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

Desirable dietary habits and other lifestyle practices reduce premature mortality and compress the period of morbidity experienced towards the end of life. Aging adults are at risk of nutritionally inadequate diets especially in relation to protein, vitamins D, B1, B6, B12, fluid and other food components. Interventions aimed at ensuring dietary adequacy also need to consider the social and cultural aspects of eating as food is fundamental to a person's well-being and quality of life. The nutrition-related health problems associated with aging such as frailty, depression, incontinence and chronic non-communicable diseases should be identified in both the individual and in the community before dietary and other health interventions are implemented. In older adults, these dietary and health promoting interventions should then focus on maximizing function and quality of life, be acceptable and finally, measurable in terms of effectiveness.
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PMID:Interventions aimed at dietary and lifestyle changes to promote healthy aging. 1104 Oct 87

Depression and anxiety disorders in the elderly are common and under-diagnosed. As depressed elderly people often present with more somatic than psychiatric symptoms, diagnosis is difficult for the general practitioner. The Geriatric Depression Scale can be used as a screening instrument for diagnosis in the elderly. The etiology of depression and anxiety disorders is multifactorial. Important risk factors are psychological stress, reduced absorption of essential nutrients such as folacin and vitamin B12, and biological changes in the brain associated with aging. Selective serotonin reuptake inhibitors (SSRIs) are the drugs of choice in the treatment of elderly people with depression and anxiety disorders. Currently, the most widely used SSRI is citalopram, which according to controlled trials has an effect not only on depressed mood but also on anxiety. The use of SSRIs combined with support and psychotherapy elicits a positive response in nearly 90% of elderly patients. In Sweden, the use of antidepressants is currently most common in the age group 75-80 years, expressed in DDD (defined daily doses/1,000 inhabitants). This indicates a fairly active treatment of the elderly in Sweden.
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PMID:[Depression and anxiety in the elderly still underdiagnosed. SSRI preparations in conjunction with psychotherapy provide effective treatment]. 1126 67

Certain dietary risk factors for physical ill health are also risk factors for depression and cognitive impairment. Although cholesterol lowering has been suggested to increase vulnerability to depression, there is better support for an alternative hypothesis that intake of n-3 long-chain polyunsaturated fatty acids can affect mood (and aggression). Possible mechanisms for such effects include modification of neuronal cell membrane fluidity and consequent impact on neurotransmitter function. Stronger evidence exists concerning a role for diet in influencing cognitive impairment and cognitive decline in older age, in particular through its impact on vascular disease. For example, cognitive impairment is associated with atherosclerosis, type 2 diabetes and hypertension, and findings from a broad range of studies show significant relationships between cognitive function and intakes of various nutrients, including long-chain polyunsaturated fatty acids, antioxidant vitamins, and folate and vitamin B12. Further support is provided by data on nutrient status and cognitive function. Almost all this evidence, however, comes from epidemiological and correlational studies. Given the problem of separating cause and effect from such evidence, and the fact that cognitive impairment and cognitive decline (and depression) are very likely to be significant factors contributing to the consumption of a poor diet, greater emphasis should now be placed on conducting intervention studies. An efficient approach to this problem could be to include assessments of mood and cognitive function as outcome measures in studies designed primarily to investigate the impact of dietary interventions on markers of physical health.
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PMID:A healthy body, a healthy mind: long-term impact of diet on mood and cognitive function. 1131 Apr 19

While a complete understanding of the pathogenesis of Alzheimer's disease (AD) remains elusive, many conclusions can be drawn from the numerous epidemiological studies undertaken to date. Prevalence and incidence estimates show consistency, following a roughly exponential pattern with a doubling of both parameters roughly every five years after age 65. Roughly 7% of the population aged 65 and over has AD. The clinical course of the disease is reasonably well established and mortality rates rise with increasing levels of cognitive deficit. Four risk factors for AD are firmly established: increasing age, the presence of the apolipoproteinE-epsilon4 allele, familial aggregation of cases, and Down's syndrome. Numerous other associations have been shown in some studies, but not in others. For example, women generally appear at higher risk than men, as do people with lower levels of education; depression is probably prodromal; head injury is an established risk factor, and may interact with the apoE gene; several occupational exposures appear hazardous, and exposure to aluminum in the water supply confers excess risk. Hypertension and other vascular symptoms appear to predispose to AD, which is now seen as nosologically closer to vascular dementia than was previously believed. Several apparently protective factors have been identified, although preventive trials based on these have so far shown minimal effectiveness. The use of non-steroidal anti-inflammatory drugs to treat arthritis is associated with a reduced risk of AD, as is estrogen use by post-menopausal women. Physical activity appears beneficial, as does a diet with high levels of vitamins B6, B12 and folate. while red wine in moderate quantities appears protective. This review concludes with a discussion of the strengths and limitations of current epidemiological methods for studying Alzheimer's disease.
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PMID:Alzheimer's disease: insights from epidemiology. 1144 98

