Depression In Geriatric Patients Research Articles

145. Geriatric Depressive Patients May Have Dementia That is Not Being Recognized

145. Geriatric Depressive Patients May Have Dementia That is Not Being Recognized

Unrecognized Dementia in Geriatric Depressive Patients

Unrecognized Dementia in Geriatric Depressive Patients

Association between serum omega-3 PUFAs levels and cognitive impairment in never medically treated first-episode patients with geriatric depression: A cross-sectional study

BackgroundGeriatric depression increases the public health burden and health care costs, reduces quality of life. Studies have shown the association between ω-3 PUFAs levels and inflammatory markers levels and depression, but few have explored the relationship between omega-3 PUFAs, inflammatory markers, and cognitive function in geriatric depression. This study aimed to compare the differences in ω-3 PUFAs levels and inflammatory markers between geriatric depression with cognitive impairment (CI) and those without CI. MethodsA total of three hundred and five elderly patients were recruited. In addition to collecting basic information, their blood specimens were collected to detect serum EPA, DHA, AA, TC, LDL-C, IL-6, TNF-α, and hs-CRP levels. The Hamilton depression scale (HAMD), Hamilton anxiety scale (HAMA), and The Montreal cognitive assessment (MoCA) were used to assess their depression, anxiety, and cognitive function, respectively. ResultsCompared to those without CI, geriatric depression patients with CI had higher serum TC, LDL-C levels, lower EPA, DHA, and AA levels, and more elevated IL-6, TNF-α, and hs-CRP levels (all P < 0.05). Further linear regression analysis showed that EPA, DHA, and TNF-α, hs-CRP levels were significantly associated with the occurrence and the severity of CI. LimitationsNo causal relationship could be drawn due to the cross-sectional design. ConclusionsOmega-3 PUFAs and inflammatory factors levels may predict CI in elderly patients with MDD in the future. Our findings suggest that ω-3 PUFAs (EPA and DHA) and inflammatory factors (TNF-α and CRP) may predict the occurrence and the severity of CI among elderly MDD patients.

A correlational study on pain and depression in geriatric patients scheduled for orthopaedic surgery.

Pain is prevalent in geriatric patients and is not only a signal of physical diseases but also a symptom of mental health problems. This study aimed to explore the relationship between pain and depression in geriatric patients scheduled for orthopaedic surgery. The study used a correlational and cross-sectional design. The study sample consisted of geriatric patients (n=200) scheduled for orthopaedic surgery in a research and training hospital in northern Turkey. Data were collected by the researchers using the Geriatric Pain Measure and Geriatric Depression Scale. In the data analysis, descriptive statistics, Pearson's correlation, and hierarchical regression analysis were used. The patients' mean age was 73.16 ± 8.27 years. It was found that 5.5% (n=11) of the participants had mild pain, 45.5% (n=91) had moderate pain, and 49% (n=98) had severe pain. There was a positive and moderate significant relationship between the mean Geriatric Pain Measure and Geriatric Depression Scale scores (r=0.479, P < 0.01). Age (β=0.133; P < 0.05) and education (β=2.484; P < 0.05) were statistically significantly associated with depression. There was a significant and positive relationship between depression and being dependent in activities of daily living (β=5.098; P < 0.05). This study demonstrated that geriatric patients who were older, illiterate, dependent in activities of daily living, and with higher levels of pain had higher depression. A multidisciplinary team approach including nurses should be utilised in pain management and it should not be ignored that severe pain may be associated with depression in geriatric patients.

Geriatric Depression in India; Causes and Solutions: An Ayurveda Perspective

Geriatric Depression (GD) prevalence rate is on the rise as is the geriatric population in India. It can be correlated to Kaphaja Unmada in Ayurveda based on its causes and symptoms. GD patients have symptoms like Mandavakchesta (slowing of speech and actions), Tushnibhava (depressed look), Anaannabhilasha (disinclination for food). GD has several causative factors like decreased physical agility, cognitive decline, lack of financial liberty, social isolation, long standing diseases and medicines etc. Following the surge of industrialization, urbanization like western countries after 1980s, the family systems and values in India have changed. Nuclear families are on rise and elderlies in families are considered as burden. Contrastingly, earlier elderlies were regarded as source of wisdom and guidance. This study is an attempt to go through all the possible literature offline and online to find out the causes and solutions of GD in India. Findings showed that along with the common causative factors related to the old age in elderlies, ignorance from younger family members is also equally important. GD is a psychosomatic disease, so treatments approach involving the body, mind, family dynamics and values using family psychotherapies and psychoeducation, Medhya rasayana and if needed modern psychiatric medication can address all types of GD and related mental health problems in India.

