Section VI. Special Populations - Late Life Depression

Question 1

Define late life depression

Answer 1

MDD after 60 yo

Question 2

How do you differentiate between adult-onset depression, recurring in late life vs. late-onset depression?

Answer 2

Late onset depression has:
- worse prognosis
- more chronic course
- higher relapse rate
- higher levels of medical comorbidity
- higher levels of cognitive impairment
- higher level of mortality

Question 3

What part of the brain does ‘vascular depression’ burden?

Answer 3

fronto-striatal circuitry

Question 4

What are some psychotherapies that have some evidence of support for treatment of late life depression?

Answer 4

• Bibliotherapy
• Supportive therapy
• Problem-solving therapy

Question 5

What rare SEs of antidepressants should you watch for especially in the elderly?

Answer 5

• bone loss
• serotonin syndrome
• EPS
• NMS
• GI bleeds (SSRI)
• falls (SSRI)
• hyponatremia (SSRI)
• QT prolongation (Citalopram)

Question 6

What does the evidence suggest as length of treatment trial with antidepressant in elderly?

Answer 6

10-12 weeks

Question 7

Which executive dysfunctions are linked to poor antidepressant treatment response in the elderly?

Answer 7

planning
organization

Question 8

Which medications demonstrate some efficacy in improving verbal learning and improved processing speed?

Answer 8

Vortioxetine
Agomelatine

Question 9

What are the most common SEs reported with adjunctive Abilify?

Answer 9

Dizziness
Akathisia
Parkinsonism

Question 10

True/ False - Antipsychotic medication is associated with increased risk of all-cause mortality

Answer 10

True

Question 11

What are the 2 largest studies of elderly with depression?

Answer 11

IMPACT
PROSPECT