Psychosocial and Vascular Risk Factors for Depression in the Elderly

Holley, Caitlin; Murrell, Stanley A.; Mast, Benjamin T.

doi:10.1097/01.jgp.0000192504.48810.cb

Cited by 41 publications

(22 citation statements)

References 25 publications

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“…While the etiology of late life depression (LLD) can be a complex interaction of psychological, medical, disability, and psychosocial factors (3, 4), LLD has also been consistently associated with cortical atrophy in bilateral frontal brain regions, most commonly in the orbitofrontal cortex (5–9), and to a lesser extent in parietal and temporal regions (10, 11). These findings largely support neurobiological conceptualizations of depression as being heavily mediated by extended neural networks comprised of the orbitofrontal cortex, the medial prefrontal cortex, the cingulate, and anatomical connections with the temporal lobe, striatum, thalamus and brain stem (12).…”

Section: Introductionmentioning

confidence: 99%

Patterns of Reduced Cortical Thickness in Late-Life Depression and Relationship to Psychotherapeutic Response

Mackin

Tosun

Mueller

et al. 2013

The American Journal of Geriatric Psychiatry

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Objective Cortical atrophy has been associated with late life depression (LLD) and recent findings suggest that reduced right hemisphere cortical thickness is associated with familial risk for major depressive disorder but cortical thickness abnormalities in LLD have not been explored. Further, cortical atrophy has been posited as a contributor to poor antidepressant treatment response in LLD but the impact of cortical thickness on psychotherapy response is unknown. This study was conducted to evaluate patterns of cortical thickness in LLD and in relation to psychotherapy treatment outcomes. Methods Participants included 22 individuals with LLD and 12 age matched comparison subjects. LLD participants completed 12 weeks of psychotherapy and treatment response was defined as a 50% reduction in depressive symptoms. All participants participated in Magnetic Resonance Imaging (MRI) of the brain and cortical mapping of grey matter tissue thickness was calculated. Results LLD individuals demonstrated thinner cortex than controls prominently in the right frontal, parietal, and temporal brain regions. Eleven participants (50%) exhibited positive psychotherapy response after 12 weeks of treatment. Psychotherapy non-responders demonstrated thinner cortex in bilateral posterior cingulate and parahippocampal cortices, left paracentral, precuneus, cuneus, and insular cortices, and the right medial orbito-frontal and lateral occipital cortices relative to treatment responders. Conclusions Our findings suggest more distributed right hemisphere cortical abnormalities in LLD than have been previously reported. Additionally, our findings suggest that reduced bilateral cortical thickness may be an important phenotypic marker of individuals at higher risk for poor response to psychotherapy.

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Section: Introductionmentioning

confidence: 99%

Patterns of Reduced Cortical Thickness in Late-Life Depression and Relationship to Psychotherapeutic Response

Mackin

Tosun

Mueller

et al. 2013

The American Journal of Geriatric Psychiatry

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“…Depression in individuals older than 65 years is strongly associated with a vascular component leading to the concept of vascular depression [79,80,81,82,83,84]. The hypothesis is that cerebrovascular disease, especially white matter lesions, may contribute to the pathogenesis of depression, predisposing or precipitating depressive symptoms in elderly people, by disrupting neural circuits or fiber tracts connecting frontal and subcortical regions [81,85,86].…”

Section: White Matter Hyperintensities On Brain Mri: Not New But Stilmentioning

confidence: 99%

Review of Cerebral Microangiopathy and Alzheimer’s Disease: Relation between White Matter Hyperintensities and Microbleeds

Hommet

Mondon²,

Constans

et al. 2011

Dement Geriatr Cogn Disord

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Although Alzheimer’s disease (AD) is basically considered to be a neurodegenerative disorder, cerebrovascular disease is also involved. The role of vascular risk factors and vascular disease in the progression of AD remains incompletely understood. With the development of brain MRI, it is now possible to detect small-vessel disease, whose prevalence and severity increase with age. The first types of small-vessel disease to be described were white matter hyperintensities (WMHs). More recently, small areas of signal loss on T₂*-weighted images, also called microbleeds (MBs), have been reported. Cerebral MBs are focal deposits of hemosiderin that indicate prior microhemorrhages around small vessels, related to either ruptured atherosclerotic microvessels or amyloid angiopathy. Consequently, using brain MRI for the detection of microangiopathy may prove useful to improve our understanding of the impact of the vascular burden in AD pathology. The relationship between microangiopathy and the clinical course of AD or the conversion of mild cognitive impairment to AD remains questionable in terms of cognitive or affective symptoms, particularly if we consider MBs.

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“…The aetiology of depression in diabetes mellitus is still poorly understood 19,20 , but results from several, predominantly cross-sectional studies suggest the onset of depression in diabetes is associated with not only socio-demographic factors such as female sex, living alone and low income, but also with diabetes relatedfactors such as poor glycaemic control and the presence of diabetic complications. Research suggests not only a higher prevalence but also a higher recurrence rate of depression among diabetics.…”

Section: Introductionmentioning

confidence: 99%

Risk Factors for Depressive Illness among Elderly Gopd Attendees at Upth

Stanley¹

2013

IOSR-JDMS

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Psychosocial and Vascular Risk Factors for Depression in the Elderly

Cited by 41 publications

References 25 publications

Patterns of Reduced Cortical Thickness in Late-Life Depression and Relationship to Psychotherapeutic Response

Patterns of Reduced Cortical Thickness in Late-Life Depression and Relationship to Psychotherapeutic Response

Review of Cerebral Microangiopathy and Alzheimer’s Disease: Relation between White Matter Hyperintensities and Microbleeds

Risk Factors for Depressive Illness among Elderly Gopd Attendees at Upth

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