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

We show that in benign aging, normally functioning elders have minor neurobehavioral deficits in activities of daily living, and in their neurologic, motor and sensory status; hearing is peripherally and centrally impaired. Also, depression appears in 25%. Gentle physical exercise improves mobility, prevents falls, diminishes pain, wards off depression, reduces mortality, and increases cerebral blood flow and cognition. Diagnosis of Alzheimer disease consists of (1) proof of dementia, (2) meeting established clinical criteria, and (3) staging of severity. We describe dementia, giving tables to identify it and distinguish it from depression, and cite some reversible dementias. We report the accepted clinical inclusion criteria and exclusion criteria for this disease. We show, also with tables, the staging of severity of both dementia and Alzheimer disease as mild, moderate, or severe.
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PMID:Benign aging or Alzheimer disease? 747 16

Considerable evidence has accrued in the last two decades to support the hypothesis that alterations in serotonergic neuronal function in the central nervous system occur in patients with major depression. These findings include the following: (a) reduced cerebrospinal fluid (CSF) concentrations of 5-hydroxyindoleacetic acid (5-HIAA), the major metabolite of serotonin (5-HT) in drug-free depressed patients; (b) reduced concentrations of 5-HT and 5-HIAA in postmortem brain tissue of depressed and (or) suicidal patients; (c) decreased plasma tryptophan concentrations in depressed patients and a profound relapse in remitted depressed patients who have responded to a serotonergic antidepressant when brain tryptophan availability is reduced; (d) in general, all clinically efficacious antidepressants augment 5-HT neurotransmission following chronic treatment; (e) clinically efficacious antidepressant action by all inhibitors of 5-HT uptake; (f) increases in the density of 5-HT2 binding sites in postmortem brain tissue of depressed patients and suicide victims, as well as in platelets of drug-free depressed patients; (g) decreased number of 5-HT transporter (determined with [3H]imipramine or [3H]paroxetine) binding sites in postmortem brain tissue of suicide victims and depressed patients and in platelets of drug-free depressed patients. In our studies, this reduction in platelet 5-HT transporter binding is not due to prior antidepressant treatment of hypercortisolemia and is not observed in mania, Alzheimer disease, schizophrenia, panic disorder, fibromyalgia, or atypical depression. In a pilot study, this deficit predicted treatment response to an experimental antidepressant. These findings support the hypothesis that alterations in 5-HT neurons play a role in the pathophysiology of depression.
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PMID:Role of serotonin in the pathophysiology of depression: focus on the serotonin transporter. 1949 50

A cross-sectional designed study was done at Siriraj Hospital from 1990 to 1994 to determine the prevalence of dementia in Thai stroke survivors. Two hundred and twelve Thai stroke (both hemorrhage and infarction) survivors (132 males and 80 females) were enrolled in this study. The mean age of the study group was 62.78 (S.D. 11.12) years with the mean duration of stroke suffering of 2.09 (S.D. 2.74) years. All patients were screened for depression by using Thai Geriatric Depression Scale and patients with Alzheimer disease were excluded from the study. The Thai Mental State Examination (TMSE) is a standard test used in this study to identify stroke patients with dementia. Seventy stroke patients (33.02 per cent) scored below 23 points (cut-off point for dementia) and considered as dementia. Forty patients (18.88 per cent) scored below 20 points and were considered as having severe dementia, 30 patients (14.15 per cent) scored between 20-22 points (classified as mild to moderate dementia). Fifty-eight patients (27.36 per cent) were in the borderline group as they had TMSE scores between 23-25 points. Eighty four patients (39.62 per cent) of stroke survivors were determined as nondemented as their TMSE scores were over 25 points. The items of cognitive function tests in TMSE which were severely impaired in demented group were recall and calculation whereas registration and attention were relatively unaffected. Orientation and language were moderately impaired in the demented group.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Dementia in Thai stroke survivors: analysis of 212 patients. 765 77

Microglial cells account for approximately 20% of the total glial population in the central nervous system. They are distributed with no significant local differences in the white and grey matters. In contrast to astrocytes they cover non-overlapping territories. They belong to the mononuclear phagocyte system and form the resident macrophages in the brain tissue, the spinal cord and the retina. Their function in the normal neural parenchyma is unknown. However, in various pathologies they form a most reactive sensor to threats to the nervous system. Within a few hours they exhibit an activation program that we have studied in seven different experimental paradigms, e.g. following nerve section, direct brain trauma, toxic lesion, spreading depression, ischemic lesion, fiber degeneration, autoimmune diseases. Activated microglial cells become immuno-competent and are MHC (major histocompatibility complex) class 1 and class 2 positive. They express the amyloid precursor protein, APP. The complement receptor CR3bi is quickly upregulated. The mitotic activity depends on the colony stimulating factors M-CSF and GM-CSF and the appropriate receptors. Molecules discussed as signals in the activation process of microglia are cytokines such as IL-1, IL-2, IL-6, TGF beta 1. An important role could also be attributed to the unique potassium channel of microglia. Brain macrophages of microglial origin have a strong respiratory burst activity, meaning that they produce oxygen radicals. They also possess Cathepsin B and L and thus are potentially cytotoxic. Taken together, microglia are highly reactive, mobile and multifunctional immune cells of the CNS that can play a universal role in the defence of the neural parenchyma.
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PMID:Microglia, the first line of defence in brain pathologies. 776 26

