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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

As part of a larger study, 133 subjects aged 70 years and over were screened for depression using the Geriatric Depression Scale, a 30-item questionnaire, as the screening instrument. Cognitive status was assessed using the Mini Mental State Examination. The subject's own general practitioner was asked his/her opinion as to whether the subject was depressed. Poor agreement was found between depression as measured by the Geriatric Depression Scale and the general practitioner's assessment. Possible reasons for this include the difficulty of finding a satisfactory operational definition of depression for use by general practitioners, the problems of identifying depression in the elderly, the arbitrary definition provided by the scale and the confounding of depression, as measured by the scale, with cognitive status.
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PMID:Recognition of depression in the elderly: a comparison of general practitioner opinions and the Geriatric Depression Scale. 224 89

In the context of increasing concern in occidental countries about dementing diseases in the geriatric population, an epidemiological study has been done in the city of Zaragoza, Spain. The sample, randomly selected from the census, was stratified by age and sex and included 1,134 elderly (aged 65 plus years) living in the community. In phase I, lay interviewers administered the Spanish versions of the Geriatric Mental State (GMS) and Mini-Mental Status Examination to the elderly. The individuals were considered to be "probable cases" on the basis of GMS "global" scores previously reported to be valid. These "probable cases" were then examined in phase II by standardized psychiatrists using both, the GMS and MEC, but also the History and Aetiology Schedule (HAS). A proportion of "probable normals" were also examined by the psychiatrists to assess the validity of the screening procedure in the community. The identified "cases" of dementia and "cases" of depression were then studied by the neurologists in what we call phase III. Specific project criteria for dementia were used but, in fact, all identified "cases" of dementia fulfilled DSM-III criteria. Some data of the application of the AGECAT computer program in both, phase I and phase II are now reported. The different severity levels of cognitive deficits according to AGECAT criteria are compared with clinical criteria. The advantages and disadvantages of the computer program in the detection of minor cognitive difficulties are discussed.
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PMID:The AGECAT "organic" section as a screening instrument for minor cognitive deficits. 228 73

A total of 247 consecutively evaluated geriatric medical patients was administered a battery of neuropsychological and psychological tests as part of their diagnostic workup for unexplained deterioration in their functioning. Depression was assessed with a short form of the MMPI, the Brief Symptom Inventory, and the Geriatric Depression Scale. By Research Diagnostic Criteria, most suffered from major (59%) or minor (21%) depressions; some degree of cognitive impairment was seen in 80% of the patients, defining a population of "vulnerable" geriatric patients typical of referrals to a general medical hospital setting. Using both conventional score cutoff criteria and discriminant analyses, false-negative rates up to 53% for major depression and 100% for minor depression were found. Psychometric misrecognition of depression was not related to degree of dementia or education but on some measures was positively associated with verbal intelligence level and patient age. Contrary to previous suggestions that psychometric measures overestimate depression in the elderly, these findings suggest that there may be a subgroup of elderly in which treatable affective distress is not appreciated.
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PMID:Psychometric assessment of depression in an elderly general medical population. Over- or underassessment? 229 35

The Geriatric Depression Scale (GDS) and two versions of the General Health Questionnaire (GHQ 28 and corrected GHQ 28) were administered to 111 patients admitted to an acute geriatric medical unit. Depression and dementia were diagnosed by semi-structured interview using DSM III criteria. There was no statistically significant difference in the three scales between cognitively normal depressed patients and demented depressed patients. The three scales were sensitive indicators of depressive illness (greater than 90%), but the GHQ 28 and CGHQ 28 needed adjustment of their community-based threshold values.
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PMID:The effect of mild to moderate dementia on the Geriatric Depression Scale and on the General Health Questionnaire. 231 26

The prevalence of depression among nursing home residents was estimated by screening a group of residents selected from a random sample on the basis of cognitive status; it ranged from 18-20% for major depression to 27-44% for other dysphoric states. Though individual patients were observed to change over a 6-month period, depression as assessed with the Geriatric Depression Scale was, in general, persistent. Major depression was clinically confirmed in 8 of 10 patients identified at screening. It was characterized by medical disorders that complicated diagnosis and treatment, and by increased mortality relative to the rest of the population.
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PMID:Clinical features of depression in the nursing home. 251 89

Elderly hypertensive patients with psycho-organic syndrome were treated with nicardipine (40-60 mg daily) alone or combined with hydrochlorothiazide (30 mg). This treatment led not only to a significant reduction in blood pressure but also to improvement in the score of the scales used for psychogeriatric evaluation (SCAG = Sandoz Geriatric Assessment Scale and HAM-D = Hamilton Rating Scale for Depression). These findings appear to confirm the possibility to consider nicardipine a drug of first choice for the treatment of arterial hypertension in the elderly with psycho-organic syndrome.
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PMID:[Nicardipine in the therapy of arterial hypertension in elderly patients with the psycho-organic syndrome. Report on the results of the clinical study]. 252 91