A Multi-country Analysis of the Treatment Options for Late-life Depression in Geriatric Patients

A Multi-country Analysis of the Treatment Options for Late-life Depression in Geriatric Patients

Suicidality during neuromodulation in the elderly depressed: study design

IntroductionLate life depression is a major global health issue, with an estimated 7% of older adults suffering from this mental disorder. Depression is one of the most important predictors for suicide in the elderly. However, it is often difficult to recognize and manage, making treatment-resistance a common occurrence. Treatment-resistant depression itself is also a known risk factor for suicide. Recently, non-invasive neuromodulation techniques have been used as a new treatment for depression and suicidality with promising results.ObjectivesThis study aims to investigate the effect of adTMS (accelerated deep Transcranial Magnetic Stimulation) and tDCS (transcranial Direct Current Stimulation) on the suicidality of elderly, therapy-resistant depressed patients. The hypothesis is that suicidal ideation and risk of suicide will decrease after a treatment with adTMS and tDCS.MethodsIn this randomized double-blinded sham-controlled clinical trial, geriatric therapy-resistant depressive patients will receive adTMS treatment (See: Figure 1). Suicidality will be assessed before and after the active or sham treatment, through the Columbia Suicide Severity Rating Scale (C-SSRS) and Beck Scale for Suicide Ideation (BSI). After one week of rest, all patients will receive an at-home tDCS treatment for 3 weeks. Likewise, the suicide risk will be estimated before and after the tDCS. During the screening period, the severity of the patients’ depressive symptoms will be determined by using the 17-item Hamilton Depression Rating Scale (HDRS-17). In total, the trial will last for 5 weeks, and suicidality will be examined at five different time points (during screening, at T0, T1, T2 and T3).ResultsNot applicableConclusionsNot applicableDisclosureNo significant relationships.

Frailty and depression in the hypertensive older patients; a cross-sectional study

Hypertension (HT) is one of the most common chronic diseases in the elderly in our country and worldwide. HT alone can trigger depression and fragility, and it is possible that these three clinical conditions affect each other negatively. However, there is no study in the literature that evaluated the relationship between these variables. In this study, it was aimed to investigate the frequency of frailty and depression in a group of geriatric HT patients, as well as the relationship between these three variables. A total of 276 (mean age:73.0±7.2) HT elderly patients, 126 (mean age:73.6±7.8) of whom were female, were included in the study. All participants were evaluated with the Katz Activities of Daily Living (ADL) index, the Lawton-Brody instrumental activities of daily living (IADL) index, The Geriatric Depression Scale (GDS-15) and the Freid Frailty Index (FFI). Analyzes were performed by dividing them into three groups according to their FFI scores. According to the FFI scores, 94 (34.1%) as pre-frail, 87 (31.5%) as frail and 95 (34.4%) as robust. FFI scores were positively correlated with age and GDS-15. However, FFI scores were negatively correlated with HGS, ADL and IADL. Age (p&lt;0.001, OR= 1.98[1.04-1.16]), ADL (p&lt;0.01, OR= 0.51[0.36-0.71]), IADL (p=0.044, OR= 0.78[0.62-0.99]) and GDS-15 score (p&lt;0.001, OR= 1.24[1.10-1.40]) were found as independent variables for frailty. Our results provide evidence of a consistent bidirectional relationship between frailty and depression in geriatric patients with HT. Additionally, our data show that three out of four people with frailty have depression and one in two people with depression have frailty. Therefore, interventions should be developed to reduce one of the two syndromes in the elderly diagnosed with HT.

