Age at onset in late-life delusional depression

1989 ◽  
Vol 146 (6) ◽  
pp. 785-786 ◽  
Keyword(s):  
Age At Onset ◽  
Late Life ◽  
Delusional Depression

Late-Life Delusional Depression: Acute and Long-Term Treatment

1995 ◽  
Vol 7 (S1) ◽  
pp. 113-124 ◽  
Author(s):  
Barnett S. Meyers
Keyword(s):  
Elderly Patients ◽  
Late Life ◽  
Poor Response ◽  
Term Treatment ◽  
Delusional Depression ◽  
Increased Risk ◽  
Long Term Treatment ◽  
Medication Side ◽  
Continuation Treatment ◽  
High Doses

Treatment studies of delusional major depression demonstrate a poor response to standard antidepressant medications. Longitudinal studies demonstrate high relapse rates, even in patients receiving postdischarge antidepressants. The poor medical and psychiatric outcomes for late-life delusional depression and the increased risk for adverse medication reactions in this population underscore the importance of developing effective postrecovery treatments.Studies of mixed-age adults demonstrate the effectiveness of acute treatment with either electroconvulsive therapy or combination pharmacotherapy with high doses of neuroleptics and antidepressants. In considering these results in relation to the treatment of late-life delusional depression, attention must be given to the particular vulnerabilities to medication side effects of elderly patients.The potential effectiveness of continuation treatment with combined antidepressant-neuroleptic therapy is discussed. Clinical and methodologic issues related to studying the effectiveness of combination treatment in elderly patients are emphasized.

Age at Onset and Vascular Pathology in Late-Life Depression

2012 ◽  
Vol 20 (6) ◽  
pp. 524-532 ◽  
Author(s):  
Raghupathy Paranthaman ◽  
Alistair S. Burns ◽  
J. Kennedy Cruickshank ◽  
Alan Jackson ◽  
Marietta L.J. Scott ◽  
...  
Keyword(s):  
Age At Onset ◽  
Late Life ◽  
Vascular Pathology ◽  
Late Life Depression

Late-life delusional depression

1986 ◽  
Vol 11 (2) ◽  
pp. 133-137 ◽  
Author(s):  
Barnett S. Meyers ◽  
Robert Greenberg
Keyword(s):  
Late Life ◽  
Delusional Depression

scholarly journals Behaviors Characteristic of Autism Spectrum Disorder in Older Adults With Cognitive Impairment

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 155-155
Author(s):  
Elizabeth Rhodus ◽  
Justin Barber ◽  
Erin Abner ◽  
Shani Bardach ◽  
Graham Rowles ◽  
...  
Keyword(s):  
Older Adults ◽  
Autism Spectrum Disorder ◽  
Cognitive Impairment ◽  
Rating Scale ◽  
De Novo ◽  
Age At Onset ◽  
Late Life ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Clinical Dementia Rating

Abstract Autism spectrum disorder (ASD) is commonly recognized by the time of adolescence, but is poorly understood in older adults. The possibility of late-life emergence of ASD has been poorly explored. In order to investigate late-life emergence of behaviors characteristic of ASD in MCI and AD, we surveyed caregivers of 142 older adults with neurodegenerative cognitive impairment using the Gilliam Autism Rating Scale-2. Participants with high autism index ratings (Autism ‘Possible/Very Likely’, n=23) reported significantly (statistically and clinically) younger age at onset of cognitive impairment than those who scored in the Autism ‘Unlikely’ range (n=119): 71.14±10.9 vs. 76.65±8.25 (p = 0.034). Additionally, those in Autism ‘Possible/Very Likely’ group demonstrated advanced severity of cognitive impairment, indicated by Clinical Dementia Rating Scale Sum of Boxes scores. Data demonstrate that ASD behaviors may appear de novo of degenerative dementia and such behaviors are more prevalent in those with early onset dementia. Further work elucidating a connection between ASD and dementia could shed light on subclinical forms of ASD, identify areas of shared neuroanatomic involvement between ASD and dementias, and provide valuable insights that might hasten the development of therapeutic strategies.

scholarly journals Age at onset and clinical features of late life compulsive hoarding

2010 ◽  
Vol 25 (2) ◽  
pp. 142-149 ◽  
Author(s):  
Catherine R. Ayers ◽  
Sanjaya Saxena ◽  
Shahrokh Golshan ◽  
Julie Loebach Wetherell
Keyword(s):  
Clinical Features ◽  
Age At Onset ◽  
Late Life ◽  
Compulsive Hoarding

Delusional and Non-delusional Depression in Late Life

1988 ◽  
Vol 152 (1) ◽  
pp. 39-44 ◽  
Author(s):  
Robert C. Baldwin
Keyword(s):  
Depressive Symptoms ◽  
Poor Prognosis ◽  
Clinical Course ◽  
Late Onset ◽  
Late Life ◽  
Younger Patients ◽  
Delusional Depression ◽  
Discharge Status ◽  
Physical Treatments ◽  
Relapse Rates

The study tests the hypothesis that delusional and non-delusional depressive illnesses are distinct entities in late life. Two groups of 24 patients with late-onset depression, one with and one without delusions, were compared retrospectively. At the index admission, deluded patients were significantly more depressed, were in hospital for longer, responded poorly to antidepressants alone and required more physical treatments, especially ECT and major tranquillisers. Although illness severity was a major factor accounting for these differences, the finding that only the deluded group experienced delusional relapses suggests an underlying intrinsic susceptibility. The discharge status was similar for both groups, as were relapse rates over 48 months and the clinical course of depressive symptoms over 42–104 months. The findings are consistent with studies of younger patients which point to a distinction between these two types of depression, but not with recent work suggesting a very poor prognosis for delusional depression in late life.

