A Comparison of Early-Onset and Late-Onset Depressive Illness in the Elderly

Burvill, P. W.; Hall, Wayne; Stampfer, Hans G.; Emmerson, J P

doi:10.1192/s0007125000018183

Cited by 36 publications

(28 citation statements)

References 21 publications

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“…This idea is supported by studies showing a high rate of depression in patients with hypertension, diabetes, coronary disease [30,31] as well as by the frequent occurrence of silent stroke and white-matter changes detected by neuroimaging in LOD [32][33][34]. Other epidemiological [3], clinical [2,6,35] and neuroimaging studies [19,36] support the possibility of a relationship, in certain cases, between late-life depression and AD.…”

Section: Discussionsupporting

confidence: 61%

“…Admission to a hospital or contact with a health care professional for evaluation and treatment of sustained depressive symptoms constituted a depressive episode. The EOD and LOD groups, respectively, included patients who had experienced at least one previous episode of depression before the age of 60 and those who had not [6,18,19].…”

Section: Methodsmentioning

confidence: 99%

“…Searching for predictors of good and poor prognoses, some authors have drawn a distinction between early-onset depression (EOD), i.e. the first episode of depressive illness occurring before the age of 60, and late-onset depression (LOD), the first episode occurring after the age of 60, and have raised the question of whether or not LOD is partly due to a biological aging process [6].…”

Section: Introductionmentioning

confidence: 99%

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Association of the Apolipoprotein E ε4 Allele with Late-Onset Depression

et al. 2001

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Apolipoprotein E (ApoE) phenotyping was determined in 42 subjects with Alzheimer’s disease (AD), 49 with depression, including 26 with early-onset depression (EOD) and 23 with late-onset depression (LOD), and 49 controls. In the EOD group, the frequency of the ApoE Ε4 allele was not different from the control frequency (p = 0.532) but was significantly lower than in AD (p < 0.001). In the LOD group, the ApoE Ε4 frequency was significantly higher than in the controls (p = 0.034) but was not different from that in the AD group (p = 0.229). Individuals with ApoE Ε4 were at greater risk of getting AD (odds ratio, OR = 5.5, 95% confidence interval, CI, 2.0–14.0) or LOD (OR = 6.1, 95% CI, 1.9–19.0) than of EOD (OR = 0.7, 95% CI, 0.2–2.5). These results suggest an association between the ApoE Ε4 allele frequency and LOD. Patients with LOD could be at risk of developing AD by an Ε4-dependent pathway.

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Section: Discussionsupporting

confidence: 61%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Association of the Apolipoprotein E ε4 Allele with Late-Onset Depression

et al. 2001

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“…In a subset of elderly depressed patients with major depression, the first episode occurs late in life (Alexopoulos et al, 1988). This subgroup, frequently referred to as having late-onset depression, exhibits certain unique clinical, biological, and neuroimaging characteristics (Burvill et al, 1989;Heun et al, 2000;Krishnan et al, 1995Krishnan et al, , 1997Schweitzer et al, 2002), implying that late-onset depression may represent a distinct subtype of depression in the elderly. Along with observations of greater cognitive deficits (Salloway et al, 1996) and an increased risk of dementia conversion (Geda et al, 2006;Schweitzer et al, 2002), there is some evidence that patients with late-onset depression may have more pronounced atrophy in cortical and subcortical regions implicated in the pathophysiology of elderly depression (Almeida et al, 2002;Hickie et al, 2005;Steffens et al, 2000).…”

Section: Introductionmentioning

confidence: 99%

Mapping Callosal Morphology in Early- and Late-Onset Elderly Depression: An Index of Distinct Changes in Cortical Connectivity

Ballmaier

Kumar

Elderkin‐Thompson

et al. 2007

Neuropsychopharmacol

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There is some evidence of corpus callosum abnormalities in elderly depression, but it is not known whether these deficits are regionspecific or differ based on age at onset of depression. Twenty-four patients with early-onset depression (mean age ¼ 68.00, SD75.83), 22 patients with late-onset depression (mean age ¼ 74.50, SD78.09) and 34 elderly control subjects (mean age ¼ 72.38; SD76.93) were studied. Using 3D MRI data, novel mesh-based geometrical modeling methods were applied to compare the midsagittal thickness of the corpus callosum at high spatial resolution between groups. Neuropsychological correlates of midsagittal callosal area differences were additionally investigated in a subsample of subjects. Depressed patients exhibited significant callosal thinning in the genu and splenium compared to controls. Significant callosal thinning was restricted to the genu in early-onset patients, but patients with late-onset depression exhibited significant callosal thinning in both the genu and splenium relative to controls. The splenium of the corpus callosum was also significantly thinner in subjects with late-vs early-onset depression. Genu and splenium midsagittal areas significantly correlated with memory and attention functioning among late-onset depressed patients, but not early-onset depressed patients or controls. Circumscribed structural alterations in callosal morphology may distinguish late-from early-onset depression in the elderly. These findings suggest distinct abnormalities of cortical connectivity in late-and early-onset elderly depression with possible influence on the course of illness. Patients with a late onset of depression may be at higher risk of illness progression and eventually dementia conversion than earlyonset depression, with potentially important implications for research and therapy.

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“…Three such studies [20,21,22] reported a greater increase (relative to controls) of neuroticism in EOD than in LOD, and three [23,24,25] found equal increases of neuroticism in EOD and LOD. Two of the studies employed a methodologically strong community-based longitudinal prospective design with personality measures predicting depressive episodes 3-5 years [20] and 10 years [22] later.…”

Section: Introductionmentioning

confidence: 99%

Neuroticism in Remitted Major Depression: Elevated with Early Onset but Not Late Onset of Depression

Gade

Kristoffersen²,

Kessing

2015

Psychopathology

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Background: The personality trait of neuroticism is strongly related to depression, but depression is etiologically heterogeneous. Late-onset depression (LOD) may be more closely related to vascular factors, and previous studies of neuroticism in LOD versus early-onset depression (EOD) have not been consistent. Method: We examined neuroticism, extraversion and perceived stress in 88 fully remitted depressed patients with a mean age of 60 years and with a history of hospitalization for major depressive disorder. Patients were divided into those with onset after and those with onset before 50 years of age (LOD and EOD, respectively), and the two groups were compared both with each other and with matched control groups of healthy subjects. Results: EOD patients showed increased levels of neuroticism in comparison with both LOD and matched controls, who did not differ. The association between age of onset and neuroticism was confirmed in analyses based on age of depression onset as a continuous variable. Conclusion: Neuroticism may be an etiological factor in EOD but not or less so in LOD. This finding contributes to the growing evidence for etiological differences between early- and late-onset late-life depression.

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A Comparison of Early-Onset and Late-Onset Depressive Illness in the Elderly

Cited by 36 publications

References 21 publications

Association of the Apolipoprotein E ε4 Allele with Late-Onset Depression

Association of the Apolipoprotein E ε4 Allele with Late-Onset Depression

Mapping Callosal Morphology in Early- and Late-Onset Elderly Depression: An Index of Distinct Changes in Cortical Connectivity

Neuroticism in Remitted Major Depression: Elevated with Early Onset but Not Late Onset of Depression

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