Middle-aged Depression Research Articles

The gut microbiome from middle-aged women with depression modulates depressive-like behaviors and plasma fatty acid metabolism in female middle-aged mice

BackgroundIntestinal dysbacteriosis has frequently been involved in the context of depression. Nonetheless, only scant information is available about the features and functional changes of gut microbiota in female middle-aged depression (MAD). ObjectiveThis study aims to explore whether there are characteristic changes in the gut microbes of female MAD and whether these changes are associated with depressive-like behaviors. Meanwhile, this study observed alterations in the lipid metabolism function of gut microbes and further examined changes in plasma medium- and long-chain fatty acids (MLCFAs) in mice that underwent fecal microbiota transplantation (FMT). MethodsStool samples obtained from 31 MAD, along with 24 healthy individuals (HC) were analyzed by 16 S rRNA gene sequencing. Meanwhile, 14-month-old female C57BL/6J mice received antibiotic cocktails and then oral gavage of the microbiota suspension of MAD or HC for 3 weeks to reconstruct gut microbiota. The subsequent depressive-like behaviors, the composition of gut microbiota, as well as MLCFAs in the plasma were evaluated. ResultsA noteworthy disruption in gut microbial composition in MAD individuals compared to HC was observed. Several distinct bacterial taxa, including Dorea, Butyricicoccus, and Blautia, demonstrated associations with the demographic variables. A particular microbial panel encompassing 49 genera effectively differentiated MAD patients from HC (AUC = 0.82). Fecal microbiome transplantation from MAD subjects led to depressive-like behaviors and dysfunction of plasma MLCFAs in mice. ConclusionsThese findings suggest that microbial dysbiosis is linked to the pathogenesis of MAD, and its role may be associated with the regulation of MLCFAs metabolism.

Grey matter abnormalities in major depressive disorder patients with suicide attempts: A systematic review of age-specific differences

BackgroundPrevious studies have reported alterations in brain structure in major depressive disorder (MDD) patients with suicide attempts. However, age-related changes in suicidal MDD patients remain unclear. MethodsWe performed a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Embase, PubMed, and Web of Science were searched to identify relevant studies from inception to January 2023. All voxel-based and surface-based morphometry studies comparing suicidal MDD patients to MDD or healthy controls were included. Studies were then grouped by age range (old, middle-age, adolescent) and the commonalities and age-related structural brain alterations were summarized. The included studies were evaluated using the Newcastle-Ottawa Scale (NOS). ResultsA total of 17 studies met the inclusion criteria, including 3 of late-life depression (LLD) patients, 11 of middle-aged depression (MAD) patients, and 3 of adolescent depression (AOD) patients. The majority of studies had moderate to high NOS scores, indicating good quality. Patients in all three age groups exhibited extensive alterations in the lateral, medial, and orbital regions of the frontal lobes. Furthermore, suicidal MAD patients showed a specific decrease in the gray matter volume of the dorsolateral prefrontal cortex compared to suicidal LLD patients. Cortical thickness and left angular gyrus volume were decreased in suicidal MAD and suicidal LLD patients, but increased in suicidal AOD patients. ConclusionThis systematic review summarizes structural brain changes in suicidal MDD patients at three age groups: elderly, middle-aged, and adolescent. These findings help elucidate the common circuitry of MDD related to suicide over the lifespan and highlight unique circuitry associated with different ages. These findings may help predict the risk of suicide in MDD patients at different ages.

Treatment-resistant first-time depression in middle age

Treatment-resistant first-time depression in middle age

Nonfermented Dairy Intake, but Not Fermented Dairy Intake, Associated with a Higher Risk of Depression in Middle-Age and Older Finnish Men