Depression has an overall prevalence of 5-8%. The prevalence of late life depression is estimated among people 65 years of age to be 15%. There is a great under-diagnosis and under-treatment of late life depression with the most serious consequence being premature death. Depression is also an important and independent risk factor for mortality following myocardial infarction, while patients with stroke associated with depression also have a higher death rate. The suicide rate is increased in elderly especially elderly men with depression. The aetiology of depression is more heterogeneous than depression in younger adults. Obviously age-related changes in the brain increase the risk for depression. Patients with neurodegenerative disorders also run a higher risk for being depressed. In Alzheimer's disease the frequency is around 50%. Deficiency of essential nutrients like folic acid and vitamin B12 is an obvious risk factor for both disorders with cognitive impairment and depression. Treatment of depression in the elderly follows the same lines as treatment of depression in younger patients. Many different drugs may be prescribed; however, the risk of adverse events is greater in the elderly. The drugs of choice are the selective serotonin re-uptake inhibitors (SSRIs), which have a response rate of around 65%. Of interest is that emotional disturbances like irritability, aggressiveness and anxiety also respond to treatment with SSRIs. A comprehensive treatment of late life depression, which includes social and psychological support, has a response rate of 80-90%.
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PMID:Late life depression. 1182 38

The intrinsic factors involved in the temperature-dependent impairment of neuronal activity in hippocampal CA2-CA1 regions were investigated using optical recording techniques. At 32 degrees C, stimulation of the Schaffer collaterals in the hippocampal CA2 region evoked depolarizing optical responses that spread toward the CA1 region. The optical response was characterized by fast and slow components that were mainly related to the presynaptic action potentials and excitatory postsynaptic response, respectively. The increase of the temperature to 38 degrees C was associated with a reversible depression of the neuronal activity in the hippocampal brain preparations. The depression of neuronal activity was irreversible when the temperature was increased to 40 degrees C. In the presence of 22 mM glucose, the depression of the neuronal activity at 38 degrees C was significantly attenuated. Pyruvate (22 mM), but not lactate (22 mM), also improved the depression of neuronal activity induced by the temperature increase. Adenosine (200 microM) strongly depressed the excitatory postsynaptic response, but not presynaptic action potentials. 8-Cyclopentyl-1,3-dimethylxanthine (8-CPT) (10 microM), an adenosine A1 receptor blocker, attenuated the adenosine-induced depression of the excitatory postsynaptic response. 8-CPT (10 microM) prevented the impairment of the excitatory postsynaptic response induced by the increase of the temperature to 38 degrees C. In contrast, the depression of presynaptic action potential at 38 degrees C was not prevented by 8-CPT (10 microM). N omega-nitro-L-arginine methyl ester (L-NAME), a nitric oxide synthase (NOS) inhibitor, and methylcobalamin (10 microM), a vitamin B12 analogue, attenuated the inhibition of pre- and postsynaptic activities induced by the increase of the temperature to 38 degrees C. Glibenclamide, a KATP channel blocker, did not protect neuronal activity from the effects of the increase of the temperature. These results suggest that the heat-induced depression of neuronal activity is mediated by multiple factors, such as impairment of energy metabolism and increase in extracellular adenosine and nitric oxide (NO) levels in hippocampal neurons.
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PMID:Intrinsic factors involved in the depression of neuronal activity induced by temperature increase in rat hippocampal neurons. 1183 Sep 30

