handbook of Depression and Comorbidity brings together scholarly contributions from world-class researchers to present a careful and empirically based review of depressive comorbidity. [books.google.com]
Entire Body System
- Fatigue
Energy Normal energy level, but reduced activity due to poor initiation related to fatigue. Executive. Subacute decrease in energy and increased complaints of fatigue. [moodclinic.com.au]
Although not as severe as those of major depression, symptoms of persistent depressive disorder also include the presence of two (or more) of the following: Feelings of hopelessness Low self-esteem Low energy or fatigue Poor appetite or overeating Difficulty [my.clevelandclinic.org]
Decreased ability to care for self Physical symptoms : Significant change in appetite or weight Psychomotor retardation Physical pains without any discernable reason Gastrointestinal symptoms Headaches Multiple diffuse symptoms Insomnia or hypersomnia Fatigue [valleybehavioral.com]
Fatigue, lack of energy. Poor self-esteem. Difficulty with concentration or decision making. Feeling hopeless. C. A person has not been free of the symptoms during the two-year time period (one-year for children and adolescents). D. [allaboutdepression.com]
- Weight Loss
loss or weight gain Decrease in sexual urge Behavioral Symptoms: Becoming withdrawn socially; avoiding social interactions Becoming slow in movements Losing interest in maintaining personal hygiene or grooming Decrease in the abilities to function in [sen.ust.hk]
(P = .008), more weight loss and a suppressed appetite (P less than .007), fewer feelings of worthlessness (P = .01), less diminished concentration (P = .04), and fewer thoughts of death (P less than .001). [mdedge.com]
Megestrol acetate and mirtazapine for the treatment of unplanned weight loss in the elderly. Pharmacotherapy. 2009;29(4):383–397. 74. Jung Y, Jun T, Kim K, Bahk W. [dovepress.com]
Longer duration of symptoms, a personal history of depressive episodes, a serious suicide attempt, childhood events, a family history of depression, and high neuroticism are more often present in EOD, whereas decreased appetite/weight loss is more prominent [jmedsoc.org]
Depression is associated with poor food intake and weight loss and is an important psychological component for becoming malnourished in late life.[4],[5] Older adults are at a high risk of cognitive impairment, although it is no longer considered as a [ijcm.org.in]
- Weight Gain
[…] loss or weight gain Decrease in sexual urge Behavioral Symptoms: Becoming withdrawn socially; avoiding social interactions Becoming slow in movements Losing interest in maintaining personal hygiene or grooming Decrease in the abilities to function in [sen.ust.hk]
The authors found, using a continuous age of onset indicator ranging from 4 to 64 years and adjusting for socio-demographic factors, late onset depression was associated with less sadness (P less than .001), less weight gain and fewer increases in appetite [mdedge.com]
Side effects include weight gain and sedation due to histamine receptor effects. [statpearls.com]
- Malaise
Parental characteristics included mother's internalizing symptoms, which were assessed with the Rutter Malaise Inventory34 when the study members were ages 5, 7, and 9 years. [jamanetwork.com]
Gastrointestinal
- Increased Appetite
The most important symptoms elevating the risk of late-onset depression in a multivariate model were lack of joy and interest, poor concentration, increased appetite, lack of energy and joint pain. [ncbi.nlm.nih.gov]
Common side effects include sedation, increased appetite causing weight gain, dry mouth, and constipation. Noradrenergic effects are more pronounced over the anti-histaminergic effects at higher dosages and thus lower sedative effects. [statpearls.com]
- Loss of Appetite
On the other hand, true loss of appetite may mistakenly be attributed to low quality of food. - Fatigue : This symptom is usually present, however it may be blamed on old age, and treated with vitamins and other 'antifatigue' drugs. [annals-general-psychiatry.biomedcentral.com]
Loss of appetite: This symptom is also difficult to assess, especially in individuals living in circumstances whereby the quality of food may be low. On the other hand, true loss of appetite may mistakenly be attributed to low quality of food. [ncbi.nlm.nih.gov]
Cardiovascular
- Heart Disease
No 1.684 (1.487–1.907) <0.001 CHF, congestive heart failure; COPD, chronic obstructive pulmonary disease; CRI, chronic renal insufficiency; CVA, cerebrovascular accident; DM, diabetes mellitus; HTN, hypertension; IHD, ischemic heart disease; LOD, late-onset [hindawi.com]
