Late-Life Depression, Mild Cognitive Impairment, and Dementia.

Late-life depression, mild cognitive impairment, and dementia.

JAMA Neurol. 2013 Mar 1; 70(3): 374-82
Richard E, Reitz C, Honig LH, Schupf N, Tang MX, Manly JJ, Mayeux R, Devanand D, Luchsinger JA

To evaluate the association of late-life depression with mild cognitive impairment (MCI) and dementia in a multiethnic community cohort.A cohort study was conducted in Northern Manhattan, New York, New York.A total of 2160 community-dwelling Medicare recipients aged 65 years or older were included in the study.Depression was assessed using the 10-item version of the Center for Epidemiological Studies Depression scale (CES-D) and defined by a CES-D score of 4 or more. We used logistic regression for cross-sectional association analyses and proportional hazards regression for longitudinal analyses.Mild cognitive impairment dementia, and progression from MCI to dementia were the main outcome measures. We also used subcategories of MCI (amnestic and nonamnestic), and dementia (probable Alzheimer disease and vascular dementia, including possible Alzheimer disease with stroke).Baseline depression was associated with prevalent MCI (odds ratio, 1.4; 95% CI, 1.1-1.9) and dementia (2.2; 1.6-3.1). Baseline depression was associated with an increased risk of incident dementia (hazard ratio [HR], 1.7; 95% CI, 1.2-2.3) but not with incident MCI (0.9; 0.7-1.2). Persons with MCI and coexisting depression at baseline had a higher risk of progression to dementia (HR, 2.0; 95% CI, 1.2-3.4), especially vascular dementia (4.3; 1.1-17.0), but not Alzheimer disease (1.9; 1.0-3.6).The association of depression with prevalent MCI and with progression from MCI to dementia, but not with incident MCI, suggests that depression accompanies cognitive impairment but does not precede it. HubMed – depression


Metabolic imbalance in affective disorders.

J Med Life. 2013 Mar 15; 6(1): 45-49
Ladea M, Barbu C, Rosu D

Introduction: Depression is the most frequent mental disorder encountered in all medical services. Multiple studies have shown that depression may predict the onset of different conditions, such as heart disease, diabetes, stroke and many other. The relation between depression and diabetes is still unclear. Materials and methods: In this study we evaluated patients with both major depressive disorder and type 1 or 2 diabetes, and observed the evolution of depressive and diabetes symptoms under adequate treatment. This observational, naturalistic study included 43 patients admitted in a psychiatric ward of “Alexandru Obregia” Clinical Hospital, Bucharest, diagnosed with Major Depressive Disorder (MDD) and Diabetes mellitus (DM) type 1 or 2. All patients received antidepressant and antidiabetic treatment. Results: The majority of patients were women (60.5%), and the mean age was 49.7 years. Average hospitalization period was 23 days, with longer period of hospitalization of patients with DM type 1. Patients had severe depression. Mean value of fasting glycemia at admission was of 174 mg / dl, but it decreased at discharge, in paralel with the amelioration of depression. Conclusions: The depression associated with DM type 1 is more severe. These patients require higher doses of antidepressants and longer hospitalization period. Amelioration of depression seems to have a positive impact on the blood sugar level of depressed patients with diabetes. HubMed – depression


Breathing exercises improve post-operative pulmonary function and quality of life in patients with lung cancer: A meta-analysis.

Exp Ther Med. 2013 Apr; 5(4): 1194-1200
Liu W, Pan YL, Gao CX, Shang Z, Ning LJ, Liu X

Previous research has shown that breathing exercises may improve the prognosis and health status in patients with lung cancer by enhancing pulmonary function and quality of life (QOL). However, individually published results are inconclusive. The aim of the present meta-analysis was to evaluate the clinical value of breathing exercises on post-operative pulmonary function and QOL in patients with lung cancer. A literature search of Pubmed, Embase, the Web of Science and CBM databases was conducted from their inception through to October 2012. Crude standardized mean differences (SMDs) with 95% confidence intervals (CIs) were used to assess the effect of breathing exercises. A total of eight clinical studies were ultimately included with 398 lung cancer patients. When all the eligible studies were pooled into the meta-analysis, there was a significant difference between the pre-intervention and post-intervention results of breathing exercises on post-operative pulmonary function; forced expiratory volume in 1 sec (FEV1): SMD, 3.37; 95% CI, 1.97-4.77; P<0.001; FEV1/FVC: SMD, 1.77; 95% CI, 0.15-3.39; P=0.032). Furthermore, the QOL in patients with lung cancer was significantly improved following the intervention with breathing exercises; there were significant differences between the pre-intervention and post-intervention results on the ability of self-care in daily life (SMD, -1.00; 95% CI, -1.467 to -0.52; P<0.001), social activities (SMD, -0.94; 95% CI, -1.73 to -0.15; P=0.02), symptoms of depression (SMD, -0.91; 95% CI, -1.25 to -0.57; P<0.001) and symptoms of anxiety (SMD, -0.91; 95% CI, -1.20 to -0.63; P<0.001). Results from the present meta-analysis suggest that breathing exercises may significantly improve post-operative pulmonary function and QOL in patients with lung cancer. HubMed – depression