Depresión del adulto mayor peruano y variables sociodemográficas asociadas: análisis de endes 2017 / Depression of the peruvian elderly adult and associated sociodemographical variables, analysis of endes 2017

Objetivo: Determinar las variables sociodemográficas asociadas a la depresión en el adulto mayor peruano a partir de la información obtenida mediante la Encuesta Demográfica y de Salud Familiar (ENDES) del año 2017 realizada por el Instituto Nacional de Estadística e Informática (INEI). Métodos: Estudio observacional, correlacional y de corte transversal que usó una muestra probabilística de 4917 adultos mayores (60 años a más). Para la determinación de depresión en la población se usó como instrumento el Patient Health Questionnaire (PHQ) de 9 preguntas, incluido en el cuestionario de salud en la sección de salud mental del ENDES 2017. Resultados: La prevalencia de depresión en el adulto mayor peruano en el año 2017 fue de 14,2%. Como variables sociodemográficas asociadas a la depresión fueron el sexo femenino [ORaj 1,995 (1,684 -2,364)]; carecer de instrucción [ORaj 2,524 (2,126 - 2,996)]; la edad mayor de 75 años [ORaj 1,763 (1,494 - 2,080)]; vivir en una zona rural [ORaj 1,410 (1,198 -1,659)]; y ser pobre [ORaj 1,456 (1,229 - 1,724)]. No hubo asociación entre depresión y discapacidad (p=0,704). [ORaj 1,103 (0,663 - 1,835)]. Conclusión: La prevalencia de depresión en el adulto mayor peruano es alta. Las variables sociodemográficas que estuvieron asociadas como factores de riesgo para el desarrollo de depresión en el adulto mayor fueron de sexo femenino, el carecer de instrucción, edad mayor de 75 años, vivir en zona rural y ser pobre.

Objective: To determine the sociodemographic variables associated with depression in the elderly of Peru based on the information obtained through the Demographic and Family Health Survey (ENDES) of the year 2017 carried out by the National Institute of Statistics and Informatics (INEI). Methods: An observational, correlational and cross-sectional study that used a probabilistic sample of 4917 older adults (60 years and over). For the determination of depression in the population, the Patient Health Questionnaire (PHQ) of 9 questions included in the health questionnaire in the mental health section of ENDES 2017 was used as an instrument. Results: The prevalence of depression in the Peruvian elderly in 2017 was 14.2%. As sociodemographic variables associated with depression were the female sex [OR 1.995 (1.684 -2.364)]; lack instruction [ORaj 2.524 (2.126-2996)]; the age over 75 years [ORaj 1.763 (1.494 2.080)]; live in a rural area [ORaj 1.410 (1.198 -1.659)]; and be poor [ORaj 1.456 (1.229 - 1.724)]. It was not associated with disability (p = 0.704). [ORaj 1.103 (0.663-1835)]. Conclusion: It was concluded that the prevalence of depression in the Peruvian adult is high. Among the sociodemographic variables that were identified as risk factors for presenting depression were female sex, lacking education, age over 75, living in rural areas and being poor.

Depressão e sua relação com a adesão à farmacoterapia anti-hipertensiva em idosos / Depression and its relationship with adherence to antihypertensive pharmacotherapy in elderly

Objetivo: analisar a relação entre adesão ao tratamento medicamentoso anti-hipertensivo e a depressão em idosos hipertensos assistidos pela Estratégia Saúde da Família na cidade de Brazlândia, Distrito Federal. Método: Trata-se de estudo descritivo, transversal. Foi realizada entrevista estruturada e aplicação de questionários (EDG-15 e MMAS-8) em idosos hipertensos (n=261). Resultados: A análise mostrou 59% do sexo feminino, 90% de baixa escolaridade, 53% eram aposentados, 68% eram casados, 13% moravam sozinhos, 78% recebiam até 2 salários mínimos, 68% não faziam automedicação, 38% obtinham o medicamento no posto de saúde, 88% era sedentário, 81% não era tabagista, o medicamento mais usado foi o diurético 60%, 22% estava em monoterapia. Conclusão: A análise comparativa evidenciou que a medida de pressão arterial e a forma como adquire o medicamento são variáveis independentes da adesão ao tratamento. A prevalência de depressão foi de 37%. A razão de prevalência mostrou maior risco de depressão em pacientes com pressão arterial inadequada, com circunferência abdominal inadequada, com sobrepeso e que não aderem ao tratamento. A razão de prevalência mostrou menor risco de depressão nos homens e tabagistas.

