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Follow-up study of depression in the elderly

Clinical and SPECT data

Published online by Cambridge University Press:  03 January 2018

Eleanor Halloran ,
Neil Prentice ,
Catherine L. Murray ,
Ronan E. O'Carroll ,
Michael F. Glabus ,
Guy M. Goodwin  and
Klaus P. Ebmeier
Eleanor Halloran*
Affiliation:
MRC Brain Metabolism Unit, Royal Edinburgh Hospital, Morningside Park, Edinburgh EHI0 5HF
Neil Prentice
Affiliation:
MRC Brain Metabolism Unit, Royal Edinburgh Hospital, Morningside Park, Edinburgh EHI0 5HF
Catherine L. Murray
Affiliation:
MRC Brain Metabolism Unit, Royal Edinburgh Hospital, Morningside Park, Edinburgh EHI0 5HF
Ronan E. O'Carroll
Affiliation:
MRC Brain Metabolism Unit, Royal Edinburgh Hospital, Morningside Park, Edinburgh EHI0 5HF
Michael F. Glabus
Affiliation:
MRC Brain Metabolism Unit, Royal Edinburgh Hospital, Morningside Park, Edinburgh EHI0 5HF
Guy M. Goodwin
Affiliation:
MRC Brain Metabolism Unit, Royal Edinburgh Hospital, Morningside Park, Edinburgh EHI0 5HF
Klaus P. Ebmeier
Affiliation:
MRC Brain Metabolism Unit, Royal Edinburgh Hospital, Morningside Park, Edinburgh EHI0 5HF
*
Professor Klaus P. Ebmeier, MRC Brain Metabolism Unit, Royal Edinburgh Hospital, Morningside Park, Edinburgh EHI0 5HF
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Abstract

Background

Imaging studies in depression of the elderly are often small and highly selective.

Aims

To investigate a large group of elderly depressed patients in order to assess changes in clinical, imaging and neuropsychological variables at follow-up.

Method

Patients (n=175, age range 65–91 years) with clinical depression were identified from consecutive local referrals. Clinical interviews, neuropsychological tests and SPECT scans were carried out at referral and at two-year follow-up.

Results

Of 84 re-examined patients, 46.5% were well, 9.5% were ill, 33% partially recovered and 11% had developed dementia. Duration of illness before index assessment was the only factor to predict outcome. Thirty-nine patients could be scanned and followed up. There were no differences between patients with good or poor depressive outcome on SPECT. Ten clinically improved patients could be re-examined with SPECT. There were relative increases in right cingulate gyrus and right cerebellum at follow-up.

Conclusions

The patient group was comparable with other studies showing high levels of residual depressive symptoms. Activity changes in limbic cortex are implicated in depression of old age.

Type
Papers
Information
The British Journal of Psychiatry , Volume 175 , Issue 3 , September 1999 , pp. 252 - 258
Copyright
Copyright © 1999 The Royal College of Psychiatrists 