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BACKGROUND:In India,elderly persons constitute 8.6% of total population which is projected to reach 19% by 2050.There is lack of information on the magnitude of depression among elderly population in India.Depression is among the leading causes of disability adjusted life years in the world and a serious health problem among older adults.AIM AND OBJECTIVES:To study the prevalence of depression in geriatric patients and to assess the severity and risk factors for depression in geriatric population.METHODOLOGY;This is a cross-sectional study done in 150 geriatric patients attending Geriatric OPD in Government Rajaji Hospital,Madurai who are above 65 years in three months study period and are assessed using Semi-structured proforma to collect information regarding socio-demographic profile,Mini Mental status examination,Geriatric Depression Scale and Presumptive Stressful life events scale and ICD-10 diagnostic criteria to diagnose depression.RESULTS:Prevalence of depression was 29% of which 20% are mildy depressed.Older adults are less likely to endorse cognitive –affective symptoms of depression including dysphoria,worthlessness and guilt.Sleep disturbance ,fatigue,loss of interest ,hopelessness,poor memory are more common.CONCLUSION:The study revealed high prevalence of depression among geriatric patients attending tertiary care hospitals,Sociodemographic,clinical and psychosocial variables as risk factors for depression.But its undiagnosed and overlooked.Prevention of risk factors and early diagnosis may reduce the morbidity ,mortality and improve quality of life.

Altered intrinsic default mode network functional connectivity in patients with remitted geriatric depression and amnestic mild cognitive impairment.

Patients with geriatric depression exhibit a spectrum of symptoms ranging from mild to severe cognitive impairment which could potentially lead to the development of Alzheimer's disease (AD). The aim of the study is to assess the alterations of the default mode network (DMN) in remitted geriatric depression (RGD) patients and whether it could serve as an underlying neuropathological mechanism associated with the risk of progression of AD. Cross-sectional study. A total of 154 participants, comprising 66 RGD subjects (which included 27 patients with comorbid amnestic mild cognitive impairment [aMCI] and 39 without aMCI [RGD]), 45 aMCI subjects without a history of depression (aMCI), and 43 matched healthy comparisons (HC), were recruited. All participants completed neuropsychological tests and underwent resting-state functional magnetic resonance imaging (fMRI). Posterior cingulate cortex (PCC)-seeded DMN functional connectivity (FC) along with cognitive function were compared among the four groups, and correlation analyses were conducted. In contrast to HC, RGD, aMCI, and RGD-aMCI subjects showed significant impairment across all domains of cognitive functions except for attention. Furthermore, compared with HC, there was a similar and significant decrease in PCC-seed FC in the bilateral medial superior frontal gyrus (M-SFG) in the RGD, aMCI, and RGD-aMCI groups. The aberrations in rsFC of the DMN were associated with cognitive deficits in RGD patients and might potentially reflect an underlying neuropathological mechanism for the increased risk of developing AD. Therefore, altered connectivity in the DMN could serve as a potential neural marker for the conversion of geriatric depression to AD.

Risk Factors for Depression in Hospitalized Elderly Patients with Malnutrition

Background: There is a lack of information about the factors that affect depression in hospitalized geriatric patients with malnutrition. We aimed to determine the risk and influencing factors of depression in these patients. Methods: The prospective, descriptive study was conducted on 125 elderly patients with malnutrition in Istanbul, Turkey in 2018. The Mini Nutritional Assessment-short form was used in determining the nutritional statuses of the participants, and the Geriatric Depression Scale-short form was used for the status of depression. Results: A negative relationship was found between nutritional status and risk of depression in the study (p: 0.000; r: -0.558). Depression was detected in 52.8% of the patients. 60.8% were women and 39.2% were men. It was also found that BMI scores, gender, marital status, level of education, lifestyle and location, the existence of chronic diseases, chronic medication use, hospital stay period, and mobilization affect the emergence and severity of depression in geriatric patients (p ＜ 0.005). Multivariate regression analysis showed that increased risk of depression occurs with female gender (OR: 24.665, 95% CI: 5.83-104.34), marital status (OR = 11.97, 95% CI: 3.51-40.86), mobilization (OR: 9.52, 95% CI: 1.79-50.71) and malnutrition (OR = 0.49, 95% CI: 0.27-0.89). Conclusions: Depression was frequent in elderly patients with malnutrition. Also, many factors (e.g. low BMI, female gender, mobilization etc.) affect it in hospital. Therefore, close follow-up of patients is important.

Low-Charge Electrotherapy in Geriatric Major Depressive Disorder Patients: A Case Series.