Objective: To analyze the relationship between adherence to antihypertensive drug treatment and depression in hypertensive elderly assisted by the Family Health Strategy in the city of Brazlândia, Federal District. Method: This is a descriptive cross-sectional study. Structured interviews and questionnaires (EDG-15 and MMAS-8) were performed in hypertensive elderly (n = 261). Results: The analysis showed 59% female, 90% low educated, 53% were retired, 68% were married, 13% lived alone, 78% received up to 2 minimum wages, 68% did not self-medicate, 38% obtained 88% sedentary, 81% non-smoker, 60% diuretic, 22% monotherapy. Conclusion: The comparative analysis showed that the measurement of blood pressure and the way you buy the drug are independent variables of treatment adherence. The prevalence of depression was 37%. The prevalence ratio showed a higher risk of depression in patients with inadequate blood pressure, inadequate waist circumference, overweight and not adhering to treatment. The prevalence ratio showed lower risk of depression in men and smokers.

Análise do perfil neurogeriátrico de um grupo de idosos pertencentes a um plano de saúde do município de São Paulo, Brasil / Análisis del perfil neurogeriatrico de un grupo de ancianos pertenecientes a un plan de salud del municipio de São Paulo, Brasil / Análisis del perfil neurogeriatrico de un grupo de ancianos pertenecientes a un plan de salud del municipio de São Paulo, Brasil

A ampliação da expectativa de vida culmina com aumento das doenças crônicas não transmissíveis (DCNT) como demências e depressão. Através dos instrumentos Mini-Exame do Estado Mental (MEEM) e Teste do Desenho do Relógio (TDR) e da Escala de Depressão geriátrica (EDG), foi encontrado: 11% da amostra com déficit cognitivo importante pelo MEEM; 17,3% com risco de desenvolvimento de quadro demencial pelo TDR; e 28,21% com sintomas depressivos pela EDG.

The expansion of life expectancy culminates with an increase in chronic noncommunicable diseases (CNCD) such as dementia and depression. Through the Mini-Mental State Examination (MMSE) and Clock Drawing Test (TDR) and the Geriatric Depression Scale (EDG), 11% of the sample with significant cognitive deficits were found by MMSE; 17.3% with risk of developing dementia by TDR; and 28.21% with depressive symptoms by EDG.

La ampliación de la expectativa de vida culmina con aumento de las enfermedades crónicas no transmisibles (DCNT) como demencias y depresión. A través de los instrumentos Mini-Examen del Estado Mental (MEEM) y Prueba del Dibujo del Reloj (TDR) y de la Escala de Depresión geriátrica (EDG), se encontró: el 11% de la muestra con déficit cognitivo importante por el MEEM; 17,3% con riesgo de desarrollo de cuadro demencial por el TDR; y 28,21% con síntomas depresivos por EDG.

Relationship between Emotional Abuse and Depression among Community-Dwelling Older Adults in Korea

Despite recent advances, there is little research on factors associated with emotional abuse among Korean older adults. The present study investigated the relationships between depression and emotional abuse among community-dwelling Korean older adults. We analyzed the dataset from the Survey of Living Conditions and Welfare Needs of Korean Older Persons conducted by the Korea Institute for Health and Social Affairs in 2011. Older adults (aged >65 years, n=10674) were randomly selected. Multivariate logistic regression was used to investigate factors associated with emotional abuse in terms of sociodemographic, health-related, and psychological variables, including depression using the short version of the Geriatric Depression Scale. In our study, 9.4% of the older adults reported experiencing emotional abuse in the previous year. In addition, 44.0% of those experiencing emotional abuse suffered from depression. Multiple logistic regression modeling showed that depression in older adults was independently associated with emotional abuse [odds ratio (OR)=1.788, p < 0.001]. Along with depression, poor social support (OR for no social support=1.712, p < 0.001) and having chronic illnesses (OR for more than 3=1.481, p < 0.005) were associated an increased risk of emotional abuse. Our results showed that emotional abuse among older adults in Korea is prevalent. Our findings suggest that depression, poor social support, and having chronic illnesses are significant factors associated with emotional abuse among the Korean older adult population. Addressing these factors with preventive interventions could have significant public health implications. Further studies are warranted to gain a better understanding of emotional abuse in older Korean adults.

