Cognitive and Functional Impairment in Chinese Elderly With Late-Onset Depression.
Cognitive and Functional Impairment in Chinese Elderly with Late-onset Depression.
Filed under: Depression Treatment
East Asian Arch Psychiatry. 2012 Mar; 22(1): 25-30
Tam CW, Lam LC
OBJECTIVES. To investigate cognitive and functional impairment in Chinese elderly subjects with late-onset depression. METHODS. Subjects with late-onset depression and who were clinically non-demented were recruited. Their cognitive and functional scores were compared with those of cognitively normal elderly controls and elderly persons with mild cognitive impairment. Functional ability was assessed by the Disability Assessment for Dementia score. Various cognitive domains were assessed including global cognitive function, delayed episodic memory, working memory, and categorical verbal fluency test. RESULTS. A total of 105 depressed subjects and 324 non-depressed controls (149 normal elderly controls and 175 with mild cognitive impairment) were recruited. The depression group had significantly poorer performance in all cognitive assessments compared to the normal elderly control group. The depression group had a similar cognitive profile to those with mild cognitive impairment, except that its subjects had slightly better performance in the Categorical Verbal Fluency Test, delayed recall testing, and the Chinese version of the Alzheimer’s Disease Assessment Scale-Cognitive subscale test. Depressed subjects had significantly lower functional scores in instrumental activities of daily living than the non-depressed, normal elderly controls, and those with mild cognitive impairment. CONCLUSIONS. Our results demonstrate that Chinese elderly with late-onset depression had cognitive impairments in multiple domains similar to those encountered in the age- and sex-matched non-depressed controls with mild cognitive impairment. However, their functional performance was significantly poorer than that in these controls. This study provided extensive characterisation of the range and depth of cognitive and functional impairments in elderly patients with late-onset depression.
HubMed – depression
Cognitive Function, Functional Performance and Severity of Depression in Chinese Older Persons with Late-onset Depression.
Filed under: Depression Treatment
East Asian Arch Psychiatry. 2012 Mar; 22(1): 12-7
Tam CW, Lam LC
OBJECTIVES. The relationship between cognitive status and depressive symptoms and their liability to cause functional decline are of clinical and public health importance as it appears to be common, frequently coexists, and may be treatable. This study examined the relationship of depression severity and cognitive performance and the impact of such an interaction on functional ability in Chinese elderly subjects with late-onset depression. METHODS. A total of 105 non-demented elderly patients with late-onset depression were recruited. Impairment in instrumental activities of daily living and severity of depression were respectively assessed with the Disability Assessment for Dementia scale and the 24-item Hamilton Depression Rating Scale. Various cognitive domains were assessed including global cognitive function, delayed episodic memory, and executive functions. The relationship between specific cognitive impairment and mood symptom severity was assessed. The clinical correlates of functional performance were also examined. RESULTS. Increasingly severe depression was associated with lower scores in the Mini-Mental State Examination, delayed recall, and poorer performance in the Trail Making Test-Part A (after adjusting for the effect of age and education). The severity of apathy correlated negatively with the Mini-Mental State Examination scores only. Among the depressed subjects, greater levels of depression and apathy, poorer performance in Trail Making Test-Part B, and mild parkinsonian signs were associated with lower functional scores. CONCLUSIONS. Lack of interest and motivation, depressive mood, compounded by behavioural abnormalities resulting from executive dysfunction, accounted for functional disability in elderly subjects with late-onset depression. These relationships may provide the background for developing interventions targeting functional deficits associated with specific cognitive dysfunctions and depression.
HubMed – depression
Obstetrician/gynecologists and postpartum mental health: Differences between CME course takers and nontakers.
Filed under: Depression Treatment
J Contin Educ Health Prof. 2012 Dec; 32(1): 39-47
Leddy MA, Farrow VA, Joseph GF, Schulkin J
Continuing medical education (CME) courses are an essential component of professional development. Research indicates a continued need for understanding how and why physicians select certain CME courses, as well as the differences between CME course takers and nontakers.Obstetrician-gynecologists (OB-GYNs) are health care providers for women, and part of their purview includes mental health, such as postpartum depression (PPD) and psychosis (PPP). This study evaluated OB-GYNs’ knowledge, attitudes, and behavior (KAB) regarding PPD/PPP, and compared characteristics of CME course takers and nontakers.A survey was sent to 400 OB-GYNs.Response rate was 56%. One-third had taken a CME course on PPD/PPP. Those who consider themselves a “specialist” were less likely to have taken a CME course on postpartum mental health than those who consider themselves “both primary care provider and specialist.” Non-CME course takers rely on clinical judgment more. They also are less likely to track patients’ psychiatric histories and they utilize validated assessments less frequently. However, CME course takers and nontakers did not differ on knowledge or belief items.CME courses on PPD/PPP were associated with increased screening and utilization of validated assessments. There was no association between having taken a course and several knowledge questions. It is unclear if CME courses are effective in disseminating information and altering KAB.
HubMed – depression
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