To examine the feasibility of low-charge electrotherapy (LCE) in treating geriatric major depressive disorder (MDD) patients. Bi-temporal LCEs (approximately 25 mC) were performed with an electroconvulsive therapy (ECT) instrument three times per week. We used the Hamilton Depression Scale 17 (HAMD-17) and the Hamilton Anxiety Scale (HAMA) to assess the effects of LCE and the Mini-Mental State Examination (MMSE) to evaluate the cognitive function change before and after LCE. Six visits occurred at the baseline, after LCE sessions 3, 6, and 9, after the last session, and at the end of the one-month follow-up period. Four patients were enrolled in the study. Two patients completed all LCE sessions. Two patients withdrew during the trial, one due to the adverse event of uroschesis potentially caused by atropine and the other due to her own will. All four patients completed the follow-up sessions. The HAMD-17 and HAMA scores were reduced significantly at the last LCE session and the end of the follow-up period compared with the scores at the baseline. As measured by the MMSE, cognitive impairment showed no significant changes at the last LCE session and the end of the follow-up period compared with that at the baseline. In this case series, LCE showed potential as an alternative current-based treatment for treating geriatric MDD patients. Further research is needed to assess the efficiency and safety of LCE.

Lifestyle intervention improve the weight and exercise patterns of geriatric depressed patients

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S148. Lifestyle Intervention Improve the Weight and Exercise Patterns of Geriatric Depressed Patients

S148. Lifestyle Intervention Improve the Weight and Exercise Patterns of Geriatric Depressed Patients

Prevalence of sarcopenia in patients with geriatric depression diagnosis.

In this study, the aim was to identify the prevalence of sarcopenia among patients with geriatric depression (GD) diagnosis and to collect data to illuminate precautions to reduce disease load. The study was completed with 116 patients (GD group) aged 65years or older with possible or definite depression diagnosis according to the Geriatric Depression Scale (GDS) criteria and 301 volunteers aged from 18 to 39years (control 1) and above 65years (control 2). Our prospective and cross-sectional study applied the Hamilton Depression Rating Scale (HDRS) to control 1 group and the GDS and Mini Mental Test (MMSE) to control 2 and GD groups. All groups had skeletal muscle mass index (SMMI), muscle strength, and physical performance assessed with sarcopenia diagnosis according to the European Working Group on Sarcopenia in Older People (EWGSOP) diagnostic criteria. In our study, in parallel with the severity of disease in patients with GD diagnosis, the prevalence of sarcopenia (led by severe sarcopenia) was observed to be high compared to the control group. The prevalence of sarcopenia was 12.7%/24.2% among women and 13.8%/44.0% among men and 13.4%/32.8% in total in the control 2 and GD groups, respectively. There was a significant increase observed in the prevalence of sarcopenia, led by severe sarcopenia with a definite depression diagnosis. For GD patients, diagnosis of sarcopenia in the early stages and precautions like improving muscle functions with protein support in diet and resistance exercises will make it possible to contribute to improving clinical results of the disease.

Study of depression in the geriatric patients attending psychiatry OPD in a tertiary care hospital

Introduction: Major depressive disorder is widely prevalent in the general population and depression in geriatric patients is quite common. Increasing geriatric population in the country coupled with lack of awareness of depression and therefore lack of adequate care may lead to the suffering of the elderly people. We attempted to study depression in geriatric patients and the associated risk factors. Aims: Our aim was to study characteristics and associated risk factors of depression in geriatric patients attending the psychiatry outpatient department (OPD) for the first time. Materials and Methods: A total of 100 geriatric patients aged above 60 years, attending psychiatric OPD for the first time were enrolled in the study. Informed consent of patients who agreed to participate in the study was taken and socio-demographic data collected. A 30 item Geriatric depression scale was used to assess the severity of depression. Cognitive functions were screened by using the Mini-mental status examination (MMSE) in those suspected of neuro-cognitive problems. We excluded patients having psychotic and substance use disorders and having cognitive impairment interfering with giving information. Results: Headache and sleep disturbances were the most common presenting symptoms in geriatric patients with depression. The two non-modifiable risk factors found to be significantly associated with depression in the geriatric population were older age group and female gender. However, the potentially modifiable risk factors for depression in the geriatric population were low socioeconomic status, loss of a spouse, living alone, chronic co-morbidities, cognitive impairment, bereavement and restricted activities of daily living (ADL). Conclusion: Geriatric patients attending psychiatry OPD primarily for their somatic symptoms should be evaluated for depression, as a high prevalence rate of depression was found among them. Better awareness regarding depression will help for early ide