Características multidimensionais de saúde de idosos com sintomas depressivos / Multidimensional health characteristics of elderly people with depressive symptoms / Características multidimensionales de la salud de los ancianos con síntomas depresivos

O objetivo do estudo foi analisar as características multidimensionais de saúde de idosos com sintomas depressivos. Estudo descritivo e exploratório, realizado com 12 idosos com pré-disposição para sintomas depressivos, avaliados por instrumentos de avaliação de humor, cognição, funcionalidade e vulnerabilidade. Os dados foram analisados em relação à frequência relativa, e discutidos à luz das políticas nacionais de saúde para idosos. Os resultados permitiram conhecer as características de saúde dos idosos com sintomas depressivos, com destaque para os idosos com pré-disposição grave, que apresentaram maior vulnerabilidade e declínio cognitivo; no entanto, idosos com pré-disposição moderada à depressão devem ser avaliados, visando à prevenção de agravos.

El objetivo del estudio fue analizar las características multidimensionales de salud de los ancianos con síntomas depresivos. Estudio descriptivo y exploratorio, realizado con 12 ancianos con pre-disposición para síntomas depresivos, evaluados por instrumentos de evaluación del humor, cognición, funcionalidad y vulnerabilidad. Los datos fueron analizados en relación a la frecuencia relativa y discutidos a la luz de las políticas nacionales de salud para ancianos. Los resultados permitieron conocer las características de salud de los ancianos con síntomas depresivos, con destaque para los ancianos con pre-disposición grave, que presentaron mayor vulnerabilidad y declinación cognitiva, sin embargo, los ancianos con pre-disposición moderada a la depresión deben ser evaluados para la prevención de agravios.

The objective of the study was to analyze the multidimensional characteristics of elderly health with depressive symptoms. Descriptive and exploratory study, carried out with 12 elderly people with a pre-disposition for depressive symptoms, evaluated by instruments of humor evaluation, cognition, functionality and vulnerability. Data were analyzed relative to relative frequency and discussed in light of national health policies for the elderly. The results allowed us to know the health characteristics of the elderly with depressive symptoms, especially the elderly with severe pre-disposition, who presented greater vulnerability and cognitive decline, however, the elderly with moderate predisposition to depression should be evaluated for prevention Of injuries.

Association between Depression and Sociodemographic Factors of Elderly Welfare Facility Users in a City / 정신신체의학

OBJECTIVES: As the prevalence of elderly depression increases, it becomes urgent problem to provide preventive and management measures. But in practice, it is difficult to detect depression in early stage. The purpose of this study is to evaluate the association between sociodemographic factors and depression in elderly welfare facility users in a city. METHODS: In this research, the severity of depression and sociodemographic factors(gender, age, education, comorbid disease, housing type, number of children, number of family members living with the subjects) was evaluated through PHQ-9 and interview. Using the data, the associations of depression and sociodemographic factors were analyzed. Based on PHQ-9 depression cut-off value(10 points), the subjects were divided into two groups, and the difference of the variables between groups were analyzed statistically. RESULTS: ‘Own house’(YES/NO), education(less than elementary school graduation/more than elementary school graduation) were sociodemographic factors which showed significance difference in mean PHQ-9 scores. Group with Over PHQ-9 10 points showed less ‘having their own house’ and less education level than group with less PHQ-9 10 points. CONCLUSIONS: With this research, it is expected that the risk factors for the elderly depression can be understood and the measures for early detection and invention of elderly depression would be provided.

Prevalencia de depresión mayor en adultos mayores atendidos ambulatoriamente en un hospital de lima metropolitana / Prevalence of major depression in elder people attending a national hospital in Lima

El objetivo del presente estudio es describir, analizar prevalencia y factores de riesgo predictivo asociado a depresión mayor, en adultos mayores atendidos en consulta ambulatoria de psiquiatría de un hospital, y en un grupo de adultos mayores no asegurados. Se evaluó a 79 adultos mayores no asegurados de una comunidad del Callao y a 221 pacientes con depresión y depresión comórbida, atendidos en consulta ambulatoria de psiquiatría. Se aplicó una encuesta de consumo de medicamentos. Los resultados indican que los factores demográficos son independientes de depresión en ambos grupos (OR=1.792, IC95%=0.573-5.606, edad; OR=1.123, IC95%=0.435-4.768, sexo; OR=2.344, IC95%=0.325-16.928, autopercepción de salud; OR=1.905, IC95%=0.642-2.434, depresión; OR=1. 250, IC95%=0.642-2.434, consumo de medicamentos; OR=1.260, IC95%=0.763-2.084, número de enfermedad). Las personas no aseguradas evidencian depresión comórbida con diabetes mellitus, HTA, Artrosis, encontrando mayor frecuencia en mujeres de 60 a 75 años que en mujeres de 76 años a más.

