Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011570 (depression)
172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Cerebrospinal fluid concentrations of corticotropin-releasing hormone (CRH), thyrotropin-releasing hormone (TRH) and somatostatin (SRIF) were measured in 77 female inpatients with moderate to extreme dementia and in 17 elderly female controls. Both multi-infarct (MID) and Alzheimer-type (SDAT) demented patients had equally elevated CSF CRH and TRH but not SRIF levels as compared with the controls. This elevation was, however, not seen in patients with simple dementia while it was most prominent in those exhibiting marked depressive symptoms. It is concluded that depression rather than dementia itself may be associated with CSF CRH and TRH elevation in elderly patients with cognitive impairment.
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PMID:Cerebrospinal fluid neuropeptides in dementia. 148 50

Depressive symptoms have been reported in patients with mild to moderate Alzheimer's disease (AD). Recent evidence suggests that a noradrenergic deficit originating from neuronal degeneration in brainstem nuclei may represent an organic correlate of these disturbances. We examined the neuropathological changes in the locus coeruleus (LC), substantia nigra (SN), basal nucleus of Meynert and cortex of 52 patients (12 male, 40 female, mean age 83.2 +/- 6.4 years) with pathologically verified AD. Fourteen patients (1 male, 13 female) showed signs of depression. The majority of these patients suffered from severe physical disability or sensory impairment and developed persistent delusions, but had less cognitive impairment. Neuronal counts in the LC were significantly lower than in the 38 patients without depression (36.9 +/- 14.0; 51.4 +/- 28.0 neuromelanin-pigmented cells per section per nucleus; F = 3.4, df = 1, 50, P = 0.04). Neuron counts were higher in the basal nucleus of Meynert in depressed AD patients and there were no differences of the neuron numbers in the SN. Depression (main effect; F = 4.5, P = 0.04) contributed significantly to the variance of neuronal counts in the LC, even when covarying for gender, age of onset, cognitive impairment and cortical Alzheimer pathology. The observed disproportionate loss of noradrenergic and cholinergic neurons in the LC and basal nucleus of Meynert may represent an important organic substrate of depression in AD.
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PMID:Clinical and neuropathological correlates of depression in Alzheimer's disease. 148 85

Certain psychiatric complications are associated with various stages of PD. The possible causes known to date are analysed. Depression, isolated cognitive impairments, pharmacotoxic psychosis and dementia-related changes are the predominant mental disorders in PD. PD and depression syndrome occur very frequently in old age. Behaviour and mimicry of patients with progressive PD and of patients with depression syndrome are sometimes so similar that the two conditions can be differentiated only by long-term monitoring. In addition, PD and depression may occur simultaneously. However, frequency and intensity of depressive phases do not differ in PD patients and aged-matched depressed patients without PD. About one third of patients hospitalized at the neurological department of the Geriatric Hospital Lainz require antidepressant drug treatment. Similar percentages were found for other chronic cerebral and extracerebral diseases in the aged. Major depressions are independent of the parkinsonian disability and can be successfully managed only by antidepressant medication. Pharmacotoxic psychoses are not only serious conditions, they also reveal the limitations of therapeutic options. The unusual frequency of such acute psychoses, i.e. 30 to 60% in the terminal stages of the disease, indicates a special relation between antiparkinson medication and increasing neurotransmitter disturbances. Permanent pronounced depression in the sense of DSM III is not one of the symptoms of typical PD. States of dementia occur only in connection with a second or third cerebral pathology, mostly in combination with SDAT and MID.
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PMID:Mental disorders in Parkinson's disease. 149 Dec 44

Response slowing on psychological tasks is found both in Alzheimer's disease and depression. However, the underlying cause for this slowing may be different in the two disorders. This research examined whether the behavioral slowing found in Alzheimer patients results from a reduction in their rate of cognitive processing, whereas the slowing in depressed geriatric patients reflects a purely motor retardation. This hypothesis was tested using a task in which subjects had simply to determine the number of dots present in an array (i.e., enumeration). In all four subject groups (Alzheimer patients, depressed geriatric patients, healthy old controls, and healthy young controls), response time increased linearly with array size. The slope of this linear function (reflecting rate of enumeration) was the same in the normal and depressed patients, but was significantly greater in the Alzheimer patients, suggesting the presence of a cognitive slowing in Alzheimer's disease, but not in depression.
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PMID:Cognitive slowing in Alzheimer's disease and geriatric depression. 151 39

A group of 1070 community-living persons aged 65 and over was assessed using the GMS-AGECAT package and other interviews at years 0 and 3. Year 3 interviewers were 'blind' to the findings at year 0, and the prevalence of organic disorders and depression was very similar in both years. According to the results at year 3, minimum and maximum prevalence figures for dementia at year 0 were 2.4% and 3.8% for moderate to severe and 0.4% and 2.4% for mild or early cases, with a best estimate of 3.5% and 0.8%, or 4.3% overall, divided into: senile, Alzheimer's type 3.3%; vascular 0.7%; and alcohol-related 0.3%. The overall incidence of dementia, clinically confirmed by six-year follow-up, was 9.2/1000 per year (Alzheimer type 6.3, vascular 1.9, alcohol related 1.0). Three years later, 72.0% of those with depressive psychosis and 62.3% of those with depressive neurosis were either dead or had some kind of psychiatric illness. Nearly 60% of milder depressive cases (7.2% of the total sample) had either died or developed a chronic mental illness. The outcome of depressive pseudodementias is equivocal so far. Findings at year 3 provide validation of AGECAT computer diagnosis against outcome; organic and depression diagnoses are seen to have important implications for prognosis.
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PMID:Alzheimer's disease, other dementias, depression and pseudodementia: prevalence, incidence and three-year outcome in Liverpool. 842 28

