Assessment of the Person with Late-life Depression

Glover, Juliet; Srinivasan, Shilpa

doi:10.1016/j.psc.2013.08.004

Cited by 19 publications

(15 citation statements)

References 54 publications

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“…CLBP patients with depression were significantly younger, on average 9 years, compared with CLBP patients without depression. These observations tend to be consistent with observations for major depressive disorder where estimates in the general population are 15–17 %, while the 1-year prevalence rate in individuals ≥ 65 years is lower, at 1–4 % [31]. Significantly more CLBP patients with depression were single/divorced compared with CLBP patients without depression (44.3 % vs 30.1 %).…”

Section: Discussionsupporting

confidence: 88%

The impact of depression among chronic low back pain patients in Japan

Tsuji

Matsudaira

Sato

et al. 2016

BMC Musculoskelet Disord

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BackgroundChronic low back pain (CLBP) is associated with significant disability and reductions in health related quality of life (HRQoL), which can negatively impact overall function and productivity. Depression is also associated with painful physical symptoms, and is often present in patients with chronic pain. However, the incremental burden associated with depression or symptoms of depression among CLBP patients is not well understood. The objective of this study was to investigate the impact of depression on HRQoL in CLBP and to assess the relationship between depression and work impairment and healthcare use among CLBP patients in Japan.MethodsData were extracted from the 2014 Japan National Health and Wellness Survey (N = 30,000). CLBP was defined by report of diagnosed low back pain ≥3 months duration. Depression was assessed using the Patient Health Questionnaire (PHQ-9). Measurements assessed included pain, HRQoL, labor force participation, work productivity and healthcare utilization. Patients with depression (PHQ-9 ≥ 10) were compared to patients without depression (PHQ-9 < 10) using t-tests for continuous and count variables and chi-square for categorical variables, which were followed by generalized linear models adjusted for covariates. The association between presenteeism and other patient outcomes and characteristics was analysed using nonparametric correlations (Spearman’s rho).ResultsDepressed CLBP patients had significantly more severe pain and higher levels of pain compared with patients without depression (P < 0.001). Depression was associated with worse HRQoL in CLBP patients. Presenteeism, overall work impairment and activity impairment were 1.8, 1.9 and 1.7 times as high, respectively, among those with depression relative to those without depression. CLBP patients with depression had almost twice as many healthcare provider visits in 6 months than those without depression. The pattern of results remained consistent after adjustment for sociodemographic and general health characteristics. Analysis also indicated presenteeism was closely related to overall work impairment (rho = 0.99).ConclusionsDepression among CLBP patients in Japan was associated with higher pain scores and lower HRQoL scores, as well as lower labor productivity and increased healthcare use. Screening for depression in CLBP patients should be an essential part of CLBP patient care.

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Section: Discussionsupporting

confidence: 88%

The impact of depression among chronic low back pain patients in Japan

Tsuji

Matsudaira

Sato

et al. 2016

BMC Musculoskelet Disord

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“…LLD differs from younger patients with MDD in both pathophysiology and clinical presentation (Glover & Srinivasan, 2013). The sample size was small and the MDE groups were heterogenous with respect to diagnosis, age, and medication status.…”

Section: Discussionmentioning

confidence: 93%

“…The majority (6/7) of the patients with MDD were older than 60 years of age and met criteria for LLD. LLD differs from younger patients with MDD in both pathophysiology and clinical presentation (Glover & Srinivasan, 2013). Because there is an agedependent decline of mitochondrial functioning N.…”

Section: Discussionmentioning

confidence: 99%

Brain cytochrome‐c‐oxidase as a marker of mitochondrial function: A pilot study in major depression using NIRS

et al. 2019

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Background: Brain mitochondrial dysfunction is implicated in the pathophysiology of mood disorders. Brain cytochrome-c-oxidase (COX) activity is associated with the mitochondrial function. Near-infrared spectroscopy (NIRS) noninvasively measures oxidized COX (oxCOX) and tissue oxygenation index (TOI) reflecting cerebral blood flow and oxygenation.Methods: oxCOX and TOI were assessed in prefrontal cortex (Fp1/2, Brodmann area 10) in patients in a major depressive episode (N = 13) with major depressive disorder (MDD; N = 7) and bipolar disorder (BD; N = 6) compared with the controls (N = 10).One patient with MDD and all the patients with BD were taking medications.Computational modeling estimated oxCOX and TOI related indices of mitochondrial function and cerebral blood flow, respectively.Results: oxCOX was lower in patients than controls (p = .014) correlating inversely with depression severity (r = −.72; p = .006), driven primarily by lower oxCOX in BD compared with the controls. Computationally modeled mitochondrial parameters of the electron transport chain, such as the nicotinamide adenine dinucleotide ratio (NAD + /NADH; p = .001) and the proton leak rate across the inner mitochondrial membrane (k lk2 ; p = .008), were also lower in patients and correlated inversely with depression severity. No such effects were found for TOI.Conclusions: In this pilot study, oxCOX and related mitochondrial parameters assessed by NIRS indicate an abnormal cerebral metabolic state in mood disorders proportional to depression severity, potentially providing a biomarker of antidepressant effect. Because the effect was driven by the medicated BD group, findings need to be evaluated in a larger, medication-free population.

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“…Glover and Srinivasan () review depression in older adults, and while both they and Woodford and George () promote a comprehensive psychiatric interview as the “gold standard” for the assessment of depression, Glover and Srinivasan () also advocate for the use of well‐validated brief measures of depression as part of any screening process.…”

Section: Common Geriatric Short‐form Assessments: Systematic Reviewsmentioning

confidence: 99%

In Brief, Look Sharp: Short Form Assessment in the Geriatric Setting

Pachana

Mitchell²,

Pinsker³

et al. 2016

Australian Psychologist

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Objective: Older adults are an increasing proportion of the population globally. They are also an underserved population with respect to psychological services generally, and neuropsychological services specifically, with both cognitive and psychological concerns going undetected and therefore untreated. Strategies to improve detection of cognitive and psychological concerns in this population, as well as means of obtaining data within limited time or service delivery constraints, include the use of relatively brief assessment protocols. This review of such tools aims to assist clinicians in understanding when best to use such approaches with older adults. Method: A review of the extant empirical literature on brief assessment tools for older adults was undertaken, with the aim of enumerating both advantages and drawbacks of the use of such tools. Results: Although short-form assessments in geriatric settings can indeed be advantageous and appropriate, if used incorrectly, they can potentially hamper accurate diagnosis and treatment. Measures, which hold particular promise with this population span, refer to both cognitive and affective measures, and include instruments designed for specific populations, for example specific cultural groups or disorders. Conclusion: Older adults present across a wide range of settings, often with complex presentations, impaired cognition, and frail health that can challenge both diagnostic and assessment efforts as well as actual health service provision. This review provides data to enable practitioners to sharpen their practice with brief assessments for greatest efficacy in serving geriatric populations. Consideration is also given to possible areas for future clinical and research developments with respect to brief assessment strategies. bs_bs_bannerBrief geriatric assessment NA Pachana et al.Australian Psychologist (2015)

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Assessment of the Person with Late-life Depression

Cited by 19 publications

References 54 publications

The impact of depression among chronic low back pain patients in Japan

The impact of depression among chronic low back pain patients in Japan

Brain cytochrome‐c‐oxidase as a marker of mitochondrial function: A pilot study in major depression using NIRS

In Brief, Look Sharp: Short Form Assessment in the Geriatric Setting

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