Depressive disorders in the elderly and dementia: An update

Dias, Natália Silva; Barbosa, Izabela Guimarães; Kuang, Weihong; Teixeira, Antônio Lúcio

doi:10.1590/1980-57642020dn14-010001

Cited by 16 publications

(21 citation statements)

References 64 publications

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“…A low-grade pro-inflammatory profile has been associated with aging, a process that has been called "inflammaging" (101). This pro-inflammatory profile has been associated with latelife depression and neurocognitive disorders, and increased risk for the development of neurodegenerative diseases (101)(102)(103). For instance, patients with mild neurocognitive disorder who progressed to major neurocognitive disorder had significantly higher baseline levels of inflammatory mediators compared to those who retained the diagnosis of mild neurocognitive disorder on follow-up (104).…”

Section: Discussion: Challenges and Opportunitiesmentioning

confidence: 99%

Coronavirus Disease-2019 Conundrum: RAS Blockade and Geriatric-Associated Neuropsychiatric Disorders

Miranda

Teixeira

2020

Front. Med.

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Coronavirus Disease 2019 (COVID-19) is caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which primarily targets the human respiratory system and may lead to severe pneumonia and ultimately death. Mortality rate is particurlarly high among people beyond the sixth decade of life with cardiovascular and metabolic diseases. The discovery that the SARS-CoV-2 uses the renin-angiotensin system (RAS) component ACE2 as a receptor to invade host epithelial cells and cause organs damage resulted in a debate regarding the role of ACE inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) therapies during COVID-19 pandemic. Some authors proposed the discontinuation of ACEIs and ARBs for cardiovascular, kidney, and metabolic diseases, while expert opinions have discouraged that due to limited empirical evidence of their negative effect on COVID-19 outcomes, and that withdrawing treatment may contribute to clinical decompensation in high-risk patients. Moreover, as cardiovascular and metabolic diseases are associated with neurodegenerative and psychiatric disorders, especially among older adults, a critical appraisal of the potential positive effects of ACEIs and ARBs is highly needed. Herein, we aim to discuss the conundrum of ACEIs and ARBs use in high-risk patients for COVID-19, and their potential protective role on the development and/or progression of geriatric neuropsychiatric disorders.

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Section: Discussion: Challenges and Opportunitiesmentioning

confidence: 99%

Coronavirus Disease-2019 Conundrum: RAS Blockade and Geriatric-Associated Neuropsychiatric Disorders

Miranda

Teixeira

2020

Front. Med.

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“…vaskuläre Hirnerkrankungen, Morbus Parkinson) oder Läsionsorten (z. B. links frontal) werden affektive Veränderungen besonders häufig beschrieben [5,6].…”

Section: Depressionssyndrom Der Demenzunclassified

Alt und depressiv oder dement? – Pseudodepression vs. Pseudodemenz

Krombach¹,

Hörmann²,

Huber³

et al. 2021

Dtsch Med Wochenschr

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Many elderly patients suffer from both, depressive symptoms and cognitive deficits. Clinically, it oftentimes appears unclear whether the affective or the cognitive problems are primary or secondary. Modern molecular and imaging markers contribute to a more efficient distinction between depression and incipient dementia due to neurodegenerative, vascular, and other diseases. A careful history and clinical investigations are necessary to identify the underlying diseases, but they do not always offer sufficient therapeutic guidance. If in doubt, the condition should always be considered as potentially reversible and treated emphatically (but with age-appropriate caution).

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“…This is an important issue as depressive disorders are frequently associated with comorbidities that are common in the elderly population and that are linked to inflammation, such as type 2 diabetes mellitus (DM2) (20) and cardiovascular diseases (21) . Depressive disorders are even associated with dementia as a risk factor or as prodrome (22) and inflammatory mechanisms probably underly this association (23) .…”

Section: Introductionmentioning

confidence: 99%