BackgroundDespite the putative health benefits of fermented dairy products, evidence on the association between fermented dairy and nonfermented dairy intake, and depression incidence is limited. ObjectivesThis study examined cross-sectional and prospective associations between total dairy, fermented dairy, and nonfermented dairy intake with 1) the presence of elevated depressive symptoms and 2) the risk of a future hospital discharge or outpatient diagnosis of depression. MethodsData from 2603 Finnish men (aged 42–60 y), recruited as part of the Kuopio Ischaemic Heart Disease Risk Factor Study, were included. Multivariable logistic regression models were used to examine ORs and 95% CIs for elevated depressive symptoms (Human Population Laboratory scale ≥5 points) at baseline. Cox proportional hazards regression models were used to estimate HRs and 95% CIs between dairy categories and risk of depression diagnoses. ResultsIn cross-sectional analyses, fermented dairy intake in the highest (compared with lowest) tertile was associated with lower odds of having elevated depressive symptoms (adjusted OR: 0.70; 95% CI: 0.52, 0.96). Each 100-g increase in nonfermented dairy intake was associated with higher odds of having elevated depressive symptoms (adjusted OR: 1.06; 95% CI: 1.01, 1.10). During a mean follow-up time of 24 y, 113 males received a diagnosis of depression. After excluding cheese intake, higher fermented dairy intake was associated with a lower risk of depression diagnosis (adjusted HR: 0.62; 95% CI: 0.38, 1.03), which was strengthened after excluding those with elevated depressive symptoms at baseline (adjusted HR: 0.55; 95% CI: 0.31, 0.99), whereas nonfermented dairy intake in the highest tertile was associated with a 2-fold higher risk of depression (adjusted HR: 2.02; 95% CI: 1.20, 3.42). ConclusionsFermented dairy and nonfermented dairy intake were differentially associated with depression outcomes when examined cross-sectionally and over a mean period of 24 y. These findings suggest that dairy fermentation status may influence the association between dairy intake and depression in Finnish men. The KIHD study was registered at clinicaltrials.gov as NCT03221127.

Multiple pathways linking early socioeconomic circumstances and depressive symptoms in late Middle age in the U.S.

Objectives: A growing number of life course studies are examining the influence of earlier life experiences on morbidity, disability, and mortality in mid-old age. Method: Drawing from the social pathway model, this study expands the life course literature by utilizing data collected over 35 years from the National Longitudinal Survey of Youth, 1979 Cohort, spanning four life course phases (childhood, young adulthood, middle adulthood, and late-middle adulthood). Through structural equation analyses with a phantom model, we estimated depressive symptoms in late middle age as a result of pathway effects starting with childhood socio-economic status (SES) which effect young adulthood and middle adulthood. The multi-pathway life course model includes three potential mediators of middle adulthood: health risk behaviors, social activity, and negative life events. Results: We found limited support for a direct effect of childhood SES disadvantage on depressive symptoms in middle age. Instead, much of the effects of childhood SES on later-year depressive symptoms appear to be mediated by SES in young adulthood. Further, the long-term pathway is mediated through the influence of health risk behaviors and negative life events in middle adulthood. Conclusion: Our findings do not propose this chain is permanent and irreversible; rather, this study highlights the possibility that interventions focused on promoting health behaviors and improving living conditions for people from socioeconomically disadvantaged backgrounds could help reduce the instance of depression in middle age and health outcomes along the life course could be improved.

The therapeutic effect of repetitive transcranial magnetic stimulation in elderly depression patients.

Background:Depression, a common psychiatric disorder in elderly, serves as a remarkable precipitating factor for suicide among the elderly people. Here, a randomized double-blinded study was performed to investigate the efficacy of repetitive transcranial magnetic stimulation (rTMS) on improving the clinical symptoms and reducing suicidal ideation in elderly patients with depression.Methods:In this study, 103 elderly patients with depression and suicidal ideation were randomly divided into 2 groups, 48 cases in the rTMS group and 55 cases in the control group (sham rTMS). Both groups received routine drug therapy with rTMS or sham rTMS. The patients received evaluation by Hamilton depression scale and self-rating idea of suicide scale before treatment and after 2 and 4 weeks of treatment, respectively.Results:The measurement from the present study demonstrated that Hamilton depression scale and self-rating idea of suicide scale scores decreased to varying degrees in the 2 groups after treatment, and the decrease was more significant in rTMS group. The rate of marked effectiveness was much higher in rTMS group after 2 weeks of treatment compared with the control group. Furthermore, the rate of moderate effectiveness at 4 weeks after treatment was significantly higher in rTMS group compared with the control group.Conclusion:Together, the present study shows that rTMS with routine drug therapy exhibited effect with quick onset to improve the clinical symptoms and reduce suicidal ideation in elderly patients with depression.

