Late life depression with cognitive impairment: Evaluation and treatment

Consuelo H Wilkins1,2, Jose Mathews2, Yvette I Sheline21Department of Medicine (Division of Geriatrics and Nutritional Science); 2Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USAAbstract: Older adults with depression often present with signs and symptoms indicat...

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Autores principales:	Consuelo H Wilkins, Jose Mathews, Yvette I Sheline
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2008
Materias:	Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/28e14567a9524ca08d2269802e9e56f6
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spelling	oai:doaj.org-article:28e14567a9524ca08d2269802e9e56f62021-12-02T02:05:29ZLate life depression with cognitive impairment: Evaluation and treatment1178-1998https://doaj.org/article/28e14567a9524ca08d2269802e9e56f62008-09-01T00:00:00Zhttps://www.dovepress.com/late-life-depression-with-cognitive-impairment-evaluation-and-treatmen-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Consuelo H Wilkins1,2, Jose Mathews2, Yvette I Sheline21Department of Medicine (Division of Geriatrics and Nutritional Science); 2Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USAAbstract: Older adults with depression often present with signs and symptoms indicative of functional or cognitive impairment. These somatic symptoms make evaluating and treating depression in older adults more complex. Late life depression (LLD), depression in adults over the age of 65, is more frequently associated with cognitive changes. Cognitive impairment in LLD may be a result of the depressive disorder or an underlying dementing condition. Memory complaints are also common in older adults with depression. There is a wide range of cognitive impairment in LLD including decreased central processing speed, executive dysfunction, and impaired short-term memory. The etiology of cognitive impairment in LLD may include cerebrovascular disease, a significant risk factor for LLD, which likely interrupts key pathways between frontal white matter and subcortical structures important in mood regulation. Because depressive symptoms often coexist with dementia, it is important to determine the temporal relationship between depressive symptoms and cognitive change. If depressive symptoms pre-date the cognitive impairment and cognitive symptoms are mild and temporary, LLD is the likely etiology of the cognitive impairment. If cognitive changes appear prior to depressive symptoms and persist after LLD is successfully treated, an underlying dementia is more likely. Clinicians should be exclude common conditions such as thyroid disease which can contribute to depressive symptoms and cognitive impairment prior to treating LLD. Both antidepressants and psychotherapy can be effective in treating LLD. Subsequent evaluations following treatment should also reassess cognition.Keywords: late life depression, cognitive impairment, diagnosis, treatment, cognitionConsuelo H WilkinsJose MathewsYvette I ShelineDove Medical PressarticleGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 4, Pp 51-57 (2008)
institution	DOAJ
collection	DOAJ
language	EN
topic	Geriatrics RC952-954.6
spellingShingle	Geriatrics RC952-954.6 Consuelo H Wilkins Jose Mathews Yvette I Sheline Late life depression with cognitive impairment: Evaluation and treatment
description	Consuelo H Wilkins1,2, Jose Mathews2, Yvette I Sheline21Department of Medicine (Division of Geriatrics and Nutritional Science); 2Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USAAbstract: Older adults with depression often present with signs and symptoms indicative of functional or cognitive impairment. These somatic symptoms make evaluating and treating depression in older adults more complex. Late life depression (LLD), depression in adults over the age of 65, is more frequently associated with cognitive changes. Cognitive impairment in LLD may be a result of the depressive disorder or an underlying dementing condition. Memory complaints are also common in older adults with depression. There is a wide range of cognitive impairment in LLD including decreased central processing speed, executive dysfunction, and impaired short-term memory. The etiology of cognitive impairment in LLD may include cerebrovascular disease, a significant risk factor for LLD, which likely interrupts key pathways between frontal white matter and subcortical structures important in mood regulation. Because depressive symptoms often coexist with dementia, it is important to determine the temporal relationship between depressive symptoms and cognitive change. If depressive symptoms pre-date the cognitive impairment and cognitive symptoms are mild and temporary, LLD is the likely etiology of the cognitive impairment. If cognitive changes appear prior to depressive symptoms and persist after LLD is successfully treated, an underlying dementia is more likely. Clinicians should be exclude common conditions such as thyroid disease which can contribute to depressive symptoms and cognitive impairment prior to treating LLD. Both antidepressants and psychotherapy can be effective in treating LLD. Subsequent evaluations following treatment should also reassess cognition.Keywords: late life depression, cognitive impairment, diagnosis, treatment, cognition
format	article
author	Consuelo H Wilkins Jose Mathews Yvette I Sheline
author_facet	Consuelo H Wilkins Jose Mathews Yvette I Sheline
author_sort	Consuelo H Wilkins
title	Late life depression with cognitive impairment: Evaluation and treatment
title_short	Late life depression with cognitive impairment: Evaluation and treatment
title_full	Late life depression with cognitive impairment: Evaluation and treatment
title_fullStr	Late life depression with cognitive impairment: Evaluation and treatment
title_full_unstemmed	Late life depression with cognitive impairment: Evaluation and treatment
title_sort	late life depression with cognitive impairment: evaluation and treatment
publisher	Dove Medical Press
publishDate	2008
url	https://doaj.org/article/28e14567a9524ca08d2269802e9e56f6
work_keys_str_mv	AT consuelohwilkins latelifedepressionwithcognitiveimpairmentevaluationandtreatment AT josemathews latelifedepressionwithcognitiveimpairmentevaluationandtreatment AT yvetteisheline latelifedepressionwithcognitiveimpairmentevaluationandtreatment
_version_	1718402698821238784

Late life depression with cognitive impairment: Evaluation and treatment

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