Late-onset schizophrenia

2013 ◽  
Author(s):  
Sarah Brunelle ◽  
Ipsit V. Vahia ◽  
Dilip V. Jeste
Keyword(s):  
Cognitive Deficits ◽  
Late Onset ◽  
Age At Onset ◽  
Late Life ◽  
Psychosocial Interventions ◽  
Female Gender ◽  
Response To Treatment ◽  
Considerable Proportion ◽  
Premorbid Functioning ◽  
Better Than

Although schizophrenia with onset in middle or late-life is a relatively uncommon, a considerable proportion of patients do experience the first manifestations of the disease after the age of forty. The current nomenclature utilizes terminology based on age at onset: late-onset schizophrenia (LOS) for illness with onset between ages 40 and 60, and very-late-onset schizophrenia-like psychosis (VLOSLP) for onset after age 60. Recent evidence suggests more similarities than differences in epidemiology, etiology or risk factors and clinical presentation between these clinical entities, although a later onset seems to be associated with better premorbid functioning and female gender. Relatively stable cognitive deficits are observed in patients regardless of age at onset and LOS is generally not associated with a dementia, although VLOSLP are more likely to be associated with neurodegenerative processes. Antipsychotic medication is the mainstay of treatment and some psychosocial interventions may prove beneficial, but there is a lack of clinical trials focused on patients with onset in late-life. Response to treatment and outcomes tend to be better than among those with earlier onset, but special consideration should be given to biological and psychosocial factors related to the older age of patients

Assessment of Lifestyle Experiences across Lifespan and Cognitive Ageing in the Indian Context

2020 ◽  
Vol 32 (2) ◽  
pp. 308-330
Author(s):  
Avanthi Paplikar ◽  
Divya Ballal ◽  
Feba Varghese ◽  
Jala Sireesha ◽  
Ramya Dwivedi ◽  
...  
Keyword(s):  
Cultural Context ◽  
Leisure Activities ◽  
Age At Onset ◽  
Late Life ◽  
Protective Role ◽  
Attention And Memory ◽  
Clinical Dementia Rating ◽  
Healthy Elderly ◽  
Dementia Patients ◽  
Cognitive Activities

With rising numbers of elderly and dementia in developing societies, there is a need to understand factors protective against dementia. Evidence suggests that lifetime cognitive activities including education, occupation, and complex leisure activities contribute to cognitive reserve. However, these factors are understudied in India. This paper describes the validation of the Lifetime of Experiences Questionnaire (LEQ), a comprehensive measure of complex lifetime activities, to the Indian cultural context. It also examines the relationship between lifetime experiences and cognition among 52 healthy elderly and 30 dementia patients. High inter-rater (κ=0.923, p < 0.001), test-retest (ρ: 0.905 to 0.986) reliability, and internal consistency were found for LEQ-total (0.992) and sub-scores. Literate dementia patients (25) scored significantly lower mid-life (27.5 vs. 23.3), late-life (28.5 vs. 22.5) and total LEQ (83.5 vs. 20.9) scores than literate healthy group (37). LEQ scores positively correlated with global cognition, and domains of attention and memory on the Addenbrooke’s Cognitive Examination, in healthy and dementia groups. Moreover, LEQ scores correlated positively with age at onset of dementia and negatively with clinical dementia rating (CDR) scores. Our study demonstrates that lifetime activities, especially mid-life experiences, play a protective role in development of late-life dementia, and need to be advocated to preserve late-life cognition.

scholarly journals Magnetic resonance imaging in late-life depression: vascular and glucocorticoid cascade hypotheses

2012 ◽  
Vol 201 (1) ◽  
pp. 46-51 ◽  
Author(s):  
Claire E. Sexton ◽  
Marisa Le Masurier ◽  
Charlotte L. Allan ◽  
Mark Jenkinson ◽  
Lisa McDermott ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
White Matter ◽  
Magnetic Resonance ◽  
Shape Analysis ◽  
Brain Size ◽  
Age At Onset ◽  
Late Life ◽  
Voxel Based Morphometry ◽  
Resonance Imaging ◽  
Late Life Depression

BackgroundLate-life depression is a common and heterogeneous illness, associated with structural abnormalities in both grey and white matter.AimsTo examine the relationship between age at onset and magnetic resonance imaging (MRI) measures of grey and white matter to establish whether they support particular hypotheses regarding the anatomy and aetiology of network disruption in late-life depression.MethodWe studied 36 participants with late-life depression. Grey matter was examined using T1-weighted MRI and analysed using voxel-based morphometry. The hippocampus was automatically segmented and volume and shape analysis performed. White matter was examined using diffusion tensor imaging and analysed using tract-based spatial statistics.ResultsLater age at onset was significantly associated with reduced fractional anisotropy of widespread tracts, in particular the anterior thalamic radiation and superior longitudinal fasciculus. Earlier age at onset was associated with reduced hippocampal volume normalised to whole brain size bilaterally. However, no significant correlations were detected using hippocampal shape analysis or voxel-based morphometry.ConclusionsOverall, the results were compatible with the vascular hypothesis, and provided some support for the glucocorticoid cascade hypothesis.

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