Alcohol and drug abuse are the two main addictions in the elderly subject. Prevalence of alcohol dependency is 14% in those over 65 years of age and 17% in elderly psychiatric patients. The distribution of alcoholism between the sexes becomes equal with age. After 65 years of age, the sex-ratio is 1 female to 1.3 male subjects. The elderly alcoholic population consists of both subjects having become alcoholics at a young age and those in whom alcoholic behaviour appeared at a late age. In one third of elderly alcoholics such dependency appeared after 60 years of age. The main risk factors for alcoholism in the elderly subject are lonliness, death of the spouse and the presence of an invalid or bedridden spouse. In the elderly, tolerance to and dependence on alcohol are rare and appear late. Somatic complications are particularly severe (cirrhosis, liver cancer, gastritis, acute pancreatitis and myocardial involvement). Psychiatric complications include anxiety, depression and especially suicide. Alcoholism is the third most frequent cause of organic cerebral dementia, following Alzheimer disease and vascular dementia. Drug dependency is very often linked to alcoholism and consists of tranquillizers and less often of antalgics.
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PMID:[Addictive behavior in the elderly]. 793 9

Abnormalities of neurochemical systems in Alzheimer disease, which are potentially relevant to the pathophysiology of such noncognitive problems as agitation and depression, have been demonstrated. However, the role of these abnormalities in the etiology of noncognitive problem behaviors remains poorly understood. Such abnormalities in brain noradrenergic and serotonergic systems are of particular interest because of their apparent involvement in normal regulation of mood, arousal, and aggressive behavior. The nature of the noradrenergic abnormalities in Alzheimer disease is particularly complex, with evidence suggesting both structural damage and compensatory increased norepinephrine release from remaining noradrenergic neurons. Currently available drugs that alter brain noradrenergic or serotonergic activity should be evaluated for efficacy in the management of noncognitive behavioral disorders complicating Alzheimer disease.
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PMID:Neurobiologic bases of noncognitive behavioral problems in Alzheimer disease. 799 46

This article provides an overview of the theory, clinical application, and research data on behavioral treatment of depression in dementia patients. Behavioral theory of depression in nondemented adults indicates that decreased positive person-environment interactions initiate and maintain a cycle of depression that may be amenable to treatment. This same cycle is discussed as it appears in demented adults, and treatment is suggested. This treatment focuses on altering the aversive events and interactions that maintain patient depression, by increasing pleasant events and interactions, maximizing cognitive abilities, and teaching caregivers strategies for behavior change and effective problem solving. A 9-week clinical research protocol is provided with specific session-by-session content. Preliminary data are presented from a controlled clinical trial of this approach. Results thus far indicate that behavioral treatment is effective in reducing depression in patients with Alzheimer disease and in reducing the level of depression in their caregivers. The implications of these findings on future clinical care of patients and research directions are discussed.
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PMID:Behavioral treatment of depression in patients with dementia. 799 48

Individuals with Alzheimer disease often experience depression, anger, and other psychological symptoms. Various forms of psychotherapy have been attempted with these individuals, including insight oriented therapy and less verbal therapies such as music therapy and art therapy. Although there are few data-based outcome studies that support the effectiveness of these interventions, case studies and descriptive information suggest that they can be helpful in alleviating negative emotions and minimizing problematic behaviors.
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PMID:Psychotherapy for individuals with Alzheimer disease. 799 49

Estimates of the prevalence of depression in dementia patients vary widely. One problem in accurate identification of such depression is determining whether to rely on demented patients' reports or second-party caregivers' reports of symptoms. To further explore this problem, 31 outpatients with probable Alzheimer disease and their 31 caregivers were interviewed separately with depressive symptom questionnaires. Caregivers reported more depressive symptoms in dementia patients than patients reported for themselves. Correlations between caregivers' and patients' reports of individual symptoms ranged between -0.23 to 0.76, with lowest correlations found for intrapsychic distress, cognitive impairment, and hallucinations. Patients' responses were not necessarily affected by stereotypic responding or severity of impairment, but patients appeared to under-report symptomatology. Caregivers' responses were associated with the extent of contact with the patients, familial relationship, and sources of information used to determine patients' mood but were not correlated with caregivers' depression or ratings of how they would feel if they were "in the patient's shoes."
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PMID:Depression in Alzheimer patients: discrepancies between patient and caregiver reports. 830 87

Eight subjects with late-life depression, eight subjects with probable Alzheimer disease, and eight healthy age-matched controls were studied using 2-[18F]fluoro-2-deoxy-D-glucose positron emission tomography in the resting state with their eyes open and ears unoccluded. The depressed subjects showed widespread reductions in the regional cerebral metabolic rate for glucose in most major neocortical, subcortical, and paralimbic regions that were significantly different from control values (P < 0.01). The metabolic decrements in the depressed group were comparable in magnitude to those seen in the Alzheimer disease group. These data demonstrate widespread nonfocal decline in glucose metabolism in late-life depression that is comparable to the hypometabolism seen in Alzheimer disease. These findings have pathophysiological implications in major depressive disorder in the elderly.
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PMID:Regional cerebral glucose metabolism in late-life depression and Alzheimer disease: a preliminary positron emission tomography study. 834 11


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