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)

Nutritional modulation is one approach to successful aging. In animals, dietary restriction increases life span. Alterations in the macronutrient and micronutrient constituent of the diet can modulate gene expression. Anorexia is common in elderly persons. The results of studies in animals suggest that aging is associated with a decrease in the opioid feeding drive and an increase in the satiating effect of cholecystokinin. Unrecognized depression is a common, treatable cause of anorexia and weight loss in elderly persons. Protein synthesis decreases in elderly persons; nevertheless, nitrogen balance can be maintained in patients with fairly low intakes of protein. Carbohydrate intolerance is common and may be modulated by nutritional intervention and physical activity. The role of cholesterol in the development of heart disease in very old persons is controversial. Homebound and institutionalized elderly persons often do not expose their skin to sunlight; because the skin of older persons has a decreased ability to form vitamin D, the vitamin D status in these persons is precarious and they are at risk for osteopenia. Vitamins are often abused by elderly persons. Drug administration alters the vitamin requirements of persons. Borderline zinc state has been associated with deteriorating immune function, especially in persons who have diabetes mellitus or who abuse alcohol. Zinc administration appears to protect against the deteriorating vision associated with age-related macular degeneration. Selenium deficiency seems to be associated with an increased prevalence of cancer.
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PMID:Nutrition in the elderly. 305 65

Even in the presence of normal blood pressure (B.P.) in both arms in some individuals, abnormal B.P. and circulatory disturbances can be found in the brain and lower extremities. The author discovered the following five types of abnormal B.P. in the brain in the presence or absence of normal B.P. in the arms: unilateral cephalic hypertension; bilateral cephalic hypertension; unilateral cephalic hypotension; bilateral cephalic hypotension; mixed cephalic hypertension and hypotension. When the B.P. of the head exceeds about 160 mm Hg, patients experience sensation of increased pressure buildup in the head to moderate headache. When it exceeds over 220 mm Hg, most of them experience severe headache in that side of the head. When the B.P. is very low (less than 30 mm Hg in both sides), majority of the subjects experience sleep disturbance pattern, mainly insomnia and some develop excessive sleepiness; difficulty in concentration and easy forgetfulness of recent events; various degrees of irritability. They are often associated with injury of neck-shoulder area with the presence of spastic muscles in the area. Relaxation of the spastic muscles by acupuncture, TES or soft laser beam from He-Ne (7 approximately 15m Watts) often change the abnormal cephalic B.P. toward normal. Among individuals with cephalic hypotension some of them develop eye problems. Blind patients with macular degeneration and retinitis pigmentosa often have severe cephalic hypotension and reduced blood flow. Improvement of B.P. and blood flow induced by safe and effective electrical stimulation resulted in significant improvement in vision. In some patients, abnormal B.P. and blood flow of the brain are dependent on the position of the head and neck which can be classified as "Cephalo-cervical Position Dependent Dysfunction Syndrome" which interferes with the function of some of the internal organs. In many psychiatric patients with schizophrenia or severe depression, cephalic B.P. and blood flow are often reduced significantly with additional abnormal function of pancreas, thyroid gland or liver. These abnormalities can explain some of the abnormal behavior, particularly when hypoglycemia, decrease in serotonin level and decreased circulation in the brain coexist.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Non-invasive circulatory evaluation and electro-acupuncture & TES treatment of diseases difficult to treat in Western medicine. 614

Late-onset visual impairment due to cataracts, glaucoma, macular degeneration, or diabetic retinopathy afflicts approximately 10% of people older than 65, and often results in depression and social dysfunction. Whereas the majority of sighted older adults are active participants in their community, individuals suffering from progressively worsening vision experience heightened levels of isolation and reduced social support, and participate in fewer reinforcing recreational activities. This article describes our social skills training package for the treatment of depressed, visually impaired, older adults. Our treatment focuses on increasing the frequency and level of assertiveness with which visually impaired older adults interact with each other. In addition to specified treatment methods, our empirically derived program employs standardized assessment measures to evaluate therapeutic progress. Sessions are implemented to reinforce efforts to apply social skills in the environment and reestablish skills that have begun to fade.
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PMID:Social skills training for depressed, visually impaired older adults. A treatment manual. 748 64

