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

The aim of the present study was to explore variations in functioning and disability--with regard to cognition, manual dexterity, walking, energy, mood, activities of daily living and social/ lifestyle activities--every six months during a 2-year period, in 200 people with MS (PwMS) at an outpatient MS specialist clinic. Symbol Digit Modalities Test, Nine Hole Peg Test, Timed 25 Foot Walk, Fatigue Severity Scale, Beck Depression Inventory, Katz ADL Index Extended and Frenchay Activities Index were used to collect data. For analyses of statistically significant changes in scores during the study period, repeated measures ANOVA was used for ratio data and Friedman ANOVA for ordinal data. In addition, effect size as well as the mean/median change in score during the study period were determined for each functioning. Nearly all functioning studied varied significantly but there was no general deterioration in the sample. Small effect sizes were mainly found for the Frenchay Activities Index and a plausible practice effect was detected for the Symbol Digit Modalities Test. As many as 63% with regard to walking and 46% with regard to manual dexterity demonstrated >20% mean change in scores which has proved to be a reliable and clinically meaningful change. This study illustrates the importance of systematic and regular multidimensional assessment of functioning and disability in PwMS aiming to identify disabilities that could be minimized through timely and appropriate evidence-based interventions. The fluctuation in functioning and the conceivable learning effect inherent in instruments used should be taken into consideration when designing studies and interpreting the results.
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PMID:Variations in functioning and disability in multiple sclerosis. A two-year prospective study. 1856 Jul 94

Dutch GP's (General Practitioners) take care of people living in homes for the elderly. The population of these homes is selected on the basis of poor functioning on ADL (activities of daily living). We expected to find a group of elderly people within these homes that need more complex primary care. We describe the characteristics of care for an institutionalized elderly population and compare these to the care provided to their independently living peers. The design of this study is a matched case-control study in a Dutch General Practice in the study period 1/1/1998 to 1/7/2004. Our main results show that the rate of cognitive problems is two times, the prevalence of depression even three times higher in older people living in a home for the elderly than in those who live independently. Locomotory problems are a frequent problem in homes for the elderly. Rates of chronic pulmonary problems, atherosclerosis-related diseases and urinary tract infection are higher, whereas no significant differences for CVA, diabetes and cancer were found. Institutionalized older patients use more different types of medication. GP's do not have more contacts with people living in a home for the elderly than with older people living independently. We conclude that people living in homes for the elderly have complex problems, and need special attention for their specific vulnerability. Differences in care are not primarily explained by chronic disease but by problems with mobility, confusion, depression and cognition.
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PMID:[Primary care in homes for the elderly]. 1863 98

We aimed to evaluate the efficacy and safety of oxycodone/acetaminophen (O/A) and codeine/acetaminophen (C/A) vs. conventional therapy (CT) without opioids in older women suffering from osteoarthritis (OA)-related pain, sub-optimally responsive to prior conventional treatments. We performed a 6 week, randomized, single blind, controlled study in three nursing homes. We enrolled 154 women with painful OA. They were assigned to treatment with O/A (n=52) and C/A (n=52) vs. CT (n=50). We evaluated at baseline and at week 6: average pain in the last week (mean pain, MeP), pain at rest (RP), pain in movement (MP) (numeric rating scale, NRS); depressive symptoms (Beck Depression Inventory-II, BDI-II); functional status (activities of daily living, ADL) and cognitive status (mini mental state evaluation, MMSE). We considered the adverse events (AEs) in the study period. At week 6, MeP, RP and MP were significantly reduced in all three groups (p<0.001); compared to CT, O/A and C/A were associated with greater reductions in MeP (p<0.001 and p=0.004, respectively), in RP (p=0.028 and p=0.032, respectively) in MP (p<0.001 and p=0.002, respectively) and with significant improvement in BDI-II score (p=0.05 and p=0.04, respectively) and ADL value (p=0.04 and p=0.05, respectively). AE rates did not differ between groups.
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PMID:Efficacy of oxycodone/acetaminophen and codeine/acetaminophen vs. conventional therapy in elderly women with persistent, moderate to severe osteoarthritis-related pain. 1915 Jan 39

