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Buoli M, Legnani F, Nosari G, Pan A, Ciappolino V, Esposito CM, Ceresa A, Di Paolo M, Surace T, Auxilia AM, Capellazzi M, Tagliabue I, Cirella L, Zanelli Quarantini F, Dakanalis A, Clerici M, Capuzzi E, Caldiroli A. Which clinical factors and biochemical parameters are associated with late-life major depression? Int J Psychiatry Clin Pract 2023; 27:359-366. [PMID: 37755139 DOI: 10.1080/13651501.2023.2260426] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 09/11/2023] [Indexed: 09/28/2023]
Abstract
INTRODUCTION Late-life major depression (MD) is a frequent and high-cost psychiatric disorder. Our purpose was to detect clinical and biological factors possibly associated with this condition to better prevent and treat it. METHODS We recruited 343 patients, consecutively admitted for a Major Depressive Episode to the inpatient clinic of Policlinico of Milan and ASST Monza, Italy. A large set of clinical and biochemical variables was collected from clinical charts. Univariate analyses were performed both dividing the sample into two groups (age < or ≥65) and considering age as a continuous quantitative variable. Regression analyses were then performed considering as independent variables only those statistically significant at univariate analyses. RESULTS Patients aged ≥ 65 resulted in having longer duration of illness, shorter duration of last antidepressant therapy, higher number of antidepressants assumed in the past, higher frequency of treatment-resistant depression, higher frequency of overweight/obesity and diabetes. As for biochemical parameters, patients ≥ 65 showed lower total plasmatic proteins and albumin, higher uric acid and creatinine. CONCLUSIONS These preliminary results suggest less effectiveness of antidepressants, more susceptibility to metabolic disorders and poor nutritional status in patients with late-life depression; such aspects may consequently be taken into consideration for a proper therapeutic approach. KEY POINTSDepression in late life seems to be associated with poorer response to antidepressants;Clinicians should prefer compounds with minimal pharmacokinetic interactions and less risk of side effects including metabolic ones;The poor nutritional status and the higher risk of metabolic disorders in older patients points out the importance of proper diet and healthy lifestyle in this group of subjects;Further studies are needed to confirm the results of this research.
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Affiliation(s)
- Massimiliano Buoli
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Francesca Legnani
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Guido Nosari
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Anna Pan
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Valentina Ciappolino
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Cecilia Maria Esposito
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Alessandro Ceresa
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Martina Di Paolo
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Teresa Surace
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, Monza, Italy
| | - Anna Maria Auxilia
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - Martina Capellazzi
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - Ilaria Tagliabue
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - Luisa Cirella
- Healthcare Professionals Department, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Francesco Zanelli Quarantini
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Antonios Dakanalis
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - Massimo Clerici
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, Monza, Italy
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - Enrico Capuzzi
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, Monza, Italy
| | - Alice Caldiroli
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, Monza, Italy
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Borroni E, Pesatori AC, Nosari G, Monti P, Ceresa A, Fedrizzi L, Bollati V, Buoli M, Carugno M. Understanding the Interplay between Air Pollution, Biological Variables, and Major Depressive Disorder: Rationale and Study Protocol of the DeprAir Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20065196. [PMID: 36982103 PMCID: PMC10049152 DOI: 10.3390/ijerph20065196] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 03/13/2023] [Accepted: 03/14/2023] [Indexed: 05/27/2023]
Abstract
Major depressive disorder (MDD) is a serious and disabling condition, whose etiological mechanisms are not fully understood. The aim of the DeprAir study is to verify the hypothesis that air pollution exposure may exacerbate neuroinflammation with consequent alterations in DNA methylation of genes involved in circadian rhythms and hormonal dysregulation, resulting in the worsening of depressive symptoms. The study population consists of 420 depressed patients accessing the psychiatry unit of the Policlinico Hospital (Milan, Italy), from September 2020 to December 2022. Data collection is still ongoing for about 100 subjects. For each participant demographic and lifestyle information, depression history and characteristics, as well as blood samples, were collected. MDD severity was assessed through five rating scales commonly used in clinical practice to assess the severity of affective symptoms. Exposure to particulate and gaseous air pollutants is assigned to each subject using both air pollution monitoring station measurements and estimates derived from a chemical transport model. DeprAir is the first study investigating in a comprehensive picture whether air pollution exposure could be an important modifiable environmental factor associated with MDD severity and which biological mechanisms mediate the negative effect of air pollution on mental health. Its results will represent an opportunity for preventive strategies, thus entailing a tremendous impact on public health.