In fact for every medical illness studied, e.g. heart disease, diabetes, cancer, individuals who are depressed have a worse prognosis. [books.google.com]
Physical: Late-onset depression may be triggered by physical illnesses such as cancer, heart disease, and arthritis. [moodclinic.com.au]
Safety and efficacy of sertraline for depression in patients with heart failure: results of SADHART-CHF (Sertraline Against Depression and Heart Disease in Chronic Heart Failure) trial. J Am Coll Cardiol. 2010;56:692-699. 12. [psychiatrictimes.com]
Physical : Late-onset depression may be triggered by physical illnesses such as cancer, heart disease, and arthritis. [valleybehavioral.com]
Musculoskeletal
- Fracture
[…] struggles Using many medications to treat physical problems Research has also shown that depressed older adults are more disabled than their non-depressed peers, and that they tend to recover more poorly from medical illnesses such as stroke or hip fracture [moodclinic.com.au]
Because falls can invalidate old adults and even lead to increased mortality (hip fracture), avoid medications that sedate the patient.62,63 In primary care, both tricyclic antidepressants (TCAs) and selective serotonin reuptake inhibitors (SSRIs) are [dovepress.com]
Other serious side effects reported with SSRIs include the risk of falls and hip fractures, serotonin syndrome (lethargy, restlessness, hypertonicity, rhabdomyolysis, renal failure, and possible death), GI bleeding, and insomnia. [jmhhb.org]
Anti-alpha1-adrenergic properties are responsible for orthostatic hypotension phenomena that could lead to falls and hip fractures. Antihistamine properties are responsible for sedation. [annals-general-psychiatry.biomedcentral.com]
Psychiatrical
- Suicidal Ideation
We used PHQ-9 item #9 as our measure of suicidal ideation. [tandfonline.com]
The researchers also examined suicidal ideation in the mood disorder patients at baseline. Just one patient experienced suicidal ideation, and that patient didn’t have any worsening of suicidal ideation throughout the course of the study. [mdmag.com]
Last week, we examined the high rates of major depression and suicidal ideation (SI) in medical interns. In this week’s Research Connection, we’ll take a look at the second of three studies, in which Dr. [afsp.org]
Here it is imperative to inquire about any homicidal or suicidal ideations/plans. The clinician should always ask the patient about access to firearms. Conduct neuropsychological testing if needed. [statpearls.com]
Firstly, treatment outcome and suicidal ideations assessed in previous studies relate to the index episode and not exclusively to the first episode as in the present study. [ncbi.nlm.nih.gov]
- Psychomotor Retardation
Measures of depression severity, psychomotor retardation, verbal and visual memory and vascular and specific genetic risk factors were collected. [ncbi.nlm.nih.gov]
CONCLUSION: We concluded that early onset depression patients have more severe psychomotor retardation and general somatic symptoms than late onset depression patients in Korea. [koreamed.org]
retardation Physical pains without any discernable reason Gastrointestinal symptoms Headaches Multiple diffuse symptoms Insomnia or hypersomnia Fatigue or reduction in energy Changes in the structure and functioning of the brain Cognitive symptoms : [valleybehavioral.com]
- Anhedonia
Hypersomnia and suicidal plans/attempts were associated with EOD, whereas anhedonia was related to LOD. Lifetime generalized anxiety disorder was associated with EOD, whereas dysthymic disorder was related with higher age of MDD onset. [ncbi.nlm.nih.gov]
[…] explained by a medical illness or a substance.[13] To further meet criteria for Major Depressive Disorder, the depressive episode must not be attributable to another psychiatric disorder such as psychosis or a bipolar disorder.[13] Depressed or sad mood Anhedonia [en.wikipedia.org]
[…] whereas decreased appetite/weight loss is more prominent at a higher age of onset. [19],[20] In addition, elderly people with new or recurrent depression are more hypochondriacal, delusional, and tend to present more with symptoms of psychomotor change, anhedonia [jmedsoc.org]
The cardinal symptoms of major depressive disorder are anhedonia (a loss of interest in activities one used to enjoy) and a depressed mood through most of the day.7 According to the DSM 5, an older person has an episode of major depression if he or she [dovepress.com]
