Clinical Presentation and Outcome of Geriatric Depression in Subcortical Ischemic Vascular Disease

Bella, R.; Pennisi, G.; Cantone, M.; Palermo, F.; Pennisi, M.; Lanza, G.; Zappia, M.; Paolucci, S.
April 2010
Gerontology;Apr2010, Vol. 56 Issue 3, p298
Academic Journal
Background: Vascular damage of frontal-subcortical circuits involved in mood regulation and cognition might be the main contributor to the pathogenesis of late-life depression, and it is linked to poor response to treatment. Objective: To investigate the relationship between executive dysfunction and outcome of depressive symptoms among elderly patients with subcortical ischemic vascular disease. Methods: Ninety-two elderly patients with white matter lesions (WMLs) or lacunar infarcts (LAs) on brain MRI and depressive symptomatology were consecutively recruited. Depression was rated with the Hamilton Depression Rating Scale (HDRS). Evaluation of executive functions by means of the Stroop color-word test was performed at entry of the study, and WMLs were categorized into mild, moderate or severe. Mood was reevaluated by means of HDRS after the 12th week of pharmacological treatment. Results: Psychomotor retardation, difficulties at work, apathy, and lack of insight were the predominant symptoms. Fifty-six patients (62.8%) had a neuroradiological picture of WMLs, while the remaining 33 (37.1%) had LAs. Executive dysfunctions significantly and independently predict poor outcome of depressive symptoms. Patients with the severest WMLs showed not only a greater executive dysfunction, but also a minor response to antidepressant treatment. Conclusion: This study supports the vascular depression hypothesis. WMLs are of crucial clinical relevance as they are linked with cognitive symptoms and poor antidepressant outcome. Copyright © 2009 S. Karger AG, Basel


Related Articles

  • A Collaborative Care Model to Treat Late-Life Depression. Wellbery, Caroline // American Family Physician;3/1/2003, Vol. 67 Issue 5, p1107 

    Presents a study that used a collaborative care model to treat depression in the elderly. Percentage of elderly seen in primary care setting that have depression; Utilization of the Improving Mood-Promoting Access to Collaborative Treatment program to test improvement in older adults...

  • Additional treatment for late-life depression patients has its benefits.  // Geriatrics;Jul2007, Vol. 62 Issue 7, p11 

    The article reports on the benefits of additional treatment or medication to late-life depression patients. According to psychiatry professor Mary Amanda Dew, augmentation is beneficial for those who can medically handle a second antidepressant. It mentions a study in which only 69 out of the...

  • Getting Better, Getting Well: Understanding and Managing Partial and Non-Response to Pharmacological Treatment of Non-Psychotic Major Depression in Old Age. Driscoll, Henry C.; Karp, Jordan F.; Dew, Mary Amanda; Reynolds III, Charles F. // Drugs & Aging;2007, Vol. 24 Issue 10, p801 

    In general, the pharmacological treatment of non-psychotic major depressive disorder in old age is only partially successful, with only approximately 50% of older depressed adults improving with initial antidepressant monotherapy. Many factors may predict a more difficult-to-treat depression,...

  • Moderators of Remission in Patients With Late-Life Depression: Where Do We Go Next? Taylor, Warren D. // JAMA Psychiatry;Apr2016, Vol. 73 Issue 4, p319 

    The author reflects on the randomized double-blind clinical trial in the remission of patients with late-life depression. The author states the influence of aripiprazole treatment in elderly individuals with treatment-resistant late-life depression. An overview on the factors implicated to poor...

  • Do Antidepressants Cure or Create Abnormal Brain States? Moncrieff, Joanna; Cohen, David // PLoS Medicine;Jul2006, Vol. 3 Issue 7, pe240 

    The article suggests an alternative drug-centered model of drug action that is consistent with demedicalized approach to depression. An overview of evidence for disease-based action of antidepressants is provided. Antidepressants would be expected to produce different sorts of effects since they...

  • Depression in older people.  // Pulse;11/14/2012, Vol. 72 Issue 37, p28 

    The article offers tips for diagnosing and managing depression in older people. It informs that use of antidepressants is beneficial in older people suffering from moderate and severe depression. It advices to avoid antidepressants for depression in patients with dementia as depression occurs...

  • Serotonin transporter genotype interacts with paroxetine plasma levels to influence depression treatment response in geriatric patients. Lotrich, Francis E.; Pollock, Bruce G.; Kirshner, Margaret; Ferrell, Robert F.; Reynolds III, Charles F. // Journal of Psychiatry & Neuroscience;Mar2008, Vol. 33 Issue 2, p123 

    Objective: To investigate whether variable antidepressant response may be influenced by an interaction between the serotonin transporter promoter polymorphism (5-HTTLPR) and antidepressant concentration. Methods: Elderly subjects with depression treated with paroxetine ( n = 110) were genotyped...

  • Assessing for depression and mood disturbance in later life. Edwards, Margaret // British Journal of Community Nursing;Nov2004, Vol. 9 Issue 11, p492 

    Depression has been identified as a common mental disorder in old age but frequently remains undetected. The Geriatric Depression Scale is one of the most heavily promoted scales for the screening of older people. Short versions of the scale (GDS-15 and GDS-4) are recommended for use with...

  • Dyskinesia: case report.  // Reactions Weekly;7/16/2005, Issue 1060, p13 

    The article presents a case of a 63-year-old man with dyskinesia. The patient developed mild to moderate movement disorders an hour after receiving his first dose of mirtazapine for treating depression.


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics