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Results Results Dillon C, MD, PhD; Vazquez G, MD, PhD ; Corrales A, MD; Allegri RF, MD, PhD; Taragano FE, MD, PhD. CEMIC University Hospital, SIREN, Department.

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Presentation on theme: "Results Results Dillon C, MD, PhD; Vazquez G, MD, PhD ; Corrales A, MD; Allegri RF, MD, PhD; Taragano FE, MD, PhD. CEMIC University Hospital, SIREN, Department."— Presentation transcript:

1 Results Results Dillon C, MD, PhD; Vazquez G, MD, PhD ; Corrales A, MD; Allegri RF, MD, PhD; Taragano FE, MD, PhD. CEMIC University Hospital, SIREN, Department of Neurology (CONICET). Argentinan Association of Biological Psychiatry. Argentina Introduction: : As the older population increases so does the number of older psychiatric patients. Elderly psychiatric patients manifest certain specific and unique characteristics. Depression is a highly prevalent psychiatric disorder in elderly population. Various studies have reported clinical, neuropsychological and functional differences among the different subtypes of geriatric depression. Materials and y Methods Materials and y Methods A hundred and eighteen depressive patients and 40 healthy subjects matched by age and educational level were evaluated using an extensive neuropsychiatric interview, a complete neuropsychological battery, specific scales to evaluate daily life activities, quality of life (SF.36) and depressive symptoms. Depressive patients were classified into four different groups by SCAN 2.1: Major Depression Disorder (MDD: 31), Dysthymia Disorder (DD:31), Subsyndromal Depression (SsD: 29), and Depression due to mild Alzheimer's Dementia (DdD: 27). Objetive: Objetive: The aim of this research is to describe and analyze the differences among four groups of geriatric depression Conclutions Conclutions All depressive groups had significant differences in their quality of life, neuropsychological performance, daily life activities and comorbid cardiovascular disease in comparison with healthy controls. Other variables such as dislypemia, hypothyroidism, alcohol abuse and cerebrovascular disease were also associated with the different subgroups. Cognitive variables such as: cognitive profiles and global cognitive status (MMSE), Daily life activities, Depressive symptoms, Correlations between depressive symptoms and neuropsychological tests and Age of onset of depression are variables that should be taken into consideration for the study of geriatric depression. Depression in the elderly: Description and analyses of four subtypes of geriatric depression Table 1 shows demgraphic data. Neuropsychiatric and Neuropsychological significant differences (p<0.05) were observed between depressive groups, demonstrating distinctive cognitive profiles ( table 2 and 3). Moreover, significant differences (p<0.05) were found in daily life activities of the different depressive groups (table 3). Table 4 shows age of onset of the different subtypes of depression. Major Depression Disorder and Dysthymia Disorder had significant correlations between Beck Depression Scale and Neuropsychological tests (table 5 and 6). ). Moreover, all depressive subgroups showed a significant association with cardiovascular disease. MDD and DdD were associated with a positive family history of depression. MDD was associated with dislypemia, DD with hypothyroidism and alcohol abuse; and DdD with cerebrovascular disease. Depressive subgroups had significant differences in comparison to controls in Quality of Life (Mental and Physical Health) see table 7. In table 8 signifficant variables are showed that could help to discriminate between four groups MDDDDSSD DdDControlsp Patients (n)31 