- Anhedonia : Elderly depressives retain an emotional responsiveness to external positive events and profound anhedonia is rare. - Psychomotor retardation is not usually present, and generally is linked with melancholic features or 'vascular' depression [annals-general-psychiatry.biomedcentral.com]
- Feeling of Worthlessness
RESULTS AND CONCLUSION: Low spirits and feelings of worthlessness were more frequently found in EOD, they were sufficient discriminators to distinguish elderly subjects with EOD and LOD. [ncbi.nlm.nih.gov]
[…] of worthlessness (P = .01), less diminished concentration (P = .04), and fewer thoughts of death (P less than .001). [mdedge.com]
The questions are designed to test the mood, energy level, loss of interest in pleasurable activities, guilt feelings, hopelessness, worthlessness, and suicidal ideations. Each question gets a score of 0 or 1 points. [statpearls.com]
[…] of worthlessness or inappropriate guilt; and recurrent thoughts of death or suicidal ideation. [dovepress.com]
- Distractibility
Someone with late onset bipolar disorder could be experiencing a manic episode with symptoms such as: confusion or disorientation being easily distracted losing the need for sleep irritability Signs of a depressive episode can include: a loss of interest [healthline.com]
This MRI study may help the researchers identify how abnormalities in brain systems that control our ability to ignore distractions, control our emotions, and anticipate reward may contribute to the development of depression in older adults. [clinicaltrials.gov]
Undercontrolled children were irritable, distractible, emotionally labile, and rough and uncontrolled in their behavior. [jamanetwork.com]
Neurologic
- Sleep Disturbance
disturbance Decrease or increase in appetite Unusual weight loss or weight gain Decrease in sexual urge Behavioral Symptoms: Becoming withdrawn socially; avoiding social interactions Becoming slow in movements Losing interest in maintaining personal [sen.ust.hk]
Symptoms such as psychosis, sleep disturbance, and aggressiveness can be confused with dementia or depressive disorder, according to an article in Primary Psychiatry. [healthline.com]
The common side effects include gastrointestinal distress (nausea, diarrhea), anxiety, and sleep disturbance.[17] Serotonin-norepinephrine reuptake inhibitors (SNRI): These are considered as the second-line treatment and include venlafaxine, desvenlafaxine [statpearls.com]
disturbance (increased or decreased sleep) Appetite disturbance (increased or decreased appetite) typically with weight change Energy disturbance (increased or decreased energy/activity level), usually fatigue Poor memory or concentration Feelings of [en.wikipedia.org]
Both smoking and alcohol use are the risk factors of LLD.18 In addition, the use of sleep medication has been linked to LLD, but sleep disturbance in general is a risk factor for LLD.35 Screening In the following text, we only discuss screening tools [dovepress.com]
- Cognitive Disorder
OBJECTIVE: ApoE4 is a 'risk factor' for cognitive disorders like Alzheimer's dementia, and Late Onset Depression (LOD) is a forerunner of dementia. There is thus a need to study the association between ApoE4 allele and LOD. [ncbi.nlm.nih.gov]
How to demarcate the population with late-onset depression from those with vascular cognitive disorders and early-onset depression in older adults. Explore the medical needs for the late-onset depression population. [isctm.org]
A common finding of everyday clinical practice is the discrepancy between the cognitive complaints of the patient and their neuropsychological evaluation, which may indicate that there is no apparent cognitive disorder [ 45, 46 ]. [annals-general-psychiatry.biomedcentral.com]
[…] of São Paulo School of Medicine, São Paulo SP, Brazil. 3Behavioral and Cognitive Neurology Unit, Department of Neurology, and Cognitive Disorders Reference Center (CEREDIC), Hospital das Clínicas of the University of São Paulo School of Medicine, São [scielo.br]
- Chorea
Also known as Huntington’s Chorea, symptoms generally first appear between ages 30 and 50. Unlike tardive dyskinesia, Huntington's disease is progressive and severely weakens patients over a 10- to 20-year period. Cerebral palsy. [verywellmind.com]
Approved Uses AUSTEDO ® is a prescription medicine that is used to treat: the involuntary movements (chorea) of Huntington’s disease. [austedo.com]
In some cases, the arms and/or legs may also be affected by involuntary rapid, jerking movements (chorea), or slow, writhing movements (athetosis). [rarediseases.org]
It is characterized by chorea, cognitive deficits, and psychiatric symptoms. Read More Caregivers' Perspectives of Quality of Life of People With Young- and Late-Onset Alzheimer Disease. [pubfacts.com]