자전적 기억의 과일반화와 반추가 중년기 우울에 미치는 영향

본 연구의 목적은 자전적 기억과 중년기 우울과의 관계를 경험적으로 확인하는 것이다. 먼저, 본 연구는 자전적 기억의 처리 방식과 우울의 관계, 나아가 자전적 기억 중 긍정정서 기억 그리고 부정정서 기억과 우울 간의 관계를 살펴보았다. 또한, 반추의 두 측면인 반추와 숙고가 우울에 상이한 영향을 미친다는 선행 연구 결과에 의거하여, 반추와 숙고가 우울에 미치는 영향을 각각 탐색하였다. 259명의 중년기 성인의 응답 자료가 분석에 활용되었고, 자료 분석을 위해 요인분석과 로지스틱 회귀분석이 실시되었다. 분석 결과에 따르면, 자전적 기억의 과일반화와 부정정서 기억, 반추의 하위요인인 반추는 중년기 성인의 우울 가능성을 유의하게 예측한 반면, 긍정정서 기억과 숙고는 중년기 성인의 우울을 유의하게 예측하지 못하였다. 이는 중년기 성인에게 있어 자전적 기억의 과일반화, 그리고 부정적인 정보와 정서에 수동적으로 초점을 맞추는 반추적 사고 경향이 중년기 우울을 심화시키는 것으로 해석될 수 있다. 연구 결과는 중년기 우울 예방과 대처에 대한 인지적 개입의 측면에서 논의되었고, 마지막으로 본 연구의 의의와 제한점이 제시되었다.

Early Onset Depression Has Different Characteristics from Middle-Aged Depression in Terms of Circadian Rhythm

Objective The aim of this study was to identify the unique biological and circadian rhythmic characteristics of patients with early-onset depression compared to patients with middle-age-onset depression. Methods A total of 240 subjects were recruited in the study and divided into three groups: healthy young individuals, patients with early-onset depression, and middle-aged patients with unipolar depression. Patients then filled out questionnaires related to biological rhythm disturbances, mood symptoms, diurnal preference, and seasonality. Results Patients with early-onset depression had significantly different clinical features in terms of mood disorders, diurnal preference, and biological rhythm disturbances compared to middle-aged patients with unipolar depression. Conclusion Results of this study suggest that early-onset depression is different from middle-age-onset unipolar depression but similar to bipolar disorder. Keywords: Circadian rhythm; Depression; Bipolar disorder

Abstract P210: Systolic Blood Pressure Trajectories From Childhood to Adulthood and Depression in Middle Age: The Bogalusa Heart Study

Introduction: Few studies have examined the long term patterns of blood pressure change in relation to depression in middle age. Methods: We examined data from the Bogalusa Heart Study, a long-term community-based observational study of a biracial cohort, with first measurements in childhood in 1973. Men and women (n=909) who completed the Center for Epidemiologic Studies Depression Scale (CES-D) in 2010 with at least two childhood and two adult SBP measurements were included. CES-D scores were categorized using established cut points (<8, 8-15, >15). Discrete mixture modeling was employed to identify trajectory groupings of (SBP), adjusted for race (time-independent) and body mass index (time-varying). The association between SBP trajectory and CES-D scores were determined using multivariable logistic regression adjusted for antihypertensive use, education, and physical activity in 2010. Results: Mean (±SD) age was 43.1±4.5 years, 57.9% were female, and 31.7% were Black. 27.7% of participants were current smokers in 2010. Mean (SD) BMI was 31.0 (7.7). We identified four SBP patterns: always low but slightly increasing (46.8%), low and modestly increasing (22.6%), healthy and stable (21.8%), and profoundly increasing (8.9%). Relative to the largest group, the multivariable adjusted odds ratio (OR) of higher CES-D categorization, i.e. more depressed, for the modestly increasing was 1.47 (95% CI, 1.01-2.15), for the stable, 0.96 (95% CI, 0.66-1.39), and for the profoundly increasing, 1.93 (95% CI, 0.66-1.39). Each additional year of education was associated with 33% decreased odds of higher CES-D categorization (OR=0.67, 95% CI 0.59-0.77). Conclusions: Trajectories of SBP from childhood through adulthood are associated with depression in middle age. Individuals with increasing SBP may benefit from depression screening in early adulthood.