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Affiliation(s)
- Elisa Borroni
- EPIGET Lab, Department of Clinical Sciences and Community Health, University of Milan, Via San Barnaba 8, 20122 Milan, Italy; (E.B.); (A.C.P.); (P.M.); (V.B.)
| | - Angela Cecilia Pesatori
- EPIGET Lab, Department of Clinical Sciences and Community Health, University of Milan, Via San Barnaba 8, 20122 Milan, Italy; (E.B.); (A.C.P.); (P.M.); (V.B.)
- Occupational Health Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via san Barnaba 8, 20122 Milan, Italy;
| | - Guido Nosari
- Department of Pathophysiology and Transplantation, University of Milan, Via Francesco Sforza 35, 20122 Milan, Italy; (G.N.); (A.C.); (M.B.)
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122 Milan, Italy
| | - Paola Monti
- EPIGET Lab, Department of Clinical Sciences and Community Health, University of Milan, Via San Barnaba 8, 20122 Milan, Italy; (E.B.); (A.C.P.); (P.M.); (V.B.)
| | - Alessandro Ceresa
- Department of Pathophysiology and Transplantation, University of Milan, Via Francesco Sforza 35, 20122 Milan, Italy; (G.N.); (A.C.); (M.B.)
| | - Luca Fedrizzi
- Occupational Health Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via san Barnaba 8, 20122 Milan, Italy;
| | - Valentina Bollati
- EPIGET Lab, Department of Clinical Sciences and Community Health, University of Milan, Via San Barnaba 8, 20122 Milan, Italy; (E.B.); (A.C.P.); (P.M.); (V.B.)
- Occupational Health Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via san Barnaba 8, 20122 Milan, Italy;
| | - Massimiliano Buoli
- Department of Pathophysiology and Transplantation, University of Milan, Via Francesco Sforza 35, 20122 Milan, Italy; (G.N.); (A.C.); (M.B.)
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122 Milan, Italy
| | - Michele Carugno
- EPIGET Lab, Department of Clinical Sciences and Community Health, University of Milan, Via San Barnaba 8, 20122 Milan, Italy; (E.B.); (A.C.P.); (P.M.); (V.B.)
- Occupational Health Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via san Barnaba 8, 20122 Milan, Italy;
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Luchesi BM, Melo BRDS, Balderrama P, Gratão ACM, Chagas MHN, Pavarini SCI, Martins TCR. Prevalence of risk factors for dementia in middle- and older- aged people registered in Primary Health Care. Dement Neuropsychol 2021; 15:239-247. [PMID: 34345366 PMCID: PMC8283878 DOI: 10.1590/1980-57642021dn15-020012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 01/25/2021] [Indexed: 12/06/2022] Open
Abstract
It is important to assess the prevalence of risk factors for dementia to slow down the progression and evolution of the disease, and to support interventions and prevention programs. OBJECTIVE We aimed to evaluate the prevalence of these factors in individuals registered in Primary Health Care in Brazil and their relationship with sex and age group. METHODS This was a cross-sectional and quantitative study with n=300 individuals. We evaluated the prevalence of main risk factors (low education, hearing loss, high blood pressure, obesity, smoking, depression, physical inactivity, social isolation, and diabetes mellitus) and others (poor diet, alcohol use, head trauma, monolingualism, visual impairment, and sleep disorders) identified in the literature. Poisson regression was used, according to sex and age group (45-59 years/60+ years). RESULTS The main risk factors with the highest prevalence were physical inactivity (60.3%) and depressive symptoms and hypertension (56.7% each). Among the other factors, monolingualism (98.0%), visual impairment (84.7%), and irregular consumption of fruits (60.4%), and vegetables (53.5%) prevailed. No differences were identified between sexes. The regression analysis confirmed a significant difference for education and age group, with older individuals having a higher prevalence of low schooling. CONCLUSION The results can guide interventions, especially in developing countries. Practice of physical activity and healthy eating should be the focus of these interventions as they can indirectly help in reducing the prevalence of other factors. Early identification, screening and adequate treatment of depressive symptoms, high blood pressure and visual impairment can also contribute to reducing the prevalence of dementia.
