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Vincent Millischer,1,2 Sophie Erhardt,3 Örjan Ekblom,4 Yvonne Forsell,5 Catharina Lavebratt1,2 1Department of Molecular Medicine and Surgery, Karolinska Institutet, 2Center for Molecular Medicine, Karolinska University Hospital, 3Department of Physiology and Pharmacology, Karolinska Institutet, 4Department of Sport Sciences, The Swedish School of Sport and Health Sciences, GIH, 5Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden Background: Physical exercise has well-characterized positive effects on depressive symptoms. The underlying biologic mechanisms are, however, far from established. A recently discovered mechanism has linked the enhanced conversion of kynurenine to kynurenic acid (KYNA) to an increased resilience toward stress-induced depression in mice. The aim of this study was to translate these findings to humans.Materials and methods: Kynurenine and KYNA levels were measured by high-performance liquid chromatography in plasma samples from 117 patients affected by mild-to-moderate depression before and within a week after a 12-week training period at three different intensities. The patients were part of the Regassa study.Results: No differences in plasma levels of kynurenine and KYNA or in their ratio could be detected between before and after training. No effect of the intensity group could be observed. No correlation with the improvement in cardiovascular fitness (Åstrand score) or the improvement in mood (Montgomery Åsberg Depression Rating Scale score) could be observed.Limitations: As the Regassa study is based on an intention-to-treat protocol, the exact time and the exact intensity of the physical exercise are not known. Analyses of pulse data as well as personal interviews, however, were used to control the exercise protocols. Furthermore, the observations reflect chronic changes.Conclusion: Physical exercise positively affects mood and cardiovascular fitness, but does not lead to long-lasting changes in plasma levels of kynurenine and KYNA in patients affected by mild-to-moderate depression. Keywords: kynurenine pathway, kynurenine, kynurenic acid, depression, physical exercise

Background and Aims: The interrelationship between alcohol consumption and depression is complex, and the direction of the association is unclear. We investigated whether alcohol consumption influences the risk of depression while accounting for this potential bidirectionality. Methods: A total of 10 441 individuals participated in the PART study in 1998–2000, 8622 in 2001–2003, and 5228 in 2010. Participants answered questions on their alcohol consumption, symptoms of depression, childhood adversity, and sociodemographic, socioeconomic, psychosocial, and lifestyle factors. A total of 5087 participants provided repeated information on alcohol consumption. We used marginal structural models to analyze the association between alcohol consumption and depression while controlling for previous alcohol consumption and depressive symptoms and other time‐varying confounders. Results: Non‐drinkers had a higher depression risk than light drinkers (≤7 drinks/week) (risk ratio: 1.7; 95% confidence interval 1.3–2.1). Consumers of seven–fourteen drinks/week had a depression risk similar to that of light drinkers. Hazardous drinking was associated with a higher risk of depression than non‐hazardous alcohol consumption (risk ratio: 1.8, 95% confidence interval: 1.4–2.4). Conclusion: Light and moderate alcohol consumption and non‐hazardous drinking were associated with the lowest risk of subsequent depression after accounting for potential bidirectional effects. Hazardous drinking increased the risk of depression. [ABSTRACT FROM AUTHOR]

Community-based samples of old adults with current major depression (n = 17; mean age = 83.29 years) and healthy old adults (n = 51; mean age = 83.29 years) were examined on a variety of episodic recall and recognition tasks. Results indicate depression-related deficits in recall that were reduced, but not eliminated, in recognition. Control Ss were able to utilize cognitive support in the form of more study time and item organizability in free recall, whereas depressed Ss were not. However, both groups showed equal gains from the provision of category cues and beneficial effects of prior knowledge and more study time in recognition. Results suggest that depression results in deficits in effortful, elaborate processes at encoding and retrieval and that old age depression is associated with a reduced ability to utilize cognitive support to improve episodic memory. Depressed older adults appear to require cognitive support at both encoding and retrieval to demonstrate memory facilitation. [ABSTRACT FROM AUTHOR]