Comparisons of prevalence and related factors of depression in middle-aged adults between urban and rural populations in Japan

BackgroundFindings of urban-rural differences in the prevalence of depression have been controversial, and few reports have directly compared the related factors of depression between urban and rural areas. The present study aimed to investigate differences between urban and rural areas in Japan with regards to the prevalence of and related factors of depression in middle-aged adults, in order to further understanding of the features of depression in this demographic. MethodsWe used a multistage, random sampling procedure and mailing method. In total, 5000 participants were recruited from urban and rural areas in Kumamoto Prefecture (2500 in each area). Participants were aged from 40 to 64 years. Depression was assessed using the Center for Epidemiologic Studies Depression scale (CES-D). ResultsThe prevalence of middle-aged depression was not different between the urban and rural areas. Logistic regression analysis found that being female, living alone, and having a chronic illness were significantly associated with depression in urban-dwelling middle-aged adults. Younger age, sleep disturbance, and financial strain were significantly associated with depression in both urban and rural areas. LimitationsThe definition of depression was based on CES-D scores, without corroborating clinical evaluation. ConclusionsWe found no marked differences in the prevalence of middle-aged depression between the urban and rural areas. Some related factors of depression in middle-aged adults differed between urban and rural areas in Japan. Effective intervention programs for middle-aged adults with depression should consider regional differences.

Abstract 18557: Cardiovascular Risk Factor Trajectories From Childhood to Adulthood and Depression in Middle Age: The Bogalusa Heart Study

Introduction: It is well known that depression and heart disease are closely linked. However, it remains unclear whether changes in cardiovascular (CV) risk factors over time may be related to depression. Few studies have examined the long term patterns of CV risk factors in relation to depression in middle age. Hypothesis: The trajectories of cardiovascular risk factors are associated with depression and depressive symptoms. Methods: We examined data from the Bogalusa Heart Study, a long-term community-based observational study of a biracial cohort, with first measurements in childhood in 1976. Men and women who completed the CES-D in 2010 with at least two childhood and two adult CV measurements (n=913) were included. Age, systolic blood pressure, antihypertensive treatment status, smoking status, total and HDL cholesterol, were used to calculate standardized 10-year Framingham CV risk scores at each follow-up. CES-D scores were categorized using established cut points (<8, 8-15, >15). Discrete mixture modeling was employed to identify trajectory groupings of CV risk. The association between CV risk score trajectory and CES-D were determined using multivariable logistic regression adjusted for smoking, education, physical activity, and BMI in 2010. Results: Mean (±SD) age was 43.06±4.48 years, 57.9% were female, and 31.7% were black race. 27.7% of participants were current smokers in 2010. Mean (±SD) BMI was 30.97±7.73. We identified three CV risk patterns: stable (63.8%), slightly elevated (28.8%), and increasingly elevated (7.5%). Relative to stable CV risk, the multivariable adjusted odds ratio of higher CES-D categorization, i.e. more depressed, for slightly elevated was 1.49 (95% CI, 1.08-2.06), and for increasingly elevated, 1.53 (95% CI, 0.90-2.59). Smokers had increased odds of higher CES-D categorization over nonsmokers (OR=2.16, 95% CI 1.58-2.95). One-unit increases of BMI were associated with 1.02 times greater odds of higher CES-D categorization (95% CI, 1.01-1.04). Conclusions: Trajectories of cardiovascular risk from childhood through adulthood are associated with depression in middle age. Individuals with elevated or increasing cardiovascular risk profiles may benefit from depression screening in early middle age.