292740 Age (years)64.1 ±7.466.7 ± 9.166.4 ± 9.771.2 ±7.665.1 ± 6.7ns Educational level (years) 9.82 ±3,68.9 ± 4.69.7 ± 5.28.5 ±3.711.7 ±3.7ns MMSE27.2 ± 3.126.8 ± 3.427.1 ± 2.123 ±4.529.0 ± 1.0 DdD vs Control p<.0001 DdD vs MDD p <.0001 DdD vs DD p =.001 DdD vs SSD p <.0001 Table 1: Demographic Data References: Values expressed are mean ± standard deviation (SD). significant differences: p.05). MDD: Major Depression Disorder. DD: Dysthymia Disorder: SSD: Subsyndromal Depression: DdD: Depression due to Dementia: ns: not significant MEMORY MDDDDSSD DdDControlsp Inmediate logic memory 5.6 ±2.85.3 ±2,45.2 ±2.12.6±1.87.7 ±2.1!! # Delayed logic memory5.3±3.04.6 ±2.04.9±2.21.9±1.87.4 ±2.1!! # Verbal serial learning7.5 ± 2.37.5 ± 2.17.4±2.14.9±1.79.4 ± 1.4!! # Delayed serial memory6.1 ± 2.55.6 ± 2.85.2±2.52.3±2.48.1 ± 1.5!! # Cued recall8.4 ± 3.28.8± 3.18.5±3.55.5±3.111.1 ± 1.0$ # Recognition 10.5 ± 2.110.6 ± 2.310.8 ±1.58.2±3.311.7 ± 0.4 ? # Buschke Memory battery (Immediate memory). 6.5 ± 1.86.7 ± 2.06.5 ±1,44.0 ±2.67.5 ± 1.0? # Buschke Memory battery (Cued memory) 7.1 ± 17.2 ± 1.57.1 ±0.85 ±2.77.6 ± 0.8? # LANGUAGE Boston Naming Test 45.8 ± 6.846.2 ±7.744.5±7.237.4 ±10.151.6 ± 4# % ? Semantic Fluency14.4 ± 414.6 ±5.313.7 ±49.7 ±3.519.6 ± 6!! & EXECUTIVE FUNCTION Verbal Fluency 11.5 ± 4.711.6 ±510.5 ±4.86.7 ±3.415.5 3.8!! & Trail Making Test "B”213.9± 144226.7 ±148205.6 ±137310.9 ±166109.8 ± 41.6** ATTENTION Trail Making Test "A“ 66.8 ± 34.769.3 ±42.868.4 ±25.4109 ±5448.6 ± 16.6# ? Digit Span (forward)5.3 ± 14.9 ±1.25.1 ±1 6 ± 1: Digit Span (backward)3.8 ± 13.4 ±0.93.6±1.13.1±14.4 ± 1: ? VISUOSPATIAL ABILITIES Clock Drawing Test6 ± 1.35.3±2.26 ±1.53.8±2.56.5 ± 1# ? Referentes. Only signifficant “p” results (p<.05) were showed in this table. ANOVA and Scheffeé test (Pos Hoc) were used. !! Control vs all the depressive groups (MDD, DD, SSD, DMC) p<.05. # DMC vs (MDD, DD, SSD) p<.05 $ Control vs (DM, DsS y DpEM) p<.05. % Control vs SSD p<.05. & DMC vs (MDD and DD) p<.05. ** Control vs (MDD, DD y DMC) p<.05. ? Control vs DMC p<.05. : Control vs DD p<.05. MDD: Major Depression Disorder. DD: Dysthymia Disorder. SSD: Subsindromal Depression. DdD: Depression due to Dementia MDD N:31 DD N:31 SSD N:29 DdD N:27 Controls N:40 p Beck Depression Inventory 23.4 ±9.022.2±9.514.2±7.522.1 ±10.44.4±3.1Control vs all depressives p<.0001 DsS vs MDD p=.01 DsS vs DD p=.010 DsS vs DMC p=.044 Daily Life Activities 1.6 ± 2.20.5±1.40.4 ± 0.85.3 ±2.2 0.05±0.2Control vs MDD p=.022 Control vs DdD p<.0001 DdD vs all depressives p<.0001 Table 3. Beck Depression Inventory and daily life activities Table 2. Neuropsychological battery MMSESemantic FluencyVerbal FluencyBoston Naming testTMBClock Drawing Test Beck Pearson Correlation-0.386-0.436-0.42-0.4120.446-0.382 Significant (p)0.0350.0160.0210.0240.0140.037 Inmediate Logic MemoryTMATMB Beck Pearson Correlacion-0.3740.3610.377 Significant (p)0.0380.050.04 Table 5. Significant Correlations between Beck and Neuropsychological tests. Major Depression Table 6. Significant Correlations between Beck and Neuropsychological tests. Dysthymia Disorder Depression onset after 65 years YESNO Chi 2 (p)OR (IC) SSD and DdD24310.0063.09 (1.3-7) MDD and DD1248 Table 4. Age of onset of Depression Table 8. Quality of Life (SF 36)DepressiveControlsp (Post Hoc) PGH41.55 ± 1.249.64 ± 2.00.009 MGH34.46 ± 1.150.74 ± 1.9<0.0001 Calidad de Vida (SF 36)MDDDistSsDDdDControlsp (Post Hoc) PGH40.95 ± 3.140.75 ± 2.543.02 ± 1.841. 29 ± 2.049.64 ± 2.0NS MGH32.40 ± 2.432.37 ± 2.137.32 ± 2.236.59 ± 2.050.74 ± 1.9p<0.0001** Table 7. Quality of Life (SF 36). Depressive groups vs Controls References. PGH: Physical General Health, MGH: Mental General Health


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