Symptomatic Depression in Elderly Medical Outpatients

Borson, Soo; Barnes, Robert A.; Kukull, Walter A.; Okimoto, Joseph T.; Veith, Richard C.; Inui, Thomas S.; Carter, William; Raskind, Murray A.

doi:10.1111/j.1532-5415.1986.tb04316.x

Cited by 150 publications

(18 citation statements)

References 27 publications

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“…The estimated point prevalence of major depressive disorder (MDD) in older adults has been reported to range from 3–10 % (44–47) while “less than major” depressive syndromes (including dysthymia, minor depression and subsyndromal depression) are nearly twice as common with a reported prevalence of 9–24% (46, 48–51). The women in the SOF study did not undergo any formal psychiatric evaluation to determine diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Depressive Symptoms and Subjective and Objective Sleep in Community‐Dwelling Older Women

Maglione

Ancoli‐Israel

Peters

et al. 2012

J American Geriatrics Society

112

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Objectives To examine the relationship between depressive symptoms and subjective and objective sleep in older women. Design Cross-sectional. Setting Four US clinical centers. Participants 3045 community-dwelling women ≥70 years. Measurements Depressive symptoms were assessed with the Geriatric Depression Scale categorizing participants as “normal” (0–2, referent), “some depressive symptoms” (3–5), or “depressed” (≥6). Subjective sleep quality and daytime sleepiness were assessed using the Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS). Objective sleep measures were assessed with wrist actigraphy. Results In multivariable-adjusted models, there were graded associations between increased level of depressive symptoms and both worse subjective sleep quality and more subjective daytime sleepiness (p-trends <0.001). Women with some depressive symptoms (OR 1.82, CI 1.48–2.24) and depressed (OR 2.84, CI 2.08–3.86) women had greater odds of reporting poor sleep (PSQI>5). Women with some depressive symptoms (OR 1.97, CI 1.47–2.64) and depressed women (OR 1.70, CI 1.12–2.58) had greater odds of reporting excessive daytime sleepiness (ESS>10). There were also graded associations between increased level of depressive symptoms and objectively measured wake after sleep onset (WASO) (p-trend = 0.030) and long wake episodes >5 minutes (p-trend 0.006). Depressed women had modestly increased odds of WASO ≥1 hour (OR 1.37, CI 1.03–1.83). Women with some depressive symptoms (OR 1.49, CI 1.19–1.86) and depressed women (OR 2.04, CI 1.52–2.74) had greater odds of being in the highest quartile for number of nap episodes >5 minutes. No associations between depressive symptom level and prolonged sleep latency, reduced sleep efficiency, or reduced or increased total sleep time were found. Conclusion Greater depressive symptom levels were associated with more subjective sleep disturbance and objective evidence of sleep fragmentation and napping.

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Section: Discussionmentioning

confidence: 99%

Depressive Symptoms and Subjective and Objective Sleep in Community‐Dwelling Older Women

Maglione

Ancoli‐Israel

Peters

et al. 2012

J American Geriatrics Society

112

View full text Add to dashboard Cite

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“…[8], [20], [21] and [22] Studies of elderly patients with medical illness in the United States indicate that MDD and other depressive disorders are present in 20% to 45% of those ill enough to require hospitalization. [8], [23], [24], [25] and [26] These figures contrast with those for MDD reported in healthy elders living in the community via the recent Epidemiologic Cachment Area studies that indicates rates of 0.1% to 0.8% in men and 0.6% to 1.8% in women 27.…”

Section: Discussionmentioning

confidence: 99%

Safety and Efficacy of Sertraline for Depression in Patients with CHF (SADHART-CHF): A randomized, double-blind, placebo-controlled trial of sertraline for major depression with congestive heart failure