The purpose of this review is to set forth guidelines for the treatment of depression in several special populations: (1) the elderly (both ambulatory and institutionalized); (2) patients with concurrent neurologic disorders (Alzheimer's disease, Parkinson's disease, and stroke) and depression; and (3) patients with bereavement-related depression. This is a selective review of studies published in the past 10 years that have utilized structured psychiatric interviewing, randomized clinical trials, and/or monitoring of plasma antidepressant levels. Published data support specific efficacy and safety claims for both pharmacotherapeutic and psychotherapeutic approaches to the treatment of major depression in elderly ambulatory and institutionalized patients. In the case of depression associated with Alzheimer's, Parkinson's, and stroke, there is also evidence of efficacy for antidepressant medication. Finally, bereavement-related syndromal depression appears to respond to antidepressant medication, but further controlled evaluation is desirable. As emphasized by the 1991 National Institutes of Health Consensus Development Conference on the Diagnosis and Treatment of Depression in Late Life, depression in the elderly should be recognized as treatable and should be treated vigorously. Rather than being dismissed as a normal reaction to the multiple medical and psychosocial burdens of late life, it should be treated appropriately to reduce an important source of excess disability.
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PMID:Treatment of depression in special populations. 152 79

Multi-infarct dementia (MID) and dementia of the Alzheimer type (DAT) are the main syndromes in the elderly. This study aims at evaluating the possible differentiation of these syndromes on a clinical basis. The patient population consisted of demented patients hospitalized during the period April 1, 1988-September 30, 1990 at the Department of Cerebrovascular Diseases. The study included 40 patients with MID and 25 with DAT. The clinical diagnosis of dementia included medical history, neurological examination, psychiatric interview and laboratory diagnostic investigations. The severity of the dementia symptoms was rated by many rating scales and a battery of neuropsychological tests. This model of clinical procedure permitted for differential diagnosis between vascular and degenerative dementia, according to DSM-III-R criteria. Patients with multi-infarct dementia of the Alzheimer type did not differ significantly with regard to age, mean duration of cognitive impairment and level of education. In the DAT group women outnumbered men, and this was statistically significant. It should be emphasized, that a great majority of patients with cerebrovascular lesions developed early cognitive impairment, that means within the first year after stroke. In the MID group hypertension, heart disease and smoking were statistically more frequent than in the DAT group. For the preliminary evaluation the severity of cognitive impairment was quantified by Mini-Mental State and Dementia Scale. These scales showed that the degree of dementia was significantly greater in DAT patients as compared to MID patients, whereas the severity of depression assessed by Hamilton's Scale was mild and similar in both group.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Clinical and differential diagnosis of multi-infarct dementia and Alzheimer's disease]. 152 70

Depression is common in patients with senile dementia of the Alzheimer type (SDAT) and may precede the onset of the dementia; the underlying biological and neurotransmitter mechanisms may be common to both diseases, so far as norepinephrine lesions are concerned. The major routes of metabolism of amines in the brain utilize the monoamine oxidase (MAO) enzymes. Due to the consistent severity of norepinephrine lesions in the locus coeruleus of patients with pre-senile dementia or SDAT and the fact that MAO-A enzyme is the major metabolizing enzyme present in the locus coeruleus in man, the new specific, reversible MAO-A inhibitors may have a place in the treatment of depression associated with SDAT.
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PMID:Depression and senile dementia of the Alzheimer type: a role for moclobemide. 154 30

Two hundred forty-eight elderly outpatients completed a survey designed to assess knowledge about the procedural aspects and efficacy of in-hospital cardiopulmonary resuscitation. We found that older people overestimate the percentage survival to actual hospital discharge following in-hospital cardiopulmonary resuscitation by nearly 300%. Most older people also have definite opinions about the appropriate application of cardiopulmonary resuscitation for different clinical circumstances. Most believe that patients with advanced Alzheimer's disease or widespread cancer should not be resuscitated, while patients with depression or early Alzheimer's disease should. Inaccurate beliefs about cardiopulmonary resuscitation efficacy can adversely impact on decision making about resuscitation by older patients. Educational efforts for the elderly may lead to more informed decision making and thereby more appropriate use of this technology.
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PMID:Cardiopulmonary resuscitation: how useful? Attitudes and knowledge of an elderly population. 154 21

Depression is ubiquitous in primary family caregivers of Alzheimer's Disease (AD) patients, but its relationship to the overall behavior patterns of these families has received little attention thus far. The focus of the exploratory study reported here was on one aspect of this issue--affective responses between caregiver and other family members as they relate to level of depressive symptoms in the primary caregivers. Family affective responses, especially negative responses, have proven of particular salience in studies of major psychiatric disorders. Would they be equally salient in a study of depressive symptoms in primary caregivers of Alzheimer's patients? Apparently so. Thirty caregivers and extended family members participated in problem-solving family interaction tasks that were videotaped, transcribed, and coded on affect. Two variables representing angry and sad responses of extended family members to the caregiver accounted for over 44% of the variance in caregiver depressive symptoms. The relevance of these findings for treatment approaches and future research efforts are discussed.
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PMID:Family interaction and caregivers of Alzheimer's disease patients: correlates of depression. 155 93


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