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References

Abas, M. A., Sahakian, B. J. & Levy, R. (1990) Neuropsychological deficits and CT scan changes in elderly depressives. Psychological Medicine, 20, 507–520.CrossRefGoogle ScholarPubMed
Alexopoulos, G. S., Meyers, B. S., Young, R. C., et al (1996) Recovery in geriatric depression. Archives of General Psychiatry, 53, 305–312.CrossRefGoogle ScholarPubMed
American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn. revised) (DSM–III–R). Washington. DC: APA.Google Scholar
Baldwin, R. C. & Jolley, D. J. (1906) The prognosis of depression in old age. British Journal of Psychiatry, 149, 574–583.CrossRefGoogle Scholar
Beats, B. C., Sahakian, B. J. & Levy, R. (1996) Cognitive performance in tests sensitive to frontal lobe dysfunction in the elderly depressed. Psychological Medicine, 26, 591–603.CrossRefGoogle ScholarPubMed
Blazer, D., Burchett, B., Service, C., et al (1991) The association of age and depression among the elderly: an epidemiologic exploration. Journal of Gerontology, 46, M210–M215.CrossRefGoogle ScholarPubMed
Brodaty, H., Harris, L., Peters, K., et al (1993) Prognosis of depression in the elderly. A comparison with younger patients. British Journal of Psychiatry 163, 589–596.CrossRefGoogle ScholarPubMed
Brown, G. W. & Harris, T. O. (1970) Social Origins of Depression. London: Tavistock.Google Scholar
Burvill, P. W., Hall, W. D., Stampfer, H. G., et al (1991) The prognosis of depression in old age. British Journal of Psychiatry 158, 64–71.CrossRefGoogle ScholarPubMed
Cole, M. G. & Bellavance, F. (1997) The prognosis of depression in old age. American Journal of Geriatric Psychiatry 5, 4–14.CrossRefGoogle ScholarPubMed
Copeland, J. R. M., Davidson, L A., Dewey, M. E., et al (1992) Alzheimer's disease, other dementias, depression and pseudo-dementia: prevalence, incidence and three-year outcome in Liverpool. British Journal of Psychiatry, 161, 230–239.CrossRefGoogle Scholar
Crawford, J. R., Besson, J. A., Parker, D. M., et al (1987) Estimation of premorbid intellectual status in depression. British Journal of Clinical Psychology 26, 313–314.CrossRefGoogle ScholarPubMed
Ebert, D. & Ebmeier, K. P. (1996) The role of the cingulate gyrus in depression: from functional anatomy to neurochemistry. Biological Psychiatry 39, 1044–1050.CrossRefGoogle ScholarPubMed
Ebmeier, K. P., Prentice, N., Ryman, A., et al (1997) Temporal lobe abnormalities in dementia and depression: a study using high resolution single photon emission tomography and magnetic resonance imaging. Journal of Neurology, Neurosurgery and Psychiatry 63, 597–604.CrossRefGoogle ScholarPubMed
Ebmeier, K. P., Glabus, M. F., Prentice, N., et al (1998) A voxel based analysis of cerebral perfusion in dementia and depression of old age. Neuroimage, 7, 199–208.CrossRefGoogle ScholarPubMed
Folstein, M. F., Folstein, S. E. & McHugh, P. R. (1975) Mini-mental state: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.CrossRefGoogle Scholar
Friston, R. J. (1994) Statistical parametric mapping. In Functional Neuroimaging (eds R. W. Thatcher, M. Hallet, T. Zeiffiro, et al), pp. 79–93. New York: Academic Press.Google Scholar
Hamilton, M. (1960) A rating scale for depression. Journal of Neurology, Neurosurgery and Psychiatry 23, 56–62.CrossRefGoogle ScholarPubMed
Hoch, C. C., Reynolds, C. F. III, Buysse, D. J., et al (1993) Two-year survival in patients with mixed symptoms of depression and cognitive impairment: comparison with minor depression and primary degenerative dementia. American Journal of Geriatric Psychiatry 1, 59–66.CrossRefGoogle Scholar
Kay, D. W. K. (1962) Outcome and cause of death in mental disorders of old age: a long term follow-up of functional and organic psychosis. Acta Psychiatrica Scandinavica, 38, 247–276.CrossRefGoogle Scholar
Kivelä, S.-L. (1995) Long-term prognosis of major depression in old age: a comparison with prognosis of dysthymic disorder. International Psychogeriatrics, 7, 69–82.CrossRefGoogle ScholarPubMed
Knopman, D. S. & Ryberg, S. (1989) A verbal memory test with high predictive accuracy for dementia of the Alzheimer type. Archives of Neurology, 46, 141–145.CrossRefGoogle ScholarPubMed
Murphy, E. (1983) The prognosis of depression in old age. British Journal of Psychiatry 142, 111–119.CrossRefGoogle ScholarPubMed
Nelson, H. E. & Willison, J. R. (1991) The Revised National Adult Reading Test – Test Manual. Windsor: NFER–Nelson.Google Scholar
Old Age Depression Interest Group (1993) How long should the elderly take antidepressants? A double-blind placebo-controlled study of continuation/prophylaxis therapy with dothiepin. British Journal of Psychiatry 162, 175–182.CrossRefGoogle Scholar
Post, F. (1962) The Significance of Affective Symptoms in Old Age. Oxford: Oxford University Press.Google Scholar
Robinson, J. R. (1909) The natural history of mental disorder in old age. A long-term study. British Journal of Psychiatry 154, 783–789.CrossRefGoogle Scholar
Stoudemire, A., Hill, C. D., Morris, R., et al (1991) Cognitive outcome following tricyclic and electroconvulsive treatment of major depression in the elderly. American Journal of Psychiatry 140, 1336–1340.Google Scholar
Turna, T. A. (1996) Effect of age on the outcome of hospital treated depression. British Journal of Psychiatry, 168, 76–81.Google Scholar
Wechsler, D. (1901) Wechsler Adult Intelligence Scale–Revised. New York: Psychological Corporation.Google Scholar
Wilson, B., Cockburn, J. & Baddeley, A. D. (1985) Rivermead Behavioural Memory Test. Titchfield, Fareham: Thames valley Test Company.Google Scholar
Young, M J., Bresnitz, E. A. & Strom, B. L. (1903) Sample size nomograms for interpreting negative clinical studies. Annals of Internal Medicine, 99, 248–251.CrossRefGoogle Scholar
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