The high prevalence of mental disorders such as depression and dementia in institutionalized elderly patients warrants screening for psychiatric diagnosis in patients newly admitted to long-term care facilities. The diagnostic accuracy of the Mini-Mental State Examination (MMSE) and the Geriatric Depression Scale (GDS) was evaluated against a standardized psychiatric interview. The MMSE was found to be 81% sensitive and 83% specific in screening for dementia using a previously established cutpoint of less than 24/30 points. Adjusting MMSE scores for physical disabilities precluding completion of specific tasks on the MMSE did not significantly change the diagnostic accuracy of the test. The GDS was 47% sensitive and 75% specific in screening for depression using the suggested cutpoint of greater than 13/30 points. The MMSE was significantly correlated with functional status (r = 0.48, P = .0001), but not with the scores on the GDS or the clinical diagnosis of depression. The GDS did not correlate with functional status. In summary, the MMSE is a good screening test for dementia in institutionalized elderly, but the GDS is not sensitive for depression in this population.
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PMID:Instruments for screening for depression and dementia in a long-term care facility. 266 89

A double-blind, placebo-controlled trial was carried out in 97 elderly patients with age-related mental deterioration to assess the efficacy of ergoloid mesylates in improving their symptoms. Patients were allocated at random to receive either 4.5 mg ergoloid mesylates per day or a matching placebo tablet and were followed-up for 6 months after the start of treatment. Clinical examinations were performed by the doctor, using the EACG rating scale (a French version of the Sandoz Clinical Assessment Geriatric scale), and by the nurse, using the NOSIE scale, when patients entered the trial and repeated after 2, 4 and 6 months. Changes in the factors (symptom groups) covered by these scales were subjected to statistical analysis. After 6-months' treatment, a statistically significant difference in favour of the ergoloid mesylates group was observed for cognitive deficits (p less than 0.05), anxiety and mood depression (p less than 0.01), unsociability (p less than 0.01), retardation (p less than 0.05) and irritability (p less than 0.001). Treatment was very well tolerated. It was also observed that there was a progressive increase in efficacy throughout the trial; this indicates that treatment with ergoloid mesylates in patients with mental deterioration should be long-term.
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PMID:Ergoloid mesylates ('Hydergine') in the treatment of mental deterioration in the elderly: a 6-month double-blind, placebo-controlled trial. 265 Oct 14

Several lines of evidence have implicated acetylcholine (ACh) as one of the neurotransmitters found to be decreased in Alzheimer's disease (AD). Various methods of cholinergic augmentation have been attempted, with mixed results. Tetrahydroaminoacridine (THA), an acetylcholinesterase inhibitor, is currently being investigated at the McGill Centre for Studies in Aging. Preliminary uncontrolled data from a 10-week clinical trial of THA and lecithin, reported elsewhere, suggest a clinically modest but statistically significant beneficial effect on cognition, although problems exist with side effects, particularly gastrointestinal. Since the suggestion by Janowsky in 1972 that cholinergic neurotransmission may exert an inhibitory or depressant effect on mood, the evidence accumulated in the literature has been inconclusive. We undertook to assess several potential pretreatment correlates of depressive symptoms in AD and to monitor the course of these symptoms during the 10 week treatment period, using the Geriatric Depression Scale (GDS) of Brink and Yesavage. Pretreatment GDS scores were found to correlate with degree of overall disability and dementia as measured by the Rapid Disability Rating Scale (RDRS) and the Mini Mental State Examination (MMS), respectively. GDS scores over the treatment period did not change to a statistically significant degree. The meaning of these results is discussed, particularly with reference to the difficulty of diagnosis and measurement of depression in the setting of dementia.
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PMID:Canadian collaborative study of tetrahydroaminoacridine (THA) and lecithin treatment of Alzheimer's disease: effect on mood. 265 61

The aim of this multicenter study was to compare trazodone (TRA) with two reference drugs, amitriptyline (AMI) and mianserin (MIA), under double-blind conditions, in an elderly population, to ascertain age-related patterns for efficacy and tolerability. One hundred six elderly depressed inpatients, ranging in age from 60 to 83 years, diagnosed as having major depression according to DSM-III, were treated with 75 mg AMI (37 patients), 60 mg MIA (33 patients) or 150 mg TRA (36 patients) p.o.t.i.d. for 5 weeks. There were no differences in the clinical outcome among the three groups of patients at the end of the trial, with a significant amelioration (p less than 0.01) for the Hamilton Rating Scale for Depression (HRS-D) and the Geriatric Depression Scale (GDS). TRA showed a lower overall prevalence of side effects than AMI or MIA, particularly for anticholinergic (p = 0.03 vs. AMI) and cardiovascular (p = 0.05 vs. MIA) effects. For these data GDS seems to be most reliable in detecting changes in elderly depressive symptomatology; moreover a comparable therapeutic response (among the three drugs) but a better tolerance for atypical antidepressants, particularly TRA, make advisable the use of the latter drug in the elderly population.
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PMID:Clinical activity and tolerability of trazodone, mianserin, and amitriptyline in elderly subjects with major depression: a controlled multicenter trial. 266 51


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