A study on the symptom profile of depressive disorder in elderly Turkish patients: A factor analysis study

Aim: Depressive disorder manifests itself differently in elderly patients due to the symptom profile. We conducted this study on a population of elderly major depressive disorder patients in Turkey with the aim of determining the sociodemographic characteristics, distribution, and associations of their symptoms.Material and Method: A retrospective study of 137 patients hospitalized during the last ten years in the Geropsychiatric Clinic of the Department of Psychiatry, Cerrahpasa School of Medicine, Istanbul University. The patients were diagnosed according to the DSM IV criteria.Results: Majority (51.8%) of the patients were female, most of which were married (65%). The most common symptoms in elderly patients in order of frequency were distress 112 (81.8%) anxiety 97 (70.8%), and insomnia 96 (70.1%). The least frequently observed symptoms were disorientation 5 (3.6%), nihilistic delusions 5 (3.6%), and increased appetite 2 (2.2%). The symptoms clustered in accordance with the DSM IV system.Conclusion: It was concluded that the sociodemographic characteristics and weighted distribution of symptoms in Turkish geriatric depression patients were closely in parallel with the existing literature. However, results indicate a need to repeat this study in order to explore the same in a general Turkish population.Keywords: Elderly; depression; sign; symptom; factor analysis.

Physical and mental factors associated with concurrent anxiety and depression in the elderly

Objective To explore the characteristics and influencing factors for concurrent anxiety and depression in geriatric patients. Methods A total of 1 318 older people aged over 60 from Beijing were investigated and divided into four groups: high anxiety with high depression, high anxiety with low depression, low anxiety with high depression, and low anxiety with low depression, based on results of Geriatric Depression Scale(GDS)and Geriatric Anxiety Inventory(GAI). Results Logistic regression analysis found that, compared with institution-dwelling elderly, home-dwelling patients were more prone to anxiety(βlow depression=1.66, P=0.01; βhigh depression=2.41, P=0.03), regardless of depression levels, but when anxiety levels were high, depression was easier to relieve in home-dwelling elderly than in their institution-dwelling counterparts(β=-1.50, P=0.01); Compared with patients with low anxiety and low depression, family support(β=-0.16, P=0.06)and friend support(β=-0.23, P=0.01)could reduce the incidence of high anxiety and high depression.Self-care abilities could predict the occurrence of high anxiety and high depression, rather than low anxiety and low depression, in the elderly(β=-1.81, P=0.01). Comorbidities(β=0.28, P=0.09)and neurological disorders were important risk factors for concurrent anxiety and depression. Conclusions In addition to physical health and self-care abilities, strong social support and quality elderly care(especially for neurological patients)can help reduce the incidence of concurrent anxiety and depression in elderly people. Key words: Anxiety; Depression; Risk factors

GERIATRIC HEALTH ASSESSMENT AND HEARING LOSS

Aim - to examine the results of a comprehensive geriatric assessment depending on the degree of hearing loss. Material and methods. We examined 110 patients aged from 60 to 90 years with bilateral symmetrical impairment of the hearing function. The research design included examination of the otolaryngologist, auditory function test, and geriatric assessment of neuropsychological status. Two groups were allocated based upon the study of the hearing function: the main group, which included 58 people with moderate hearing loss, and the control group, which included 52 people with significant hearing loss. Results. It was revealed that hearing loss has a negative influence on the cognitive abilities of geriatric patients. With increasing degrees of hearing loss, the progression of dementia is observed. There is a direct correlation between the progression of hearing loss and development of depression in geriatric patients. Conclusion. Our study revealed a relationship between the degree of hearing loss and neuropsychological changes in geriatric patients. Hearing function test as a part of comprehensive geriatric assessment would facilitate the understanding of the causes of neuropsychological disorders in geriatric patients.

Poster Number: EI 51 - White Matter Integrity in the Corpus Callosum is Associated with Rresilience Factors in Geriatric Depression

Introduction: Resilience has a protective role on the effect of depression. Reduced white matter integrity on the contrary, is a risk factor for, and a marker of geriatric depression. The link between resilience and white matter integrity in aging can increase our understanding of antidepressant treatment and serve as a marker for treatment responsiveness in geriatric depression. We analyzed the relationship of psychological resilience factors in relation to brain white matter integrity in depressed geriatric patients.