TY - JOUR
T1 - Early- and Late-Onset Depression in Late Life
T2 - A Prospective Study on Clinical and Structural Brain Characteristics and Response to Electroconvulsive Therapy
AU - Dols, Annemiek
AU - Bouckaert, Filip
AU - Sienaert, Pascal
AU - Rhebergen, Didi
AU - Vansteelandt, Kristof
AU - ten Kate, Mara
AU - de Winter, Francois-Laurent
AU - Comijs, Hannie C.
AU - Emsell, Louise
AU - Oudega, Mardien L.
AU - van Exel, Eric
AU - Schouws, Sigfried
AU - Obbels, Jasmien
AU - Wattjes, Mike
AU - Barkhof, Frederik
AU - Eikelenboom, Piet
AU - Vandenbulcke, Mathieu
AU - Stek, Max L.
PY - 2017/2/1
Y1 - 2017/2/1
N2 - The clinical profile of late-life depression (LLD) is frequently associated with cognitive impairment, aging-related brain changes, and somatic comorbidity. This two-site naturalistic longitudinal study aimed to explore differences in clinical and brain characteristics and response to electroconvulsive therapy (ECT) in early- (EOD) versus late-onset (LOD) late-life depression (respectively onset <55 and ≥55 years). Between January 2011 and December 2013, 110 patients aged 55 years and older with ECT-treated unipolar depression were included in The Mood Disorders in Elderly treated with ECT study. Clinical profile and somatic health were assessed. Magnetic resonance imaging (MRI) scans were performed before the first ECT and visually rated. Response rate was 78.2% and similar between the two sites but significantly higher in LOD compared with EOD (86.9 versus 67.3%). Clinical, somatic, and brain characteristics were not different between EOD and LOD. Response to ECT was associated with late age at onset and presence of psychotic symptoms and not with structural MRI characteristics. In EOD only, the odds for a higher response were associated with a shorter index episode. The clinical profile, somatic comorbidities, and brain characteristics in LLD were similar in EOD and LOD. Nevertheless, patients with LOD showed a superior response to ECT compared with patients with EOD. Our results indicate that ECT is very effective in LLD, even in vascular burdened patients
AB - The clinical profile of late-life depression (LLD) is frequently associated with cognitive impairment, aging-related brain changes, and somatic comorbidity. This two-site naturalistic longitudinal study aimed to explore differences in clinical and brain characteristics and response to electroconvulsive therapy (ECT) in early- (EOD) versus late-onset (LOD) late-life depression (respectively onset <55 and ≥55 years). Between January 2011 and December 2013, 110 patients aged 55 years and older with ECT-treated unipolar depression were included in The Mood Disorders in Elderly treated with ECT study. Clinical profile and somatic health were assessed. Magnetic resonance imaging (MRI) scans were performed before the first ECT and visually rated. Response rate was 78.2% and similar between the two sites but significantly higher in LOD compared with EOD (86.9 versus 67.3%). Clinical, somatic, and brain characteristics were not different between EOD and LOD. Response to ECT was associated with late age at onset and presence of psychotic symptoms and not with structural MRI characteristics. In EOD only, the odds for a higher response were associated with a shorter index episode. The clinical profile, somatic comorbidities, and brain characteristics in LLD were similar in EOD and LOD. Nevertheless, patients with LOD showed a superior response to ECT compared with patients with EOD. Our results indicate that ECT is very effective in LLD, even in vascular burdened patients
KW - Depression
KW - early onset
KW - electroconvulsive therapy
KW - late life
KW - late onset
KW - response
KW - structural brain
UR - http://www.scopus.com/inward/record.url?scp=85008939665&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.jagp.2016.09.005
DO - https://doi.org/10.1016/j.jagp.2016.09.005
M3 - Article
C2 - 27771245
SN - 1064-7481
VL - 25
SP - 178
EP - 189
JO - American Journal of Geriatric Psychiatry
JF - American Journal of Geriatric Psychiatry
IS - 2
ER -