The purpose of this study was to test a hypothesized model for use in explaining the factors that influence depression among older adults dwelling in Ansan City in Korea. A cross-sectional community-based survey was done using face-to-face private interviews. A hypothesized model was tested using path analysis. Of the 32 hypothesized paths in the structural model, 13 were significant. Gender (beta = -.14, P = .24), income (beta = -.21, P < .00), education (beta = -.14, P = .10), activities of daily living (ADL; beta = -.29, P < .00), and somatic symptoms (beta = .29, P < .00) accounted for the incidence of depression (beta = .06, P < .00), representing 28% of the variance in depression. The fit of the model to the data was supported.
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PMID:Depression among community-dwelling older adults in Korea: a prediction model of depression. 1921 88

The 39th Annual Meeting of the Society for Neuroscience (SFN), held in Chicago, included topics covering new therapeutic developments in the field of neuroscience. This conference report highlights selected presentations on novel neuroprotective and antiparkinsonian agents, and compounds in development for the treatment of dementia, schizophrenia, depression, obesity and spinal muscular atrophy. Investigational drugs discussed include velusetrag and TD-8954 (both from Theravance Inc), SEP-228791 and SEP-226330 (both from Sepracor Inc), ADL-5510 (Adolor Corp), PF-217830 (Pfizer Inc), KB-099520 (Karo Bio AB), tesofensine (NeuroSearch A/S) and TRP6-01 (Theraptosis).
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PMID:Society for Neuroscience - 39th Annual Meeting. Part 2 - Novel therapies for neurodegenerative disorders and other CNS diseases. 1994 11

Hypertension, highly prevalent and often undiagnosed among older Mexican Americans, is associated with greater limitations in activities of daily living (ADLs) and instrumental activities of daily living (IADLs) that can lead to greater dependency for older adults. Using data from the Hispanic Established Populations for Epidemiologic Studies of the Elderly study, the rate of increase in ADL/IADL limitations for a 7-year period was examined for 3,046 older Mexican Americans classified either as reporting hypertension at baseline, first reporting hypertension at subsequent waves, or never reporting hypertension. Latent growth models indicated increased ADL/IADL limitations over time; individuals with hypertension evidenced greater increases than those without hypertension. Age, comorbidities, and depression were positively related to greater ADL/IADL limitations at baseline for all groups; only age was consistently related to ADL/IADL change over time. Development of hypertension may increase the risk of ADL/IADL decline, but early diagnosis and treatment may attenuate this effect.
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PMID:The relation of hypertension to changes in ADL/IADL limitations of Mexican american older adults. 2011 Mar 17

The association between cognitive performance and general functioning in depression is controversial. The present study evaluated the association between cognitive dysfunction and major depressive disorder (MDD, N=70) as compared with age- and gender-matched healthy controls (n=206) and its relationship to general functioning (physical and mental health quality of life, activities of daily living, and employment status) in participants with current MDD (n=26) and those with previous MDD only (n=44). Participants were assessed clinically using the Mini International Neuropsychiatric Interview (M.I.N.I.) for the depression groups and the Diagnostic Interview for Psychoses (DIP-DM) for the control group. Measures to evaluate cognition and quality of lifes comprised the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), the Short Form-36 Health Survey Questionnaire, and the Activities/Instrumental Activities of Daily Living (ADL/IADL); employment status was also assessed in MDD. The results showed that a) while individuals with current depression had worse cognitive performance in all domains than healthy controls, those individuals with previous depression had lasting cognitive impairments in the domains of immediate memory and attention as compared with healthy controls; b) individuals with current depression had lower scores in the visuospatial/constructional and attention domains and the total score than individuals with previous depression; c) individuals in the depression group as a whole who were currently unemployed had significantly lower scores in all domains (except attention) of cognitive function; d) cognitive function was not related to either physical or mental quality of life or impairments of activities of daily living (ADL, IADL); e) that unemployment in previous depression was related to poor cognitive function similar to those with current depression. The results indicate that MDD may have detrimental and lasting effects on cognitive performance partly related to poorer general functioning.
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PMID:The role of cognitive impairment in general functioning in major depression. 2013 70