Jiang

O’Connor

Silva

et al. 2008

American Heart Journal

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Background Sertraline, a selective serotonin-reuptake inhibitor (SSRI), has demonstrated substantial mood improvement in patients with post myocardial infarction or with unstable angina. The impact of sertraline on the prognosis and depression of patients with chronic heart failure (HF) and co-morbid major depressive disorder (MDD) is unknown. Method This is a prospective, randomized, double-blind, placebo-controlled study designed to assess the safety and efficacy of sertraline in the treatment of MDD in patients with HF. The study is designed also to examine the effects of treating depression on cardiac events and morbidity/mortality in HF patients. Approximately 500 men and women who are ≥45 years of age with current MDD and chronic systolic HF, characterized by left ventricular ejection fraction (LVEF) ≤45% and New York Heart Association (NYHA) class ≥ II comprise the study population. Eligible participants are randomized to either sertraline or placebo for a 12-week acute treatment phase. All patients, regardless of acute treatment phase completion, are followed routinely until the last subject completes 6-month follow-up. Quality of life and certain physiologic parameters, as well as pro-inflammatory and HF biomarkers, that may reflect the impact of sertraline in this particular population, are measured at baseline and at the end of the acute treatment phase. Conclusion Because of the high prevalence of depression and its significant adverse impact on prognosis of patients with ischemic heart disease and HF, the SADHART-CHF trial aims to assess the effects of sertraline on response of depression as well as on the cardiac prognosis of patients with HF.

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“…In primary care settings, the estimated prevalence of major depressive disorder in older adults is 3%–10%, 1–4 accounting for only a fraction of older adults suffering from depression. In community-dwelling adults older than 65 years, prevalence rates of “less than major” depressive syndromes (including dysthymia, minor depression, and subsyndromal depression) are significantly more common (9–24%), 3,5–8 and these syndromes may be even more prevalent in long-term care settings.…”

Section: Introductionmentioning

confidence: 99%

Depressive Symptoms and Circadian Activity Rhythm Disturbances in Community-Dwelling Older Women

Maglione

Ancoli‐Israel

Peters

et al. 2014

The American Journal of Geriatric Psychiatry

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Objectives Aging is associated with changes in circadian rhythms. Current evidence supports a role for circadian rhythms in the pathophysiology of depression. However, little is known about the relationship between depressive symptoms and circadian activity rhythms in older adults. We examined this association in community-dwelling older women. Methods We performed a cross-sectional analysis of 3,020 women (mean age: 83.55 ± 3.79 years) enrolled in the Study of Osteoporotic Fractures. Depressive symptoms were assessed with the Geriatric Depression Scale categorizing participants as “normal” (0–2; referent group, N = 1,961), “some depressive symptoms” (3–5, N = 704), or “depressed” (≥6, N = 355). Circadian activity rhythm variables were measured using wrist actigraphy. Results In age-adjusted and Study of Osteoporotic Fractures site–adjusted models, greater levels of depressive symptoms were associated with decreased amplitude (height; df = 3,014, t = −11.31, p for linear trend <0.001), pseudo F-statistic (robustness; df =3,014, t =−8.07, p for linear trend <0.001), and mesor (mean modeled activity; df = 3014, t = −10.36, p for linear trend <0.001) of circadian activity rhythms. Greater levels of depressive symptoms were also associated with increased odds of being in the lowest quartile for amplitude (df =1, χ2 =9240, p for linear trend <0.001), pseudo F-statistic (df =1, χ2 =49.73, p for linear trend <0.001), and mesor (df =1, χ2 =81.12, p for linear trend <0.001). These associations remained significant in multivariate models. Post-hoc analyses comparing mean amplitude, mesor, and pseudo F-statistic values pair-wise between depression-level groups revealed significant differences between women with “some depressive symptoms” and the “normal” group. Conclusion These data suggest a graded association between greater levels of depressive symptoms and more desynchronization of circadian activity rhythms in community-dwelling older women. This association was observed even for women endorsing subthreshold levels of depressive symptoms.

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Symptomatic Depression in Elderly Medical Outpatients

Cited by 150 publications

References 27 publications

Depressive Symptoms and Subjective and Objective Sleep in Community‐Dwelling Older Women

Depressive Symptoms and Subjective and Objective Sleep in Community‐Dwelling Older Women

Safety and Efficacy of Sertraline for Depression in Patients with CHF (SADHART-CHF): A randomized, double-blind, placebo-controlled trial of sertraline for major depression with congestive heart failure

Depressive Symptoms and Circadian Activity Rhythm Disturbances in Community-Dwelling Older Women

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