Objective: To describe, analyze prevalence and predictive risk factors associated with major depression, seniors attended outpatient psychiatric, and uninsured. Material and Methods: 79 elderly uninsured community surrounding Callao to EsSalud, Survey of Drug Consumption applies; and 221 patients with depression and comorbid depression, diagnosed in Psychiatry Clinic. It was used, the Drug Consumption Survey. Results: Demographic factors are independent of depression in both groups (OR = 1.792, 95%CI = 0.573-5.606, age; OR = 1.123, 95%CI = 0.435-4.768, sex; OR = 2.344, 95%CI = 0.325-16.928, health self-perception; OR = 1,905, 95%CI = 0.642 -2.434, depression;, OR = 1. 250, 95%CI = 0.642-2.434, drug use; OR = 1260, 95%CI = 0.763-2.084, disease number). Uninsured comorbid with depression show DM, hypertension, osteoarthritis, and women age 60-75 It is more frequent than in Group 76 more assured, presents qualitative spectrum same trend groups have depression and comorbidity (Figure 1, 2, 3.4) Conclusion: Both groups have depression and comorbidity, even though it is depth analysis needed to confirm data with others.

Survey of Depression in the Elderly Patients with Diabetes Mellitus / 신경정신의학

OBJECTIVES: Depression is commonly comorbid in elderly patients with physical illness. This study examined the prevalence of depression in the elderly with Diabetes Mellitus (DM). METHODS: Eighty-nine patients, over 60 years old, with DM were enrolled. The medical and psychiatric history, Hamilton Rating Scale for Depression (HDRS), Patient Health Questionnaire-9 (PHQ-9), Geriatric Depression Scale-Short form Korean (GDS-SF-K), and Mini-Mental Status Examination Korean version were examined. RESULTS: The prevalence of depression was estimated as 21.3% (male 4.5% ; female 16.9%) in HDRS, 32.6% (male 9.0% ; female 23.6%) in PHQ-9, and 24.7% (male 5.6% ; female 19.1%) in GDS-SF-K. CONCLUSION: The self-reporting scale, such as GDS-SF-K, PHQ-9 is an effective screening test for depression. The prevalence of elderly depression with DM ranged from 20% to 30%, the prevalence of depression is almost three times more common in women.

Clinical Observation of Perospirone in the Treatment of Elderly Depression / 中国药房

OBJECTIVE:To observe therapeutic efficacy and side effect of perospirone in the treatment of elderly depression. METHODS:64 elderly patients with depression were randomly divided into paroxetine combined with perospirone group (drug combination group) and paroxetine group (single drug group) with 32 patients in each group. Both groups were given paroxetine 20-40 mg/d,and drug combination group was additionally given perospirone 4-8 mg/d. HAMD and CGI-SI were adopted to evalu-ate therapeutic efficacy after 8 weeks treatment,and side effect was evaluated with TESS scale;those were compared between 2 groups. RESULTS:After 8 weeks treatment,the effective rate of drug combination group and single drug group were 75.0% and 50.0%;there was statistical significance(P0.05). CONCLUSIONS:Small-dose of perospirone can improve therapeutic efficacy of paroxetine in the treatment of elderly depression with less side effect and good safety.

Rede de suporte social a pessoas idosas com sintomas depressivos em um município do nordeste brasileiro / Red de apoyo social a personas mayores con síntomas depresivos en un municipio del nordeste de Brasil / Social support network to older people with depressive symptoms in a municipality of northeast in Brazil

Objetivo: Descrever o perfil sociodemográfico de pessoas idosas com sintomas depressivos e a estrutura de sua rede de suporte social quanto a tamanho, composição e grau de proximidade do idoso com os componentes da rede. Métodos: Estudo descritivo, transversal e quantitativo, realizado com 88 idosos, sendo utilizados para a coleta de dados a Escala de Depressão Geriátrica Abreviada, o Mapa Mínimo de Relações Sociais e um formulário constituído de questões sociodemográficas. Resultados: Predominaram pessoas idosas do sexo feminino, faixa etária de 60 a 69 anos, baixo nível de renda e escolaridade. Foram citadas 807 pessoas pelos idosos para compor sua rede de suporte social, havendo prevalência das relações íntimas e de pessoas da família. Conclusão: A identificação da rede de suporte social permite aos profissionais de saúde atuar em parceria com a mesma, no intuito de promover uma melhor qualidade de vida do idoso.

Objective: Describe the sociodemographic profile of older people with depressive symptoms and their social support structure regarding the size, composition and degree of the elderly proximity with the network components. Method:Descriptive, transversal and quantitative study, conducted with 88 elderly, being used for data collection the Short Geriatric Depression Scale, Minimum Map of Social Relations and a form composed by sociodemographic questions. Results: Predominated older people the female sex, aged 60 to 69 years, low income and education. 807 people were cited by the elderly to compose their social support network, with prevalence of intimate relationships and family members. Conclusion: The identification of social support enables health professionals to work in a partnership with it in order to promote a better quality of life of elderly.