- Difficulty Concentrating
Depression can result in irritation, withdrawal, social isolation, feelings of guilt, difficulty concentrating, a lack of energy and self-harm. [senexpertsolicitors.co.uk]
concentrating or remembering changing habits thinking of or attempting suicide If you think someone is at immediate risk of self-harm or hurting another person: Call 911 or your local emergency number. [healthline.com]
Symptoms can include feelings of despair or guilt, sadness, fatigue, difficulty concentrating, changes in appetite, and thoughts of suicide or of harming the baby. [nysenate.gov]
Workup
Physical examination to rule out any medical or neurological disorder should be part of the total workup. [statpearls.com]
Treatment
NIRS is a simple technique that can be used before treatment to evaluate the social functioning levels of patients with LOD, and predict social functioning improvement after treatment. Copyright © 2015 Elsevier Ltd. All rights reserved. [ncbi.nlm.nih.gov]
Identification of such predictors may help to stratify treatment approaches in the future and lead to the early identification of individual patients who may require alternative treatment approaches to standard antidepressants. [hra.nhs.uk]
Prognosis
Further research is warranted to ascertain the link between late-onset depression, neuropsychological deficits and prognosis. Copyright © 2010 John Wiley & Sons, Ltd. [ncbi.nlm.nih.gov]
This will give us a better understanding of the connection between brain changes, neuropsychology and depression prognosis, which is decisive for accurate diagnostics, effective treatment and targeted prevention of the disease in the long run. [clinicaltrials.gov]
In fact for every medical illness studied, e.g. heart disease, diabetes, cancer, individuals who are depressed have a worse prognosis. [books.google.com]
Given its high prevalence, its negative impact on individual health, and its negative long-term prognosis, it is a condition of great public health relevance. [grantome.com]
Etiology
In this report, a late onset depression was the initial presentation of SREAT in a middle aged patient, something rarely described before, indicating the need to suspect SREAT as a possible etiology for depression in this age group. [ncbi.nlm.nih.gov]
Various theories have been postulated to elucidate the etiology of late onset depression, but a unifying hypothesis is lacking. [go.gale.com]
These data suggest that depression in patients with early-onset PD may have a different etiology than in patients with late-onset PD. © 1989 by the American Academy of Neurology AAN Members: Sign in with your AAN member credentials (e-mail or 6-digit [neurology.org]
Epidemiology
[sup][2] The prevalence of either a major depressive episode or dysthymia in the epidemiologic catchment area survey was 2.5% in the geriatric age group. [go.gale.com]
OBJECTIVES: In this paper we review clinical, epidemiological, structural neuroimaging and genetic investigations of late life depression that have been performed over the past two decades and offer evidence that LOD is often a prodromal disorder for [ncbi.nlm.nih.gov]
This is the first volume devoted to the epidemiology, phenomenology, psychobiology, treatment and consequences of late-life depression. [books.google.com]
Patients who scored ≥16 on the Center for Epidemiologic Studies Depression Scale (CES-D) and/or were currently taking antidepressant medication specifically for the treatment of depression were considered to have depressive symptoms. [psychiatryadvisor.com]
Pagina 15 - Schiffer RB, Babigian HM: Behavioral disorders in multiple sclerosis, temporal lobe epilepsy, and amyotrophic lateral sclerosis: an epidemiologic study. [books.google.it]
Pathophysiology
CONCLUSIONS: Our findings suggest that loss of white matter integrity in parahippocampal gyrus may be associated with the pathophysiology of LOD, and thus highlight the limbic contribution to the pathophysiology of LOD. [ncbi.nlm.nih.gov]
Prevention
However, its role in prevention of incident dementia in the elderly remains inconclusive. Some studies have reported that aspirin can prevent dementia, but others have not [18]. [hindawi.com]
The hope is in the future to be able to offer patients in the risk group better assessment and treatment to prevent complications and recurrence. [clinicaltrials.gov]
Furthermore, statin may prevent depression by lower LDL and inflammation status. [journals.plos.org]
These differential findings are important factors to keep in mind for diagnostics, treatment, and prevention. Copyright © 2012 Elsevier B.V. All rights reserved. [ncbi.nlm.nih.gov]