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22 Cards in this Set
- Front
- Back
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What is are the cognitive differences between late-life depression and depression in younger people? |
Old people have more severe executive function, concentration and processing speed defects. These defects do not improve as fast or as thoroughly in older people as they do in the young |
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What are the body changes associated with late-life depression? |
Increased abdominal fat, decreased bone density, hypercortisolemia. |
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What are the seven symptoms of major depression? |
1. Depressed mood 2. Anhedonia 3. Weight loss/gain 4. In/hyper- somnia 5. Psychomotor agitation 6. Feelings of worthlessness or guilt 7. Suicidal ideation |
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What is the diagnostic criteria for major depression? |
At least 5 of the symptoms, one of which must be mood/anhedonia, which causes functional impairment and lasts at least 2 weeks. |
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What is minor depressive disoder? |
At least two of the symptoms but less than 5, lasts over 2 weeks. |
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What % of elderly people with minor depression go on to get major depression within 2 years? |
25% |
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What is the 3 year recurrence risk for late life depression? |
80% |
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Describe the stress-adaptation cycle that links illness to depression. |
Stress promotes adrenocortical activity and corticosteroid production and inflammatory response. Loss of inhibition of system impairs immune function, promotes arteriosclerosis, bone demineralisation and brain atrophy. This increases the stress response. Increased stress mediators are seen in patients with depression. |
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What is the prevalence of depression in patients with dementia? |
20% or more depending on subtype. |
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What medical conditions can cause depression? |
Viral infection Endocrinopathy (adrenocorticism, thyroidism, parathyroidism) Malignant disease Cerebravascular disease Myocardial infarction Metabolic disorders Vitamin B12 deficiency |
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What drugs are causally related to depression |
B-blockers, A-blockers (clonidine) Benzos Anti-parkinsonian drugs like l-dopa |
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Name psychosocial factors that contribute to depression. |
-Forced relocation -Low socioeconomic status -Poor physical health -Loss of a spouse -Neuroticism |
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How does loss of a spouse affect late life depression? |
Incidence of depression in widows is 14% vs 5% of general elderly. |
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How is late onset depression different to early onset depression? |
Less family history of depression, higher prevalence of dementia, greater impairment of neuropsychological tests, higher risk of dementia after a few years, more white matter lesions. |
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What % of elderly people with depression induced 'pseudodementia' go on to develop dementia within 3 years? |
40% |
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What increases suicide risk in the elderly? |
-Depression - Physical illness (only if comorbid w depression) - Disruption of social ties - Avaliability of firearms - Mood disorders - Substance abuse |
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What is the prevalence of major/minor depression in the elderly? |
5%/10% |
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What is the prevalence of major depression in institutionalised patients? |
~15% |
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What change in metabolism in dorsal neocortical structures is persistent in depression? |
Hypometabolism |
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What change in metabolism in the ventral limbic structures is persistent in depression |
Hypermetabolism. |
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How might we prevent depression in elderly people with chronic illnesses? |
Enhance their ability to achieve their goals through improving problem solving, communication, behavioural management, nutrition, insomnia to increase self-efficacy. Also, control vascular risk factors. |
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How might we reduce relapse risk? |
Maintainance treatment with antidepressants that have worked previously. |