A multiple baseline design was used to assess the effects of social skills training (SST) in a 65-year-old woman suffering from major depression and severe macular degeneration. Responses to role-played scenarios requiring assertiveness, in vivo request for assistance and social involvement, self-reported assertiveness, depression, and happiness were repeatedly recorded during baseline, treatment, and follow-up phases. Results showed progressive improvement in targeted social skills with SST in both clinic and home settings. Concurrent with enhanced levels of social skill were dramatic decreases of depression to a nonclinical level. Improved skill levels and diminished Geriatric Depression Scale scores were maintained during the 7-month follow-up period, except at the 6 month assessment after which booster treatment was applied to reinstate maximum improvement.
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PMID:Social skills training in a depressed, visually impaired older adult. 764 63

Nineteen patients (20 eyes) with the exudative form of macular degeneration were treated with parenteral interferon alfa-2a. Fifteen patients (16 eyes) had adequate follow-up for evaluation of outcome of the exudative macular lesion. The average follow-up was 8 months (range 5-11 months). Color photographs and fluorescein angiograms were evaluated independently by two masked readers for change in size, presence of fibrosis, and leakage of the neovascular lesion. During the follow-up, none of the exudative lesions resolved: one lesion became smaller, four remained the same, nine enlarged, and two could not be graded based on the photographs. Visual acuity remained 20/40 or better in four eyes. The proportion of eyes with visual acuity of 20/200 or worse increased from 35% at the initial visit to 59% at the final visit. Ten patients experienced significant but reversible side effects, including weight loss, depression, and/or hematopoietic suppression. The data from these cases do not support any significant treatment benefit from interferon alfa-2a at the doses used in exudative macular degeneration.
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PMID:Interferon alfa-2a in the treatment of exudative age-related macular degeneration. 825 94

Impairment in hearing and vision are common for persons age 65 and older, and severe impairments may result in dependencies in daily activities. Hearing loss with age often results in diminished ability to communicate with others and may lead to isolation, depression, and cognitive changes. A hearing evaluation involving simple screening tools in important for early recognition and treatment of otologic conditions. Cataracts, macular degeneration, diabetic retinopathy, and glaucoma are the most sight-threatening ocular diseases of aging. Visual loss usually occurs gradually and may go unrecognised for some time. Primary care screening is important to preserve sight and prevent disability and loss of function.
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PMID:In-office screening for age-related hearing and vision loss. 919 90

Normal changes in the lens, retina, and vitreous accompany aging, but loss of vision in late life is not an inevitable consequence of aging. Cataract, glaucoma, diabetic retinopathy, and age-related macular degeneration (ARMD) account for most vision loss in the older population. Visual impairment reduces older patients' ability to function independently and increases their risk of depression and of injury due to falls. When older persons have a visual complaint, they tend to blame it on being old and do not tell their physicians. In the primary care office, simple screening questions and examination of the dilated eye can often reveal a need for further examination and/or referral.
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PMID:Keeping an eye on vision: primary care of age-related ocular disease. Part 1. 926 Dec 84