Objetivo: Describir el perfil sociodemográfico de las personas mayores con síntomas depresivos y la estructura de su red apoyo social en relación con el tamaño, composición y grado de proximidad de los ancianos con los componentes de la red. Método: Estudio descriptivo, transversal y cuantitativo, realizado como 88 ancianos, siendo utilizado para la recolección de datos la Escala de Depresión Geriátrica Corta, Mapa Mínima de Relaciones Sociales y formulario que consta de cuestiones sociodemográficas. Resultados: Predominaron las personas mayores de los sexo femenino, con edades entre 60 y 69 años, bajos niveles de renta y escolaridad. 807 personas fueron citadas por los ancianos para componer su red de apoyo social, con predominio de las relaciones íntimas y miembros de la familia. Conclusión: La identificación de la red de apoyo social permite a los profesionales de la salud trabajar en asociación con la misma a fin de promover una mejor calidad de vida de los ancianos.

Survey of Depression in the Elderly Patients with Chronic Obstructive Pulmonary Disease / 신경정신의학

OBJECTIVES: Depression is commonly comorbid in the elderly patients with physical illness. This study examined the prevalence of depression in the elderly with chronic obstructive pulmonary disease (COPD). METHODS: The eighty-seven patients with COPD were enrolled. The subjects are over 60 years old. The medical and psychiatric history, Hamilton Rating Scale for Depression (HDRS), Patient Health Questionnaire-9 (PHQ-9), Patient Health Questionnaire-2 (PHQ-2), Geriatric Depression Scale-Short form Korean (GDS-SF-K), Mini-Mental Status Exam Korean version (MMSE-KC) were investigated. Global Initiative for Chronic Obstructive Lung Disease (GOLD), which predict the severity of COPD, also investigated. RESULTS: The prevalence of depression was estimated to be 24.7% (male 19.3% ; female 35.7%) in HDRS, 31.0% (male 24.6% ; female 43.3%) in PHQ-9, 8.0% (male 10.5% ; female 3.3%) in PHQ-2, 23.0% (male 17.5% ; female 33.3%) in GDS-SF-K. The severity of COPD (GOLD) was associated with the prevalence of depression (HDRS, p=0.027 ; PHQ-9, p=0.045 ; PHQ-2, p=0.112 ; GDS-SFK, p=0.089). CONCLUSION: The prevalence of elderly depression with COPD ranged from about 20% to 30%, the prevalence of depression is nearly two times more common in women. The severity of COPD (GOLD) was associated with the prevalence of depression. The self-reporting scale, such as GDS-SF-K, PHQ-9 and PHQ-2 is the effective screening test of depression.

Depressão em idosos de uma comunidade assistida pela Estratégia de Saúde da Família em Passo Fundo, RS / Depression in elderly assisted by family Health Care in Passo Fundo, RS / Depresión en ancianos en una comunidad asistida por la Estrategia de Salud de la Familia en Passo Fundo, RS

Objetivo: Identificar a prevalência de depressão em idosos atendidos pela Estratégia de Saúde da Família (ESF) e os fatores associados. Métodos: Estudo transversal com 151 idosos residentes em área adscrita à ESF de Passo Fundo/RS. Coletaram-se os dados utilizando questionário estruturado e Escala de Depressão Geriátrica GDS­15. Resultados: 33,1% são do sexo masculino, com faixa etária predominante entre 60-69 anos (50,3%), escolaridade média de 4,14 anos de estudo (DP: 2,63), 8,2% são analfabetos ou semianalfabetos, 21,9% declararam algum episódio depressivo e 2,6% outra doença psiquiátrica. Houve associação entre depressão e percepção de saúde, perda familiar, asma, ocorrência de fratura, insuficiência cardíaca e artrite (p < 0,01). Conclusões: os resultados mostraram que a prevalência de depressão em idosos na ESF estudada foi de 21,2%, desses, 17,9% com diagnóstico de depressão leve a moderada e 3,3% com depressão severa, necessitando de intervenções multidisciplinares e integrais visando reduzir os fatores associados e qualificar a vida dessas pessoas.

