Untreated depressive symptoms significantly worsen quality of life in old age and may lead to the misdiagnosis of dementia: a cross-sectional study

Voros, Viktor; Fekete, S.; Tényi, Tamás; Rihmer, Zoltán; Szili, Ilona; Osváth, Péter

doi:10.1186/s12991-020-00302-6

Cited by 28 publications

(19 citation statements)

References 25 publications

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“…Depression is a leading cause of disability worldwide, 1,2 and with the rapid ageing of the world's population, late‐life depression (LLD) constitutes a major and growing global challenge 3,4 . LLD is still believed to be under‐recognised and undertreated 5–7 with detrimental effects on quality of life, 8 functional ability, 9 somatic health, and life expectancy 10 . To prevent LLD and its dire consequences, the changes preceding depression onset need to be understood.…”

Section: Introductionmentioning

confidence: 99%

Brain pathology and cognitive scores prior to onset of late‐life depression

Almdahl

Agartz

Hugdahl

et al. 2022

Int J Geriat Psychiatry

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Objectives: Understanding the biological changes that occur prior to onset of latelife depression (LLD) is key to its prevention. To investigate potential predictors of LLD, we assessed cognitive scores and neurodegenerative and vascular biomarkers in healthy older adults who later developed depression. Methods: Longitudinal data from the Alzheimer's Disease Neuroimaging Initiative of 241 cognitively unimpaired and non-depressed older adults aged 56-90 at baseline with at least 4 years of follow-up were included. Participants were classified based on whether they developed an incident depression (n = 96) or not (n = 145). Cognitive measures of memory, executive functioning, and language, and biomarkers proposed to be related to LLD: hippocampal volume, white matter hyperintensity volume (WMH), and cortical and cerebrospinal fluid (CSF) amyloid beta levels, were compared between the incident depression and the neverdepressed groups at four time points: at baseline, the visit prior to onset, at onset, and after the onset of depression.Results: In the incident depression group, there was a mild decline in cognitive scores from baseline to the visit before depression onset compared with the neverdepressed group. The cognitive differences between the groups became more marked after depression onset. Baseline cortical amyloid burden, CSF amyloid beta levels, and WMH were significant predictors of incident depression. Compared to the non-depressed group, hippocampal volume was not reduced before onset, but was reduced following depression.Conclusions: Amyloid pathology and WMH can predict future development of LLD in cognitively unimpaired individuals and may be involved in precipitating vulnerability for depression in older adults.

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Section: Introductionmentioning

confidence: 99%

Brain pathology and cognitive scores prior to onset of late‐life depression

Almdahl

Agartz

Hugdahl

et al. 2022

Int J Geriat Psychiatry

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“…The other possible reason for the association might be that treatment non-adherence can cause a worsening of the illness; and can increase social isolation which is major reflection of poor quality of life. The other reason for the association might be that if a patient with chronic medical disorders including depression fails to adhere to treatment due to their physical, social and psychological health issues, which are indicators of poor quality of life [ 40 , 41 ].…”

Section: Discussionmentioning

confidence: 99%

Magnitude and factors associated with treatment non-adherence among patients with depressive disorders at St. Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia, 2019: A cross sectional study

2022

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Background Inadequate adherence to treatment is among the main underlying causes of depression becoming a chronic problem. In developing countries due to limited access to health care, inaccurate diagnoses, and scarcity of medications, poor adherence may become an even larger obstacle in the treatment of depression. The current study aims to assess the magnitude and factors related to treatment non-adherence among patients with depressive disorders. Objective To assess the magnitude and factors associated with treatment non adherence among patients with depressive disorders at St. Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia, 2019. Methods A hospital-based cross-sectional study was conducted among 415 respondents using systematic random sampling technique. Medication adherence was assessed by using Medication Adherence Rating Scale. Data was entered to Epi-data version 3.1 and analyzed using SPSS version 20. Binary logistic analysis was done and P-values less than 0.05 were considered statistically significant. Results The prevalence of treatment non-adherence among patients with depressive disorders was 26% (95%CI; 21.2, 32.5). Previous suicide attempt (AOR = 3.05, 95%CI; 1.82, 5.12), medication side effects (AOR = 2.46, 95%CI; 1.47, 4.11), moderate to high self-stigma (AOR = 2.60, 95%CI; 1.45, 4.66), and poor quality of life (AOR = 2.47, 95%CI; 1.42, 4.28) were significantly associated with treatment non-adherence among patients with depressive disorders. Conclusion and recommendation Treatment non-adherence is a common problem among patients being treated for depressive disorders. Previous suicide attempts, medication side effects, moderate to high self-stigma, and poor quality of life were significantly associated with treatment non-adherence. Appropriate interventions should be developed to promote measures to facilitate adherence in this group of patients, and address the associated factors when applicable.

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“…Furthermore, major depression was observed in >10% of patients with Alzheimer disease and in 20% of those with vascular dementia [38,39] suggesting a high ratio of positive results in both dementia and depression screening. Second, although being an old concept, the key role of depression, especially that has not been diagnosed and without treatment, in the background of pseudo-dementia may also contribute partially to the overlap between suspected dementia and suspected depression [40]. Third, cognitive deterioration and depression may share some of the common etiology contributing to their cooccurrence.…”

Section: Discussionmentioning

confidence: 99%

Assessing mental health of elderly outpatients, to screen only dementia or depression will have a strong bias

Lin

Lee

et al. 2022

Preprint

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Background: Dementia and depression have emerged as two of the major mental health concerns for elderly people, which are likely to substantially affect public health in the coming decades. Both dementia and geriatric depression are associated with increased morbidity, health care utilization, and mortality. Early detection and treatment initiation are some of the best strategies to minimize the ill effects of dementia and depression on the elderly people. To this end, large-scale screening may be the first step.Methods: Screening of individuals ≥65 years old was conducted in the outpatient department of a university hospital. Ascertainment of dementia 8 (AD8) and five-item Brief Symptom Rating Scale (BSRS-5) were used to screen for cognitive decline and depression, respectively.Findings: In total, 3079 elderly people completed both AD8 and BSRS-5. Patients tested positive for cognitive impairment and depression were 28.2% and 15%, respectively. However, 7% were tested positive by both AD8 and BSRS-5 and with statistical significance.Interpretation: The high ratio of suspected dementia and suspected depression suggested the needs and cost-effect of screening among the elderly outpatients. However, the statistically significant overlap implied potential bias when screening only one condition. Future screening program of geriatric mental health needs to consider this.

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Untreated depressive symptoms significantly worsen quality of life in old age and may lead to the misdiagnosis of dementia: a cross-sectional study

Cited by 28 publications

References 25 publications

Brain pathology and cognitive scores prior to onset of late‐life depression

Brain pathology and cognitive scores prior to onset of late‐life depression

Magnitude and factors associated with treatment non-adherence among patients with depressive disorders at St. Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia, 2019: A cross sectional study

Assessing mental health of elderly outpatients, to screen only dementia or depression will have a strong bias

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