Macular degeneration refers to the breakdown of cells in the centre of the retina. Some degeneration is an inevitable consequence of the aging process; however, when this is associated with loss of sight in the central part of the field of vision an underlying pathology is considered present. Among those aged 55 years, the prevalence of the disease in the US was estimated at 1% rising to approximately 15% among those aged 80 years. Other studies estimate the prevalence of the disease to be higher and to be increasing. The main effect of the disease is to reduce the ability of the individual to engage in everyday activities that require clear central vision. It may also be associated with elevated risks of depression and increased levels of dependency. Currently there is no effective treatment for the majority of patients. For a minority (< 10%) laser photocoagulation therapy may be effective in reducing the risk of severe vision loss. Another treatment, photodynamic therapy, is in development and many others are at an experimental stage. This review sought to establish current knowledge on the cost of illness associated with age-related macular degeneration (ARMD). A search of the literature, together with direct communication with researchers in related fields and patient support/advocacy groups, was undertaken to ascertain current knowledge on the cost of illness of ARMD. While literature on the disease is extensive and literature on treatments is emerging, no substantive information on direct or indirect costs was found although evidence that loss of earnings may occur is beginning to emerge. Some information does exist on cost of illness in diabetic retinopathy, a disease with similarities to ARMD, though even for this disease gaps in knowledge are apparent and wide variations exhibited. Given current knowledge, it is not possible to report on the cost of illness for ARMD with confidence. The lack of information on the cost of illness in ARMD presents difficulties for researchers and policy makers in assessing the cost effectiveness of the existing treatment, as well as new treatments as they become available. Given developments in treatments and the increasing prevalence of the disease, it is important that cost-of-illness information is gathered for ARMD.
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PMID:Age-related macular degeneration: cost-of-illness issues. 1134 71

Human and macaque retinae have similar retinal vascular anatomy. The general features of the retinal vascular anatomy of these two primates have much in common with more widely studied animal models such as rat and cat. However, primates are unique amongst mammals in having a region in temporal retina specialized for high visual acuity, which includes the fovea centralis (or 'fovea'). Several features distinguish the fovea from other parts of the retina, including a very high local density of cone photoreceptors, a high density of inner retinal cells during development, and an absence of retinal blood vessels. The retinal vascular complex comprises a number of cell types, in addition to vascular endothelial cells, including pericytes, microglia, astrocytes-none of which is intrinsic to the retina. In addition, amacrine-like cells make bouton-like associations with retinal vessels and may be involved in the autoregulation of blood flow. During development endothelial cells 'invade' the retina, accompanied by a population of microglial cells; glial fibrillary acidic protein (GFAP)-immunoreactive astrocytes are also seen associated with the developing vasculature, and are in advance of the vascular front by a few hundred microns. Recent findings indicate that astrocytes at the vascular front proliferate in response to factors released by endothelial cells, including leukemia inhibitory factor. Better understood is the role of GFAP-immunoreactive astrocytes just in advance of the developing vessels. These astrocytes are sensitive to hypoxia and in response release vascular endothelial growth factor (VEGF) which in turn promotes the migration, differentiation and proliferation of vascular endothelial cells. This hypoxia/VEGF-mediated process of migration, proliferation and differentiation appears common to the retinae of a variety of species, including human. However, in human and macaque retina, different mechanisms appear to govern the development of the retinal vessels growing along the horizontal meridian of the retina towards the central area, which contains the fovea. Despite the relatively advanced state of differentiation and maturation of cells in the central area compared with the periphery, the growth of retinal vessels into the central area has been described as 'retarded', and the incidence of cell proliferation associated with these vessels is lower than in peripheral vessels. Furthermore, neither retinal vessels nor their accompanying astrocytes grow into a circumscribed region which, at a later stage, develops into the foveal depression. These observations suggest that molecular markers define the foveal region and inhibit cell proliferation and vascular growth at the fovea and, perhaps, along the horizontal meridian. The findings also suggest that at the fovea, the retina is adapted morphologically to its blood supply, since in the vicinity of the fovea, the development of retinal vessels is retarded or inhibited. The limitations on vascularization of central retina has implications for its vulnerability to degenerative changes, as seen in age-related macular degeneration.
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PMID:Development of the primate retinal vasculature. 1158 18

Ophthalmologists can help to improve the quality of life for patients with age-related macular degeneration (AMD) by treating the whole patient. Patients should be encouraged to seek psychiatric care for depression, especially if symptoms are persistent. They may also cope better with their vision loss by participating in AMD support groups. For earlier diagnosis of AMD, patients at high risk should be screened; if large drusen are present, nutritional suggestions can be made. Until treatments to prevent vision loss or to restore vision are available, these approaches provide optimal care.
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PMID:Age-related macular degeneration: treating the whole patient. 1594 9


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