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Depression is a leading cause of disability, with older people particularly susceptible to poor outcomes.
To investigate whether the prevalence of depression and antidepressant use have changed across two decades in older people.
The Cognitive Function and Ageing Studies (CFAS I and CFAS II) are two English population-based cohort studies of older people aged ≥65 years, with baseline measurements for each cohort conducted two decades apart (between 1990 and 1993 and between 2008 and 2011). Depression was assessed by the Geriatric Mental State examination and diagnosed with the Automated Geriatric Examination for Computer-Assisted Taxonomy algorithm.
In CFAS I, 7635 people aged ≥65 years were interviewed, of whom 1457 were diagnostically assessed. In CFAS II, 7762 people were interviewed and diagnostically assessed. Age-standardised depression prevalence in CFAS II was 6.8% (95% CI 6.3–7.5%), representing a non-significant decline from CFAS I (risk ratio 0.82, 95% CI 0.64–1.07, P = 0.14). At the time of CFAS II, 10.7% of the population (95% CI 10.0–11.5%) were taking antidepressant medication, more than twice that of CFAS I (risk ratio 2.79, 95% CI 1.96–3.97, P < 0.0001). Among care home residents, depression prevalence was unchanged, but the use of antidepressants increased from 7.4% (95% CI 3.8–13.8%) to 29.2% (95% CI 22.6–36.7%).
A substantial increase in the proportion of the population reporting taking antidepressant medication is seen across two decades for people aged ≥65 years. However there was no evidence for a change in age-specific prevalence of depression.
Depression is common in old age and is associated with risk of dementia,
but its neuropathological correlates in the community are unknown.
To investigate for the first time in a population-representative sample
of people with no dementia the association between depression observed
during life and neurofibrillary tangles, diffuse and neuritic plaques,
Lewy bodies, brain atrophy and cerebrovascular disease found in the brain
Out of 456 donations to a population-based study, 153 brains were
selected where donors had no dementia measured in life. Alzheimer and
vascular pathology measures, Lewy bodies and neuronal loss were compared
between those with (n = 36) and without
(n = 117) depression ascertained using a fully
structured diagnostic interview during life. Brain areas examined
included frontal, parietal, temporal and occipital cortical areas as well
as the entorhinal cortex, hippocampus and brain-stem monoaminergic
Depression was significantly associated with the presence of subcortical
Lewy bodies. No association was found between depression and
cerebrovascular or Alzheimer pathology in cortical or subcortical areas,
although depression was associated with neuronal loss in the hippocampus
as well as in some of the subcortical structures investigated (nucleus
basalis, substantia nigra, raphe nucleus).
Late-life depression was associated with subcortical and hippocampal
neuronal loss but not with cerebrovascular or Alzheimer pathology.
Behavioural and psychological symptoms of dementia (BPSD) are major
contributors to the burden of dementia.
To describe the prevalence, correlates and course of BPSD in the
population of England and Wales.
The prevalence of 12 symptoms was estimated in 587 participants with
dementia and 2050 participants without dementia as part of a
population-based longitudinal study of ageing. The effect of risk factors
and the factor structure were estimated using 1782 interviews provided by
participants with dementia throughout the study.
Each symptom apart from sleeping problems was more common in the
population with dementia. The co-occurrence of the symptoms was explained
by a four-factor solution, corresponding to psychosis/apathy,
depression/anxiety, irritability/persecution and wandering/sleep
problems. Psychosis occurred more frequently with declining cognition.
Anxiety and depression were more common in younger individuals and in
those with poor self-reported health. Persistence varied between
Behavioural and psychological symptoms of dementia affect nearly all
people with dementia. Symptoms co-occur, and the symptoms that affected
individuals experience are related to their socio-demographic and
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