Objective: To identify the prevalence of depression in the elderly attended by the Family Health Strategy (FHS), and to identify the associated factors as well. Methods: transversal study with 151 elderly who live in the area registered in the FHS in Passo Fundo, RS. Data were collected through a structural questionnaire and Geriatric Depression Scale GDS-15. Results: 33.1% are male, aging predominantly from 60 to 69 years old, average schooling level 4.14 years of study (DP: 2.63), 8.2% are illiterate or semi-illiterate, 21.9% declared some depressive episode and 2.6% declared other psychiatric illness. There was association between depression and health perception, family lost, asthma, fracture occurrence, cardiac insufficiency, and arthritis (p < 0.01). Conclusions: the results showed that the prevalence of depression in the elderly in the studied FHS was of 21.2%, from which 17.9% were diagnosed with mild to moderate depression, and 3.3% with severe depression, who are in need of integral and multidisciplinary interventions aiming at the reduction of the associated factors and at the qualification of their lives.

Objectivo: Identificar la prevalencia de depresión y las características de ancianos atendidos por la Estrategia de Salud de la Familia (ESF). Métodos: Estudio transversal con 151 ancianos residentes en el área asignada a la ESF de Passo Fundo, RS. Los datos fueron recogidos utilizando un cuestionario estructurado y una Escala de Depresión Geriátrica (GDS-15). Resultados: el 33,1% eran hombres, correspondiendo la edad más frecuente al intervalo entre 60-69 años (50,3%). El tiempo medio de escolarización fue de 4,14 años (DPP: 2,63), con un 8,2% de analfabetos o semianalfabetos. El 21,9% declararon algún episodio depresivo y el 2,6% alguna otra enfermedad psiquiátrica. Se encontró una asociación entre depresión y percepción de salud, pérdida familiar, asma, incidencia de fractura, insuficiencia cardíaca y artritis (p < 0,01). Conclusiones: los resultados mostraron que la prevalencia de depresión en ancianos en la ESF estudiada fue del 21,1%; de éstos, el 17,9% fue diagnosticado de depresión leve o moderada y el 3,3% de depresión grave. Se necesita una intervención multidisciplinar e integral para minimizar los factores asociados y mejorar la calidad de vida de estas personas.

Sintomas depressivos e déficit cognitivo na população de 60 anos e mais em um município de médio porte do interior paulista* / Depression symptoms and cognitive-deficit in a population aged 60 years and older in a medium-sized city in São Paulo state, Brazil / Síntomas depresivos y de déficit cognitivo en la población de 60 años y más en una ciudad de tamaño medio en el estado de São Paulo, en Brasil

Introdução: a população mundial está envelhecendo e o Brasil segue essa tendência, o que demanda uma reorganização da sociedade para o cuidado desses idosos. Observa-se, nesta tendência, um aumento do número de casos de depressão e demência, além da vinculação destas com outras doenças crônico-degenerativas. Objetivo: estimar a prevalência dos sintomas depressivos e déficits cognitivos em uma população de 60 anos e mais, moradora de um município de médio porte do interior do estado de São Paulo, e sua associação com outras doenças crônico-degenerativas mais prevalentes. Métodos: estudo transversal, com 364 idosos, utilizando: instrumentos sociodemográficos e de morbidade; o Mini Exame do Estado Mental (MEEM), a Escala de Yesavage, a Escala de Atividades de Vida Diária e a Escala de Atividades Instrumentais de Vida Diária (AIVD). Foram realizadas: análises estatísticas de frequências dos escores dos instrumentos; apresentação da sumarização das variáveis e as possíveis associações entre depressão/demência, aplicando-se o teste do X2 seguido do ajuste de um modelo de regressão logística para dados ordinais. Resultados: a suspeita de depressão foi encontrada em 44% (160) e o déficit cognitivo foi identificado em 38,7% (141) dos idosos. Aproximadamente 75% dos idosos, com suspeita de depressão ou déficit cognitivo, eram portadores de pelo menos mais uma patologia crônica. Foi possível estabelecer associações estatisticamente significativas entre: suspeita de depressão e AIVD (p<0,0001; OR=7,59; IC=3,361-7,139) e déficit cognitivo e AIVD (p=0,0007; OR=3,967; IC=1,788-8,799). Não foram encontradas associações entre idade, situação conjugal, escolaridade, inserção no mercado de trabalho, aposentadoria ou renda. Conclusão: idosos de ambos os sexos estão vulneráveis a doenças como depressão e demência. Por outro lado, sintomas depressivos e déficit cognitivo foram associados ao escore dos idosos comprometidos, segundo as AIVD. *Parte da Dissertação de Mestrado apresentada à Faculdade de Medicina de Botucatu para a obtenção do Título de Mestre em Saúde Pública.