Low folate is associated with poorer response to selective serotonin reuptake inhibitors (SSRIs) in major depressive disorder (MDD). Folate supplementation in MDD has been studied in other settings with promising results. The objective of this study was to assess the efficacy of methylfolate as an adjunctive treatment among adults with MDD and inadequate response to an SSRI. Twenty-two adults (59% female; mean age 45.2 +/- 11.0 years) with DSM-IV MDD, partial or nonresponse to an SSRI after at least 4 weeks of treatment, and a 17-item Hamilton Depression Rating Scale (HAM-D-17) score > or = 12 were enrolled in this 8-week prospective open trial. Exclusion criteria included current use of anticonvulsants or psychotropics other than an SSRI, or B12 deficiency. Leucovorin (folinic acid), which is metabolized to methylfolate, was added to SSRIs at 15-30 mg/day. Folate levels rose from 28 +/- 19 ng/mL to 301 +/- 203 ng/mL (p < 0.001). HAM-D-17 scores among the 16 completers decreased from 19.1 +/- 3.9 to 12.8 +/- 7.0 (p < 0.01). However only 31% of completers and 27% of the intent-to-treat (ITT) sample achieved response (> or = 50% reduction in HAM-D-17 scores), and only 19% of completers and 18% of the ITT sample achieved remission (HAM-D-17 < or = 7). Leucovorin appears to be modestly effective as an adjunct among SSRI-refractory depressed individuals with normal folate levels. The application of leucovorin as an adjunct in the setting of refractory depression deserves further study.
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PMID:Folinic acid (Leucovorin) as an adjunctive treatment for SSRI-refractory depression. 1204 38

Although most researchers are concerned with the major side effects of oral contraceptives, swelling, nausea, depression, poor circulation, and weight gain are labeled ''minor'' and ignored. A few researchers have found that these side effects seem related to nutritional depletion in oral contraceptive users, especially: 1) Vitamin-B6, which is linked to depression and tryptophan level abnormalities in pill users and may be associated with nausea and weight gain. Studies show a daily need 10-30 times greater than that for women not on the pill. 2) Folic acid deficiency, common among women but a 25% deficiency rate has been noted in pill users. This has been associated with cell malformation and may be a reason for the high spontaneous abortion rate in women who conceive immediately after discontinuing the pill. 3) B1 and B12, the vitamins affecting energy, skin, and hair. Although not linked to any side effects, levels are low in pill users. 4) Vitamin-C, definitely depleted in pill users. This may be part of the bodily change resulting in cardiac problems and thrombosis. Full vitamin supplementation is recommended for all women taking oral contraceptives, including these vitamins as well as Vitamin-E and bioflavinoids. Vitamin supplements are routine for pregnancy. They should also be routine for the pseudopregnancy of oral contraception.
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PMID:Women on the pill are opening up a small case of side effects every morning. 1222 10

In fiscal 1974 and fiscal 1975, $650000 will be spent on contracts for studies of birth control methods and their relationship to birth defects. The effect of oral contraceptives (OCs) on various nutrients is among top interest. It has been shown that OCs increase blood levels of Vitamin-A, copper and iron while they decrease folic acid, zinc and Vitamin-B12 and B6. The decrease of Vitamin-B6 interfers with the tryptophan mechanism and affects glucose tolerance as well as neurotransmitters which can be directly related to reports of depression and a higher rate of bladder cancer. A question arose as to whether dietary supplements would counteract the nutritional depletion. The group of unanswered questions was summed up by a question: "So, the question is, is it the pill or the pill user?"
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PMID:Effects of OCs on various nutrients is among top priority research areas. 1225 42

Hyperhomocysteinemia (HHCY) is a consequence of disturbed methionine metabolism. It results from enzyme and/or vitamin deficiency. Epidemiological and clinical studies have proven HHCY to be an independent risk factor for atherosclerotic cardiovascular diseases, stroke, peripheral arterial occlusive disease and venous thrombosis. Trials in progress may clarify the "causality" of high homocysteine (HCY) concentrations and will assess the value of HCY lowering therapy. HHCY is also seen as a risk factor for neurodegenerative diseases such as cognitive impairment, dementia, Alzheimer's disease, and also for depression. There is a high prevalence of HHCY as a syndrome of vitamin shortage in elderly subjects, which strongly increases with advancing age. Elderly people have a high frequency of vitamin B12 deficiency which is more reliably diagnosed by measurement of serum methylmalonic acid and holotranscobalamin II, the metabolically active B12 fraction, than by total serum vitamin B12. Subjects who follow a strict vegetarian diet also have a high prevalence of HHCY caused by vitamin B12 deficiency. For prevention of neurological damages an early diagnosis of vitamin B12 deficiency is important. Furthermore, HHCY is a factor in the pathogenesis of neural tube defects and preeclampsia. HCY should be measured in patients with a history of atherothrombotic vessel diseases, in patients with diabetes or hyperlipidemia, in renal patients, in adipose subjects, in elderly people, in vegetarians, in postmenopausal women, and in early pregnancy.
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PMID:Hyperhomocysteinemia: a new risk factor for degenerative diseases. 1238 6


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