Management of Late-Life Depression in the Context of Cognitive Impairment: a Review of the Recent Literature

AbstractPurpose of ReviewEvidence regarding the treatment of late-life depression is not necessarily generalizable to persons with a neurocognitive disorder and comorbid depression. Thus, this article reviews recent evidence that pertains to the treatment of depression in older adults with neurocognitive disorders, and synthesizes and critically analyzes this literature to identify methodological issues and gaps for the purpose of future research.Recent FindingsControlled trials and meta-analyses examining depression treatment in neurocognitive disorders, published between 2015 and 2019 (N = 16 reports), can be divided into those addressing pharmacotherapy, psychological and behavioral therapy, and somatic therapy. The evidence generally does not support benefit of antidepressant medication over placebo in treating depressive disorders in dementia. No pharmacological studies sinc e 2015 have examined antidepressant medication in participants with mild cognitive impairment (MCI). Problem adaptation therapy demonstrates efficacy for depression in MCI and mild dementia. Other psychological and behavioral interventions for depressive symptoms in dementia demonstrate mixed findin gs. The only somatic treatment trials published since 2015 have assessed bright light therapy, with positive findings but methodological limitations.SummaryPsychological, behavioral, and somatic treatments represent promising treatment options for depression in neurocognitive disorders, but ...
Source: Current Psychiatry Reports - Category: Psychiatry Source Type: research

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There are so many new updates to The Right to Die: The Law of End-of-Life Decisionmaking (Wolters Kluwer 2020). Here are some of them:Idaho’s first reported judicial decision on end-of-life decision making, finding the Idaho advance directive statute constitutional as it applies to pregnant women. An appellate ruling in California upholding most of the interdisciplinary team approach to medical decision making for unbefriended patients in long-term care facilities.  Promulgation of federal regulations that expand and protect statutory conscience rights in health care, including with respect to advance direc...
Source: blog.bioethics.net - Category: Medical Ethics Authors: Tags: Health Care syndicated Source Type: blogs
This study aimed to investigate the significant socio-demographic, lifestyle-related and disease-related correlates of depressive symptoms among this cohort. Cross-sectional data were obtained from a sample of 154 Chinese community-dwelling older adults with MCI. MCI subjects were screened by the Montreal Cognitive Assessment. Depressive symptoms were measured by the Geriatric Depression Scale. Possible correlates of depressive symptoms in individuals with MCI were explored by multiple linear regressions. The prevalence of depressive symptoms among Chinese older adults with MCI was 31.8%. In multiple regression analysis, p...
Source: International Journal of Environmental Research and Public Health - Category: Environmental Health Authors: Tags: Article Source Type: research
CONCLUSIONS: The combination of memantine with escitalopram was well tolerated and as effective as escitalopram and placebo in improving depression using HAM-D. Combination memantine and escitalopram was significantly more effective than escitalopram and placebo in improving cognitive outcomes at 12 months. Future reports will address the role of biomarkers of aging in treatment response. PMID: 31519517 [PubMed - as supplied by publisher]
Source: The American Journal of Geriatric Psychiatry - Category: Psychiatry Tags: Am J Geriatr Psychiatry Source Type: research
ConclusionFew evidence-based best-practice models or guidelines for the diagnosis of YOD exist internationally. Increased awareness of the signs and symptoms of YOD among all healthcare professionals is necessary. There is a need for improved linkages to be developed between Geriatric Medicine, Neurology, Psychiatry, and Primary Care services and in certain instances for suspected cases of YOD to be referred to neurology-led memory clinics.
Source: Age and Ageing - Category: Geriatrics Source Type: research
ConclusionWhilst some areas of Comprehensive Geriatric Assessment are achieved adequately, others are not.  Our electronic assessment did not include a Geriatric Depression Score. Although pain was frequently assessed, again a score was not always used. Other areas for improvement include visual acuity, fractures and osteoporosis and advanced care planningThe results of this audit have been presented to the team, adjustments have been made to our electronic assessments so that we can record and capture this data better. There will be a reaudit in 6 month’s to evaluate improvement.
Source: Age and Ageing - Category: Geriatrics Source Type: research
ConclusionSignificant improvements are noted since 2016 with the overall prevalence of antipsychotic prescribing decreasing from 35% to 16%, with the majority of these prescriptions having a clear indication. It is reassuring that residents are not receiving prn medications frequently. We await the national clinical guidance on “Appropriate Prescribing of Psychotropic Medication in People with Dementia” to further guide our practice.
Source: Age and Ageing - Category: Geriatrics Source Type: research
ConclusionDyadic interventions (and psychoeducational programmes in particular) have the potential to benefit both people with dementia and their care partners by decreasing depression and anxiety, increasing knowledge and coping skills and helping improve cognitive function. (Moon and Betts Adams, 2012) The practical guidance document developed from this review provides HSCPs with useful advice and information to facilitate the setting up and running of post-diagnostic psychoeducational support programmes.
Source: Age and Ageing - Category: Geriatrics Source Type: research
A recent study concludes that wearing hearing aids is associated with later onset of dementia and a reduced risk of anxiety, depression, and falls.
Source: Health News from Medical News Today - Category: Consumer Health News Tags: Hearing / Deafness Source Type: news
DISCUSSIONWhereas some AD biomarkers showed to be associated with affective symptoms in AD, most evidence was inconsistent. This is likely due to differences in study design or heterogeneity in affective symptoms. Directions for future research are given.
Source: Neuroscience and Biobehavioral Reviews - Category: Neuroscience Source Type: research
Manufacturers are stepping up efforts to integrate hearing assistive technology with smart phones and Bluetooth technology, according to a recent article from NextAvenue—a PBS media outlet for older adults. The article describes apps that work directly with hearing aids from Audibel, NuEar, Oticon, Phonak, Starkey, and others. The apps allow users to stream sound directly to their hearing aids, translate calls into text, and sync with smart home systems. Others automatically turn off the lights when you turn off your hearing aid at night, alert you when someone rings the doorbell, or use your phone as a microphone to...
Source: American Speech-Language-Hearing Association (ASHA) Press Releases - Category: Speech-Language Pathology Authors: Tags: Academia & Research Audiology Health Care News Private Practice Schools Slider Hearing Assistive Technology hearing loss Source Type: blogs
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