The increase in the number of people suffering from dementia because of aging is a serious problem for caregivers since the feature of this pathology is irreversible and advancing. We designed an intervention study with Skype and webcam for patient with dementia being cared at home by their caregiver to prevent a further memory deterioration (seriousness of dementia) and to reduce a care burden as well. For a period of 12 weeks, a 4-patient-caregiver pair communicated with a hospital nurse through the computer for 30 minutes once a week. The patient and the caregiver worked as a pair. From the beginning of the intervention period, the intervention group and control group (n = 4) were assessed with cognitive scale, ADL scale, care burden scale and depression scale for the caregiver, and the like once in 4 weeks for 12 weeks. The initial report on the 8th week showed signs of improvement on the intervention group in HDS-R, also it improved the scale of moral of the caregiver as their scale of depression decreased.
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PMID:[The support system for dementia patient and their caregiver with Skype and webcam]. 2044 2

Mild cognitive impairment (MCI) is considered to be a transition state between normal cognition and dementia. The subtype of MCI are highly heterogeneous in terms of etiology, presentation, and prognosis. Patients with the amnestic subtype of MCI are at a high risk of progression to Alzheimer disease (AD); this subtype may represent the prodromal stage of AD. In contrast, patients with the non-amnestic subtype may be at a high risk of progression to a non-AD dementia, including dementia with Lewy bodies, frontotemporal dementia, and vascular dementia. Most patients with amnestic MCI exhibit pathologic abnormalities in the mesial temporal lobe structures; several other concomitant pathologic abnormalities, including argyrophilic grain disease, neurofibrillary tangles, hippocampal sclerosis, and vascular lesions are also observed. Patients with MCI often exhibit neuropsychiatric symptoms, such as depression and apathy, and instrumental ADL are minimally restricted. Moreover, patients with MCI who are not aware of their memory deficits and in whom practice effects are not observed exhibit parietotemporal hypoperfusion on single photon emission CT, indicating that these findings are predictors of progression to AD. In this review, I have discussed the most current aspects related to the concept and clinical presentation of MCI, with emphasis possible risk factors for conversion to dementia.
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PMID:[Concept and clinical presentation of mild cognitive impairment]. 2067 76

Little is known about the dyadic experience over time of people with dementia and their next of kin. The aim of this study was to investigate the state of mind of people with dementia, their next of kin's experience of burden and satisfaction, and factors associated with these experiences over a 3-year period. The sample consisted of 32 people with dementia living at home with family caregivers in the south of Sweden. Data were collected during the period 2004-2007 and consisted of patients self reports (GDS), dementia nurse assessment (MMSE, Berger and ADL) and next-of-kin assessment (patient's state of mind and care provision). Data also consisted of next-of-kin's self reports concerning health, burden and satisfaction. The result showed that patients' state of mind was mainly positive at baseline but a deterioration was seen over time in the patient's mood and cognitive functioning together with an increase in ADL-dependency and suspected depression. Dependency in personal ADL entailed a higher risk of being in a negative state of mind. For next of kin the experience of burden increased while satisfaction decreased over the 3 years. The inter-relationship between the patients' mood and the caregiver's satisfaction and burden seems to get stronger over time. At baseline caregiver burden was mainly related to the next of kins' general health and to patient behaviours that were difficult to handle. During the progression of the disease caregiver satisfaction becomes increasingly related to patient state of mind and dependency. There is, however, a need for more research focusing on the specific inter-relational aspects as previous studies have mainly focused on either the situation for the person with dementia or on the caregiver.
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PMID:Wellbeing among people with dementia and their next of kin over a period of 3 years. 2124 57


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