Introduction: the world population is ageing, and Brazil follows this tendency, which requires the reorganization of society for care provision to older people. In such tendency, an increasing number of cases of depression and dementia is observed in addition to their association with other chronic-degenerative diseases. Objective: to estimate the prevalence of depression and cognitive-deficit symptoms in a population aged 60 years and older, residing in a middle-sized city in São Paulo state and to associate the population with other more prevalent chronic degenerative diseases. Methods: cross-sectional study on 364 older people using the following instruments: socio-demographic and morbidity, Mini Mental State Examination, Yesavage Scale, the Activities of Daily Living Scale, and the Instrumental Activities of Daily Living (IADL) Scale. The following were performed: statistical analyses of the instruments' score frequencies; presentation and summarization of the variables; and the possible associations between depression/dementia by applying the X2 test followed by fitting of a logistic regression model for ordinal data. Results: the suspected depression was found in 44% (160), and cognitive deficit was observed in 38.7% (141) aged. About 75% of the individuals with suspicion of depression or cognitive deficit had at least another chronic pathology. It was possible to establish statistically significant associations between suspected depression and IADL (p<0.0001; OR=7.59; CI=3.361-7.139) and cognitive deficit and IADL (p=0.0007; OR=3.967; CI=1.788-8.799). No associations were found between age, marital status, schooling, placement in the work market, retirement or income. Conclusion: male and female older individuals are vulnerable to diseases, such as depression and dementia. On the other hand, depression symptoms and cognitive deficit were associated with the score of compromised older individuals, according to IADL.

Introducción: la población mundial está envejeciendo y Brasil sigue esta tendencia, que requiere una reorganización de la sociedad para el cuidado de los ancianos. Acepta-se que este número creciente de casos de la depresión y la demencia están asociados con otras enfermedades crónicas. Objetivo: estimar la prevalencia de los síntomas depresivos y deterioros cognitivos en una población de 60 años y más de edad, residente en una ciudad de tamaño medio en el Estado de São Paulo y su asociación con las enfermedades crónicas más frecuentes. Métodos: estudio transversal con 364 pacientes, utilizando los siguientes instrumentos: variables socio-demográficas y de morbilidad, el Mini Examen del Estado Mental, Yesavage Escala y Escala de Actividades de la Vida y Actividades Instrumentales de la Vida Diaria. Se realizaron: análisis estadísticos de frecuencias de las puntuaciones de los instrumentos; la presentación de los resúmenes de las variables y se estudiaran las posibles asociaciones entre la depresión y la demencia mediante la aplicación de la prueba de X2 seguido por el ajuste de un modelo de regresión logística para datos ordinales. Resultados: la depresión fue encontrada en el 44% (160) y el deterioro cognitivo fue identificado en 38,7% (141) de las personas mayores. En aproximadamente el 75% de los pacientes ancianos con depresión, también se sospechó de deterioro cognitivo en los pacientes que tuvieron al menos una enfermedad más crónica. Fue posible establecer asociaciones estadísticamente significativas entre: sospecha de depresión y AIVD (p<0,0001, OR=7.59, IC=3,361-7,139) y déficit cognitivo y AIVD (p=0,0007; OR=3,967; IC=1,788-8,799). No se encontró asociación entre sospecha de depresión y déficit cognitivo con la edad, el estado civil, la educación, la entrada en el mercado de trabajo, los ingresos o la jubilación. Conclusión: los adultos mayores de ambos los sexos son vulnerables a enfermedades como la depresión y la demencia. Por otra parte, los síntomas depresivos y el déficit cognitivo fueron asociados a la puntuación de los ancianos comprometidos, segundo el AIVD.

Effect of cognitive-behavioral therapy on the quality of life of dderly depression patients with chronic pain / 中华行为医学与脑科学杂志