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Affiliation(s)
- Bruna Moretti Luchesi
- Undergraduate Medical School, Universidade Federal de Mato Grosso do Sul, Campus de Três Lagoas - Três Lagoas, MS, Brazil
- Graduate Program in Nursing, Universidade Federal de Mato Grosso do Sul, Campus de Três Lagoas - Três Lagoas, MS, Brazil
| | | | - Priscila Balderrama
- Undergraduate Medical School, Universidade Federal de Mato Grosso do Sul, Campus de Três Lagoas - Três Lagoas, MS, Brazil
| | - Aline Cristina Martins Gratão
- Graduate Program in Nursing, Universidade Federal de São Carlos - São Carlos, SP, Brazil
- Graduate Program in Gerontology, Universidade Federal de São Carlos - São Carlos, SP, Brazil
| | - Marcos Hortes Nisihara Chagas
- Graduate Program in Gerontology, Universidade Federal de São Carlos - São Carlos, SP, Brazil
- Bairral Institute of Psychiatry - Itapira, SP, Brazil
| | - Sofia Cristina Iost Pavarini
- Graduate Program in Nursing, Universidade Federal de São Carlos - São Carlos, SP, Brazil
- Graduate Program in Gerontology, Universidade Federal de São Carlos - São Carlos, SP, Brazil
| | - Tatiana Carvalho Reis Martins
- Undergraduate Medical School, Universidade Federal de Mato Grosso do Sul, Campus de Três Lagoas - Três Lagoas, MS, Brazil
- Graduate Program in Nursing, Universidade Federal de Mato Grosso do Sul, Campus de Três Lagoas - Três Lagoas, MS, Brazil
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Melrose S. Late life depression: nursing actions that can help. Perspect Psychiatr Care 2019; 55:453-458. [PMID: 30499598 DOI: 10.1111/ppc.12341] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2018] [Accepted: 11/09/2018] [Indexed: 11/27/2022] Open
Abstract
PURPOSE This article explains the symptoms of late life depression (LLD) and discusses evidence-informed actions that nurses can implement to provide older adults with the help they need. CONCLUSIONS Recognizing and addressing depression in older adults can enhance quality of life. PRACTICE IMPLICATIONS People with LLD may not appear sad or express feelings of depression. Instead, they demonstrate loss of interest, frailty, cognitive impairment, suicidal ideation, unexplained somatic complaints, and loneliness. Documenting symptoms, screening, and assessing suicidal ideation are essential. Positive outcomes are associated with antidepressant medications, cognitive behavioral therapy, electroconvulsive therapy, neuromodulation therapies, and exercise.
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Affiliation(s)
- Sherri Melrose
- Faculty of Health Disciplines, Centre for Nursing and Health Studies, Athabasca University, Athabasca, Alberta
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Horackova K, Kopecek M, Machů V, Kagstrom A, Aarsland D, Motlova LB, Cermakova P. Prevalence of late-life depression and gap in mental health service use across European regions. Eur Psychiatry 2019; 57:19-25. [PMID: 30658276 DOI: 10.1016/j.eurpsy.2018.12.002] [Citation(s) in RCA: 91] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 12/04/2018] [Accepted: 12/08/2018] [Indexed: 10/27/2022] Open
Abstract
Background We aimed to determine the prevalence and gap in use of mental health services for late-life depression in four European regions (Western Europe, Scandinavia, Southern Europe and Central and Eastern Europe) and explore socio-demographic, social and health-related factors associated with it. Methods We conducted a cross-sectional study based on data from the Survey on Health, Ageing and Retirement in Europe. Participants were a population-based sample of 28 796 persons (53% women, mean age 74 years old) residing in Europe. Mental health service use was estimated using information about the diagnosis or treatment for depression. Results The prevalence of late-life depression was 29% in the whole sample and was highest in Southern Europe (35%), followed by Central and Eastern Europe (32%), Western Europe (26%) and lowest in Scandinavia (17%). Factors that had the strongest association with depression were total number of chronic diseases, pain, limitations in instrumental activities of daily living, grip strength and cognitive impairment. The gap in mental health service use was 79%. Conclusions We suggest that interventions to decrease the burden of late-life depression should be targeted at individuals that are affected by chronic somatic comorbidities and are limited in mental and physical functioning. Promotion of help-seeking of older adults, de-stigmatization of mental illness and education of general practitioners could help decrease the gap in mental health service utilization.
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Affiliation(s)
| | - Miloslav Kopecek
- Third Faculty of Medicine, Charles University Prague, Czech Republic; National Institute of Mental Health, Klecany, Czech Republic
| | - Vendula Machů
- National Institute of Mental Health, Klecany, Czech Republic; Faculty of Science, Charles University Prague, Czech Republic
| | - Anna Kagstrom
- National Institute of Mental Health, Klecany, Czech Republic
| | - Dag Aarsland
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK
| | - Lucie Bankovska Motlova
- Third Faculty of Medicine, Charles University Prague, Czech Republic; National Institute of Mental Health, Klecany, Czech Republic
| | - Pavla Cermakova
- Third Faculty of Medicine, Charles University Prague, Czech Republic; National Institute of Mental Health, Klecany, Czech Republic.
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An Observational Study on the Factors of Successful Aging in a Sample of Nonagenarian Patients in a Rehabilitation Hospital Complex. JOURNAL OF POPULATION AGEING 2017. [DOI: 10.1007/s12062-017-9175-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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