Age or age of onset: which is the best criterion to classify late-life depression?

Abstract

In late-life depression (LLD), several differences between patients whose first episode is reported after age 65 (late-onset depression, LOD) and those with early-onset depression (EOD) might reflect the effects of brain ageing. To test this hypothesis, we analysed the impact of current age and age at illness onset on a number of clinical and cognitive manifestations in 438 outpatients with major depressive disorder aged >60 years, treated with venlafaxine for 12 weeks. When compared to the EOD group, patients with LOD were older (P < 0.00001) and associated with lower depression severity (P = 0.0029), lower global cognitive functioning [Mini-Mental State Examination (MMSE): P = 0.0001; Repeatable Battery for the Assessment of Neuropsychological Status: immediate memory, P = 0.0009, and delayed memory, P < 0.00001; Delis-Kaplan Executive Function System measuring executive functions: Trail-Making Test (TMT) -P = 0.0004 and Colour-Word Interference Test, Inhibition -P = 0.0063], and more dyskinesias (Abnormal Involuntary Movement Scale: P = 0.0006). After controlling for its interactions with age of onset, current age was inversely correlated with Montgomery Åsberg Depression Rating Scale scores at baseline (P < 0.00001) and week 12 (P = 0.0066), MMSE (P < 0.00001), delayed memory (P < 0.00001), and TMT (P = 0.0021). Age of onset predicted impairment in immediate (P = 0.023) and delayed memory (P = 0.0181), and dyskinesias (P = 0.0006). Although most features of LLD are related to ageing rather than to late-onset, LOD is a possible separate diagnostic entity characterised by memory dysfunction and increased liability to movement disorders.

Neurological, Metabolic, and Psychopathological Correlates of Lifetime Suicidal Behaviour in Major Depressive Disorder without Current Suicide Ideation

“…After submitting request forms to the NIMH, we were authorised to analyse 482 CO-MED patients and 438 IRL-GRey participants prior to this study, we have already used CO-MED data to investigate SI persistence during antidepressant treatment and clinical differences between severe and moderate SI [47,48]. Instead, IRL-GREY data have been analysed by our research group to test different diagnostic criteria for late-life depression [49].…”

“…All participants were enrolled after obtaining their written informed consents. This research group certifies that data collected from participants in the CO-MED and IRL-GREY trials were exclusively used for scientific research: prior to access, the aims of our investigations were clearly stated in the request forms [47][48][49].…”

“…The assessment procedures were detailed in our previous publications [47][48][49]. In sample 1, assessment tools included: the Mini International Neuropsychiatric Interview (M.I.N.I.)…”

“…In sample 1, assessment tools included: the Mini International Neuropsychiatric Interview (M.I.N.I.) [52]; the 30-item Inventory of Depressive Symptomatology-Clinician Rating (IDS-C30) (Corruble et al [53]); the 16-item Quick Inventory of Depressive Symptomatology (QIDS-C16) [51]; the Concise Associated Symptoms Tracking (CAST) [54]; the Altman Self-Rating Mania Scale (ASRM) [55]; the Work and Social Adjustment Scale (WSAS) [56]; the Psychiatric Diagnostic Screening Questionnaire (PDSQ) [57]; a questionnaire specifically developed for the CO-MED project to assess adverse childhood experiences [19,[47][48][49]. The Concise Health Risk Tracking-Self Report (CHRT) scale [50] was used to assess the occurrence of general thoughts that might predispose to SBr (items 1-9) during a depressive episode and to exclude patients who reported active SI (items 10-12) in the previous 24 h. As reported in the CO-MED operational manuals (www.co-med.org), a semi-structured interview was used to retrospectively assess lifetime SBi.e., the most severe SB ever experiencedin each patient, which was scored from 0 = no suicidal tendency to 7 = attempted suicide with definite intent to die or be potentially medically harmful.…”

Amyloid deposition and its association with depressive symptoms and cognitive functions in late-life depression: A longitudinal study using amyloid- β PET images and neuropsychological measurements

“…Among these, lateonset depression (LOD) and early-onset depression (EOD) distinguished by the age of rst onset appear to have distinct characteristics (3)(4)(5). While a systematic review has indicated no clinical differences between EOD and LOD groups except for a family history of depression (6), other comparative studies have shown higher prevalence of cognitive decline, somatic complaints, and vascular risk factors in LOD than in EOD (3,7,8). LOD also demonstrates distinct functional network patterns, suggesting that it has different pathological changes from EOD, as evidenced by functional magnetic resonance imaging (MRI) studies (9).…”