Objective To explore the influence of cognitive-behavioral therapy on the quality of life of elderly depression patients with chronic pain.Methods 60 patients were divided into the cognitive-behavioral therapy(CBT) group and non-cognitive-behavioral therapy(N-CBT) group,30 cases in each group.The patients in CBT group were treated with cognitive-behavioral therapy combined with mirtazapine,and the patients in N-CBT group were treated with mirtazapine only.Before treating and after the 4th week and 12th week,depression,anxiety and chronic pain were assessed respectively with Hamilton Depression Scale ( HAMD),Hamilton Anxiety Scale (HAMA),and Visual Analogue Scales (VAS),the quality of life was assessed with the WHO Quality of Life ( WHO.QOL-100).No significant different scores of HAMD,HAMA,VAS and WHOQOL-100 existed between two groups before treatment.Results Depression,anxiety and chronic pain were significantly related to the life quality of elderly depression patients with chronic pain ( r =-0.506 ～ -0.676,P ＜ 0.01 ).At the end of the 12th treating week,the scores of HAMD(36.82 ±7.93),HAMA(8.26 ±3.13),VAS(4.35 ±0.52) and WHOQOL100 ( respectively ( 65.71 ± 17.29 ),( 92.36 ± 13.55 ),( 77.91 ± 12.26 ),( 78.33 ± 12.81 ),( 81.79 ± 12.43 ),( 18.95 ± 11.91 ),( 19.98 ± 11.56 ) ) were significantly different from those before treatment in CBT group,and the change of each indicator score was significantly greater in CBT group than those in N-CBT group ( t =3.020 ～9.761,P＜ 0.01 ).Conclusion Cognitive-behavioral therapy can effectively improve the life quality of the elderly depression patients with chronic pain.

The study on curative effect of acupuncture therapy with the Shu-points of five Zangs and Ge-shu point on elderly depression / 国际中医中药杂志

Objective To observe the clinical effect of acupuncture on elderly depression. Methods A total of 63 patients were designated into a treatment group and a control group by using a random number table. Acupuncture on Ge-shu point and Shu-points of Five-Zangs were administrated for the treatment group, and Fluoxetine was used for the control group at a dosage of 20 mg, once daily. The treatment of both groups lasted for 6 weeks. Results The curative effect of acupuncture was sound on relieving depression and the scores of HAMD in the treatment group exhibited a decreasing trend. There was no statically significant difference between the two groups on the total effective rate and the cure rate. Conclusion It has a good anti-depression result to needle Shu-points of Five-Zangs.

Therapeutic Effect of Tianeptine on Elderly Depression and Hippocampal Volume Change / 대한정신약물학회지

OBJECTIVE: This research was performed to study the effect of tianeptine, a novel antidepressant, on elderly depressed patients, to compare the hippocampus size between a normal control group and the elderly depressed group, and to measure the change of hippocampal volume according to the treatment effect of tianeptine. The relationship between hippocampus size and severity of depression at baseline was also studied. METHODS: A group of elderly depressed patients and normal control subjects over 62 years old were recruited fifteen elderly depressed patients, all male, of average age 70 (range 62-80 years old) and 15 normal control subjects were recruited along with age and education duration matched. To investigate the effect of the antidepressant, Montgomery-Asberg Depression Rating Scale (MADRS), Hamilton Depression Rating Scale (HDRS) and Clinical Global Impression (CGI) scale were applied at baseline, and the 4th and 8th weeks. MRI was used to compare the volume of the hippocampus between the patients group and the control group, and to measure the hippocampal volume of the patients at baseline and after the 8-week treatment. RESULTS: For the elderly depressed patient group, tianeptine significantly reduced MADRS, HDRS and CGI (Ed-deleted part is unnecessary as this meaning is obvious from being in the `Results' section). There was no significant difference of hippocampal volume between the elderly depressed patients group and the normal control group, nor between the elderly depressed patients group at baseline and after the 8-week treatment. CONCLUSION: This study shows that tianeptine is a safe, effective and well-tolerated antidepressant for elderly depression. However, a change of hippocampal volume was not observed over the course of an 8-week, short-term therapy.

Study on Cognitive dysfunction of the major depression in Elderly by P300 / 中华物理医学与康复杂志

Objective To explore the detection methods for cognitive dysfunction of the major depression in Elderly and analyze their clinical significance.Methods Using matched-pairs study,42 patients with seniie de- pressive disorders(experimental group)and 42 normal aged people(control group)were examined with auditory e- voked potential P300(event related potential,ERP-P300)and SECF,respectively.Results It was found that the scores with registration,span,recall,classification and total score of the subjects in the experimental group were sig- nificantly lower than those in the control group(P

Diagnosis and Treatment of Elderly Depression

The diagnosis and treatment of elderly depression has gained growing importance because of its major impact on the patients s wellbeing, personal, social, and familial achievements. Depressive disorders are characterized by moodaffect, thought-cognition, psychomotor activity and somatic manifestations. Especially geriatric depression is more represented by thought-cognition and somatic manifestations. And it is also associated with comorbid mental or physical conditions that may lead to a decrease in life expectancy. Diagnosis of geriatric depression consists of history taking, laboratory, neurocognitive test, brain imaging technique and genetic study. As for its treatment, physical treatment such as pharmacological treatments, electroconvulsive therapy, and phototherapy have been emphasized but should also include psychosocial intervention such as supportive, family and cognitive-behavioral psychotherapy.