ISSN:1064-7481    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

The authors sought to determine the prognosis of depression in old age by reviewing original literature on this topic from three computer databases. All reports used at least 20 patients over age 60, followed up for at least 1 year, with affective status as outcome, and a quantitative meta-analysis was performed to combine results. Sixteen hospital-based and five community-based studies were selected, involving 1,487 and 249 depressed subjects, respectively. Most studies had serious methodological limitations. For combined results, 60% of patients in the hospital-based studies were well or had relapses-with-recovery, and 14%–22% were continuously ill; 19%–34% of community subjects were well; 27% were continuously ill, and most of the remainder had died. Physical illness, cognitive impairment, and severe depressive symptoms were frequently but inconsistently related to poor prognosis. Future studies must attend to composition of study populations and outcome assessment and control of extraneous prognostic factors.

ISSN:1064-7481    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

The authors examined the individual and relative roles of atrophy, comorbid medical illness, and cerebrovascular risk factors in the pathogenesis of late-life major depressive disorder (MDD). They used magnetic resonance imaging techniques to study 28 subjects with late-life MDD, 29 healthy control subjects, and 34 subjects with probable dementia of the Alzheimer type (DAT). Depressed subjects showed increases in cerebrospinal fluid volumes comparable to the DAT group but significantly different from control subjects. High-intensity signals, but not measures of atrophy correlated significantly with cerebrovascular risk factor scores. A logistic regression revealed that both brain atrophy and medical illness are associated with an increased risk of developing MDD. Data suggest that both atrophy and comorbid medical illness increase the likelihood of developing MDD in late life.

ISSN:1064-7481    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

The authors compared the CERAD Behavior Rating Scale for Dementia (CBRSD) with the Cohen-Mansfield Agitation Inventory (CMAI) for their ability to detect behavioral symptoms in community-dwelling dementia patients with mild-to-moderate global impairment. Both instruments were administered to caregivers of 33 cognitively impaired patients seen in a dementia clinic at initial evaluation or follow-up visit. Endorsement of a higher percentage of items on the CBRSD than the CMAI suggests greater sensitivity of this instrument to the behavioral symptoms seen in community-dwelling patients. There was good correlation between the number of items endorsed on both scales but not between subscales of the CMAI and factors of the CBRSD that appeared related to agitation. Thus, the CBRSD and CMAI both seem to measure behaviors that occur in dementia patients, but the CBRSD's two agitation-related factors do not appear to measure agitation as defined by the CMAI.

ISSN:1064-7481    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

The authors investigated the syndromal and cognitive profiles of 25 DSM-III-R older schizophrenic inpatients with continuous acute psychotic symptoms and compared them with 20 younger schizophrenic patients by means of a multidimensional assessment battery. Subjects were medically well and without neurological comorbidity and were comparable in length of current hospitalization and medication regimens. There were no significant differences between the two groups on various symptom rating scores or on neurological variables. The older group's mean scores for various cognitive measures did not reach the value for senile dementia. They also scored significantly better on a memory test and on formal cognitive functions. These findings support the notion of a stable encephalopathy, rather than a dementia-like process, underlying the course of the illness. Authors discussed limitations and implications of these findings.

ISSN:1064-7481    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

The understanding of adjustment to aging calls for models that illustrate the interaction of psychosocial and health factors. The authors surveyed a group of retired Catholic sisters, examining the contributions of psychosocial f actors and religiousness to life satisfaction, psychological distress, and depression. Life satisfaction was best explained by a four-factor model that included mastery, social support, physical functioning, and religious commitment. General level of distress was best predicted by physical functioning, social support, and mastery, but not religiousness. Depression, on the other hand, was predicted by mastery, social support, and religious commitment. These data are consistent with a proposed model in which internal, external, and coping resources mediate the psychological impact of impaired functional status.

ISSN:1064-7481    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Losing close attachments through death in late life is common and can lead to depression. Previous work has shown the clinical benefits of treating these depressions. This article describes the 2-year course of 53 elderly subjects with bereavement-related depression after responding to various treatments. Forty-six patients experienced a full response to acute treatment, but 36% experienced relapse or recurrence. This finding suggests that the treatment response in depressed bereaved older patients is more brittle than expected.

ISSN:1064-7481    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

The authors compared the efficacy and side effects of trazodone and haloperidol for treating agitated behaviors associated with dementia. Twenty-eight elderly patients with dementia and agitated behaviors were randomly assigned to double-blind treatment with either trazodone (50–250 mg/day) or haloperidol (1–5 mg/day) for 9 weeks. There was no significant difference in improvement between the medication groups. Adverse effects, however, were more common in the group treated with haloperidol. Improvement in individual areas suggested that repetitive, verbally aggressive, and oppositional behaviors responded preferentially to trazodone, whereas symptoms of excessive motor activity and unwarranted accusations responded preferentially to haloperidol. These results indicate that moderate doses of trazodone and haloperidol are equally effective for treatment of overall agitated behaviors in patients with dementia, but specific symptoms may respond preferentially to a particular agent.

ISSN:1064-7481    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Citalopram, in European studies, has shown some early promise for treatment of poststroke depression and behavioral complications of dementia. An open pilot study of citalopram was conducted in 16 patients with dementia and behavioral disturbances. Citalopram was well tolerated by 13 of the patients, and 9 had a clinically impressive response. A significant overall mean reduction in disruptive vocalizations was observed by means of a novel technique of computer-assisted real-time observation. The mean citalopram plasma level-to-dose ratio was found to be twice that previously reported in younger patients. These pilot findings should encourage future placebo concentration-controlled trials.

ISSN:1064-7481    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

The authors describe major depression with delusions occurring for the first time in an elderly man receiving metoclopramide and review the literature concerning metoclopramide and depression.

ISSN:1064-7481    

出版商:OVID    

年代:1997

数据来源: OVID