The case control study of clinical symptoms and cognitive function between starting young and middle-aged depression patients with and without attempted suicide behavior

Objective To compare the difference of clinical symptoms and cognitive function between starting young and middle-aged depression patients with and without attempted suicide behavior. Methods Depressive patients were divided into two groups.One group was composed of patients with attempted suicide behavior(n=62), the other group was composed of patients without attempted suicide behavior(n=61). The cognitive function were measured by WAIS-RC, Wechsler Memory Scale and Wisconsin Card Sorting test(WCST). The patients were evaluated by symptom checklist 90(SCL-90). Results There were significant differences in the score of depressive factor between tow groups, such as attempted suicide(2.90±1.00, 2.51±0.76). There were significant differences in some nenuropsychological test between tow groups, such as long-term memory (35.28±6.87, 41.60±4.24), short-term memory (51.32±13.41, 118.98±10.95), intelligence quotient(107.41±15.78, 118.98±10.95), total quizzes number (73.18±27.02, 64.14±28.71), perseverative errors(32.77±17.93, 23.73±13.64). Conclusions There are certain characteristics on clinical symptoms of depressive patients with attempted suicide.The low cognitive function levels play an important role in the risk of suicide in depressive patients. Key words: Depression; Suicide behavior; Cognitive function; Neuropsychological test

Mood Disorders May Look Different inDSM-5

Mood Disorders May Look Different in<i>DSM-5</i>

Boys bullied at school risk depression in middle age

Boys bullied at school risk depression in middle age

Loss of parents in childhood – associations with depression, loneliness, and attitudes towards life in older Finnish people

Aim. This study examines the prevalence of parental loss in childhood of older generations in Finland and how it is associated with demographic variables, depression, feelings of loneliness and attitudes towards life in old age. Background. A parental loss is a significant trauma in a child's life. It has long-term consequences in late adulthood, such as depression in middle age. Loss of parent/parents has not been under concern in the nursing literature. Little is known about the prevalence of parental loss and its consequences in old age such as depression, inner feelings of loneliness and life attitudes. Methods. The data were collected with a postal questionnaire from a random sample of 3728 older people (≥75 years) in Finland who responded to a question concerning loss of a parent when respondent was age ≤17 years. Results. Of those responding to the question concerning parental loss, 31.2% had lost their mother and/or father in the childhood (at age ≤17 years). Loss of parents was associated with lower level of education, physically heavy lifetime work, and not being married. There was no statistically significant relation between the loss of parent/parents in the childhood and self-reported depression or loneliness in the old age. In addition, loss of parent/parents was not associated with any attitudes towards life, such as life satisfaction, plans for the future, zest for life or happiness. Conclusions. Surprisingly many people from older generations had lost their parent/parents in their childhood, but it is not associated with depression, feelings of loneliness or other attitudes towards life. Several explanations for this are discussed. Relevance to clinical practice. Loss of parents does not necessarily lead to older people's psychological frailty. Nurses should be cautious when making interpretations about older people's early life history. Among older people early losses may be a source of successful coping skills rather than a risk factor for depression, loneliness and pessimistic life attitudes.

Prognosis of Depression in Old Age Compared to Middle Age: A Systematic Review of Comparative Studies

Depression in old age has a poor long-term prognosis; equal evidence shows that the same is true of depression in middle age. The authors sought to identify research that has compared the prognosis of depression in late life with depression in midlife under similar conditions. The authors separated studies that examined age at presentation/recruitment from studies of age at first episode of depression, studies that examined remission/response from those that examined relapse/recurrence, and those that examined mortality/risk of dementia. Evidence suggests that response and remission rates to pharmacotherapy and ECT are not sufficiently different in old-age depression and middle-age depression to be clinically significant. Older patients at study entry appear to have a higher risk of further episodes, which informs the debate about the duration of continuation treatment for depression in older people. However, older patients and patients with late-onset depression are at increased risk of medical comorbidity. Medical comorbidity is a risk factor for inferior treatment response and poor antidepressant tolerability. Elderly patients with early-onset depression are more likely to have had a higher number of previous episodes, which also adversely influences prognosis compared to elderly depressed patients with late onset of illness. With control for confounding variables, remission rates of depression in patients in late life are little different from those in midlife, but relapse rates appear higher. Findings underline the importance of assessing factors related to patient age and not just to age itself in evaluations of risk factors for poor prognosis.