Prognosis of late life depression: a three‐year cohort study of outcome and potential predictors

International Journal of Geriatric Psychiatry - Tập 21 Số 1 - Trang 57-63 - 2006
R Baldwin1, Andrew Gallagley2, Mhairi Gourlay2, Alan Jackson3, Alistair Burns4
1Old Age Psychiatry, Manchester Royal Infirmary, Manchester, UK
2Old Age Psychiatry, Wythenshawe Hospital, Manchester, UK
3Department of Image Science & Biomedical Engineering, University of Manchester, UK
4School of Psychiatry & Behavioural Sciences, Wythenshawe Hospital, Manchester, UK

Tóm tắt

AbstractBackgroundLate‐onset depression (LOD) has a poor prognosis which may be worsened by the presence of cerebrovascular disease. Few studies have explored prospectively the influence of vascular risk factors on longer term prognosis.MethodsThe original study involved 50 patients with LOD and 35 healthy age matched controls. Follow‐up was at three years. Baseline measures included clinical, neuroradiological and neuropsychological variables. Outcome was assessed by mortality, progression to dementia and clinical course of depressive disorder.ResultsSixty‐two (73%) of the original cohort agreed to be re‐interviewed. Seven participants had died (all from the depressed group) and six developed dementia, all but one from the depressed group. Vascular dementia predominated (although not significantly so) among those with dementia at follow‐up. For 28 depressed patients with complete follow‐up data (56% of the original sample), poor outcome was predicted by lower High Density Lipoprotein (HDL), raised Erythrocyte Sedimentation Rate (ESR) and a higher score on the Hachinski Index scale and one test of immediate memory. Initial response to treatment was not associated with later outcome.ConclusionLate‐onset depressive disorder is associated with a high rate of mortality and possibly dementia. Biochemical and inflammatory markers may be important in prognosis and their role should be confirmed in future studies. Copyright © 2005 John Wiley & Sons, Ltd.

Từ khóa


Tài liệu tham khảo

Abas M, 2002, Depression and mortality in a high‐risk population: 11‐Year follow‐up of the Medical Research Council Elderly Hypertension Trial, Br J Psychiatry, 181, 123

10.1176/ajp.150.11.1693

10.1001/archpsyc.1997.01830220033006

American Psychiatric Association (APA), 1994, Diagnostic and Statistical Manual

10.1192/bjp.149.5.574

10.1192/bjp.163.1.82

10.1002/1099-1166(200012)15:12<1097::AID-GPS251>3.0.CO;2-N

10.1192/bjp.180.2.157

10.1017/S0033291703008870

10.1192/bjp.186.4.308

10.1001/archpsyc.59.7.605

10.1093/gerona/58.3.M249

10.1016/0165-1781(89)90148-0

10.1002/gps.930050304

Cole MG, 1999, Prognosis of depression in elderly community and primary care populations: a systematic review and meta‐analysis, Am J Psychiatry, 156, 1182, 10.1176/ajp.156.8.1182

10.1097/00041552-200403000-00010

10.1016/0022-3956(75)90026-6

10.1016/0002-9343(77)90874-9

10.1001/archneur.60.5.753

10.1001/archneur.1975.00490510088009

10.1111/j.2044-8341.1959.tb00467.x

10.1016/0006-3223(94)00174-2

10.1192/bjp.185.2.102

10.1177/070674378903400515

10.1176/ajp.154.4.497

10.1002/(SICI)1520-6394(1998)8:4<142::AID-DA2>3.0.CO;2-N

10.1016/S0278-5846(00)00168-8

10.1192/bjp.184.6.488

10.1192/bjp.142.2.111

10.1192/bjp.152.3.347

10.1136/bmj.317.7164.982

10.1016/S0006-3223(02)01811-5

10.1016/S0306-9877(02)00244-X

10.1016/0022-510X(93)90041-V

10.1017/S0033291798007521

10.1017/S003329179800693X

Spitzer RL, 1979, Schedule for Affective Disorders and Schizophrenia—Life‐time Version (SAD‐L)

10.1097/00124509-200103000-00009

10.1177/0891988704269819

10.1080/13607860220142413

10.1148/radiol.2241010419

Thase & Rush, 1995, Psychopharmacology. The Fourth Generation, 113

Webster DD, 1968, Critical analysis of the disability in Parkinson's disease, Modern Treatment, 257

10.1161/01.STR.22.3.312

World Health Organisation, 1993, The ICD‐10 Classification of Mental and Behavioural Disorders: Research Criteria

Thông tin
Thông tin xuất bản

International Journal of Geriatric Psychiatry

Tập 21 Số 1

57-63

Thông tin tác giả