Assessment of Depression in Three Medically ill, Elderly Populations: Alzheimer's Disease, Parkinson's Disease, and Stroke

Strober, Lauren B.; Arnett, Peter A.

doi:10.1080/13854040802003299

Cited by 37 publications

(37 citation statements)

References 85 publications

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“…There is no clear relationship between the severity of stroke and the occurrence of PSD 57. Research has shown that 50% of those who have experienced a stroke 3 months ago are more plausible to be depressed yet another year.…”

Section: Factors Contributing To the Risk Of Psdmentioning

confidence: 99%

“…In brief, following factors contribute to the difficulty of diagnosing PSD: (1) overlapping signs and symptoms of stroke and depression, which are indistinguishable to each other, to the patient and providers, (2) lack of proper training in mental health care professionals to recognize which symptoms are more related to stroke than depression, and (3) medical care providers usually have limited knowledge about the differences between depression and “typical” signs of aging and stroke 57. Therefore, clinicians should define a set of valid criteria for diagnosis of PSD 66.…”

Section: Diagnosis Of Psdmentioning

confidence: 99%

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Management of depression in elderly stroke patients

Lökk

Delbari²

2010

NDT

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Poststroke depression (PSD) in elderly patients has been considered the most common neuropsychiatric consequence of stroke up to 6–24 months after stroke onset. When depression appears within days after stroke onset, it is likely to remit, whereas depression at 3 months is likely to be sustained for 1 year. One of the major problems posed by elderly stroke patients is how to identify and optimally manage PSD. This review provides insight to identification and management of depression in elderly stroke patients. Depression following stroke is less likely to include dysphoria and more likely characterized by vegetative signs and symptoms compared with other forms of late-life depression, and clinicians should rely more on nonsomatic symptoms rather than somatic symptoms. Evaluation and diagnosis of depression among elderly stroke patients are more complex due to vague symptoms of depression, overlapping signs and symptoms of stroke and depression, lack of properly trained health care personnel, and insufficient assessment tools for proper diagnosis. Major goals of treatment are to reduce depressive symptoms, improve mood and quality of life, and reduce the risk of medical complications including relapse. Antidepressants (ADs) are generally not indicated in mild forms because the balance of benefit and risk is not satisfactory in elderly stroke patients. Selective serotonin reuptake inhibitors are the first choice of PSD treatment in elderly patients due to their lower potential for drug interaction and side effects, which are more common with tricyclic ADs. Recently, stimulant medications have emerged as promising new therapeutic interventions for PSD and are now the subject of rigorous clinical trials. Cognitive behavioral therapy can also be useful, and electroconvulsive therapy is available for patients with severe refractory PSD.

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Section: Factors Contributing To the Risk Of Psdmentioning

confidence: 99%

Section: Diagnosis Of Psdmentioning

confidence: 99%

Management of depression in elderly stroke patients

Lökk

Delbari²

2010

NDT

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“…The prevalence of major depression among older inpatients with significant medical comorbidity ranges from 10% to 25%, and for clinically significant depressive symptoms from 23% to 28% [7,8]. In old age, depression is particularly prevalent in patients with cardiovascular disease [9], stroke [10], Parkinson's disease [11], diabetes [12], and Alzheimer disease [13]. It is also widely acknowledged that significant medical comorbidity may interact with depression [9,14].…”

Section: Introductionmentioning

confidence: 99%

Psychological treatment of depressive symptoms in Chinese elderly inpatients with significant medical comorbidity: A meta-analysis

Dai

Cuijpers

2011

BMC Psychiatry

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BackgroundAs it is uncertain whether psychological treatments for depressive symptoms are effective in elderly inpatients with significant medical comorbidity, we aimed to assess the treatment effectiveness not only on depressive symptoms but also on somatic symptoms in these inpatients.MethodsWe performed a meta-analysis of randomized controlled studies assessing the effects of psychological treatments in Chinese older inpatients with significant medical comorbidity based upon extensive searches of the most comprehensive computerized Chinese academic database.ResultsThe overall effect size for depressive symptoms of twelve studies which compared psychological treatments with a care-as-usual control group was d = 0.80 (95% Confidence Intervals (CI) = 0.60-0.99; p < 0.001). The relative risk of psychological intervention of being effective or not, compared to control condition, was 1.52 (95% CI = 1.25-1.85; p < 0.001).ConclusionsWe conclude that psychological treatments of depressive symptoms are effective for Chinese elderly inpatients with significant medical comorbidity which should receive more attention in medical settings.

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“…1 Depression co-occurs in 30%250% of individuals with Alzheimer's type dementia and in 40%2 50% of those with Parkinson's disease (PD). 2,3 Estimates of poststroke depression range between 20% and 70%.…”

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confidence: 99%

Mental Health Diagnoses and Health Care Utilization in Persons With Dementia, Parkinson’s Disease, and Stroke

Calleo¹,

Amspoker²,

Marsh³

et al. 2015

JNP

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In late life, neurological disturbances, depression, and anxiety frequently complicate the clinical presentation but are often undertreated. An administrative database of 3,034 male veterans, age 55 years and older, with a diagnosis of dementia, Parkinson's disease, or stroke was examined for the prevalence of mood and anxiety disorders and mental health service use. Those with more than one of these neurological diagnoses were most likely to have a comorbid depressive or anxiety disorder. The majority of patients with anxiety and depression were prescribed antidepressants. Mental health specialty visits were less frequent than medication treatment overall but most common for those with dementia only. These data suggest that specialty mental health care remains a significant unmet need for individuals with neurological disorders complicated by depression and anxiety.

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Assessment of Depression in Three Medically ill, Elderly Populations: Alzheimer's Disease, Parkinson's Disease, and Stroke

Cited by 37 publications

References 85 publications

Management of depression in elderly stroke patients

Management of depression in elderly stroke patients

Psychological treatment of depressive symptoms in Chinese elderly inpatients with significant medical comorbidity: A meta-analysis

Mental Health Diagnoses and Health Care Utilization in Persons With Dementia, Parkinson’s Disease, and Stroke

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