Depression is a common disorder in the elderly. In population-based studies the rate of treatment is low. In spite of this most of the studies on the outcome of depression in the elderly are based on treated series. This study used data from a population of 1,101 very elderly persons. Of these, 7.2% (n=78) were diagnosed as having a major depression and 3.5% (n=39) as having a dysthymia at an initial examination. Both syndromes were over-represented in persons affected by dementia. Seventy-seven per cent of the depressed persons had consulted a physician recently and 17% were treated for depression. Three years later those who were depressed and had survived were re-examined. At the follow-up examination, 48.6% of the non-demented persons and 14.3% of the demented were depressed. In conclusion, the rate of treatment of depression in the very elderly is low and the course is chronic or relapsing in almost half of the cases. [ABSTRACT FROM AUTHOR]

Abstract Knowledge about the epidemiology of psychiatric symptoms and associated variables in the growing cohort of very elderly is sparse. The aim of this study was to further explore this issue in a very elderly population using data from physician examinations and informant interviews. Three-hundred-and-thirty persons aged 90 and over were extensively examined by physicians, including the administration of a psychiatric interview. Informants were also interviewed. Of the 330 participants, 253 persons had complete data. Of the 253, 114 were suffering from dementia and 139 were not. Generally the informants reported more psychiatric symptoms than what were recorded at the physicians' examinations. The most commonly reported symptoms included sleep disturbances anxiety and suicidal thoughts. If dementia was present, informants generally reported more psychiatric symptoms than the persons themselves. However, both suicidal and depressive thoughts were more often registered at the physicians' examinations. No correlations were found between somatic disorders, social support, demographic variables or disabilities in daily living and number of psychiatric symptoms according to informant or physician data. The prevalence of psychiatric symptoms was generally high, especially if dementia was present. The agreement between physician and informant data concerning psychiatric symptoms was poor. [ABSTRACT FROM AUTHOR]

In the Kungsholmen project, a longitudinal study of a total population, samples of non-demented and demented elderly persons with a depressive disorder were followed over 3 years. Of 668 persons who received a full medical examination, 62 were found to have a depressive disorder. Of these, 28 were demented and 34 non-demented. Two-thirds of the 62 had not been previously recognized as having a depressive disorder. There was no difference in this regard between the demented and non-demented samples. After 3 years, only two out of 20 non-demented cases had recovered from their depressive disorder. This is in contrast to the demented cases, where only one of 11 were still depressed. These results indicate the need for greater attention to the recognition and management of depressive disorders in the elderly. [ABSTRACT FROM AUTHOR]

Background: Elderly people with paranoid symptoms are a taxing group for medical and social services, but studies of the prevalence of these symptoms in the general elderly population are rare. This study aimed to estimate the community prevalence and to identify some associated variables.Method: A community samples of 1420 elderly people, was extensively examined by nurses and physicians.Results: Paranoid ideation was found in 6.3% of the sample. The prevalence in people with cognitive dysfunction (n = 381, 12.1%) was higher than in those without (n = 1039, 2.6%). Once cognitive impairment had been controlled the associated variables were: being divorced, being female, having depressive symptoms, using psychotropic drugs, having no friends or visitors, using community care and being an immigrant.Conclusion: Paranoid symptoms in this elderly population were associated most strongly with cognitive impairment. Other associated variables pointed to a higher level of social isolation than others in the community. [ABSTRACT FROM AUTHOR]

Background: Clinicians see many more nonagenarian patients now and there is a need for epidemiological data relating to this group. The aim of the present study was to investigate the prevalence of depressive symptoms and syndromes in this age group.Method: The DSM-IV and the ICD-10 criteria for depression were used and correlated with physical health, disability in daily life, gender, use of drugs, social circumstances and cognitive dysfunction. Data were derived from 329 persons aged 90 and over, registered in a parish of Stockholm, who had been extensively examined by physicians and nurses.Results/conclusions: The prevalence of Major Depressive Episode as defined in DSM-IV was 7.9%; and of mild, moderate and severe Depressive Episode (combined); as defined in ICD-10 9.1%. No gender difference was found. Disability in daily life and the use of psychotropic drugs were found to correlate with depressive symptoms and syndromes. [ABSTRACT FROM AUTHOR]

The influence of cardiovascular signs (CVS) on cognitive performance was examined in 227 older adults not suffering from dementia between 75 and 96 years of age who were sampled from the community. Participants received a comprehensive physical examination that included specific evaluation of current CVS, including dyspnea, cardiac murmur, and edema in lower limbs. They were administered tests of digit span, episodic recall and recognition, verbal fluency, and visuospatial skill. CVS were found to predict performance on tests of episodic memory and visuospatial skill, after the effects of age, education, gender, relevant drug use, and mood symptoms were controlled for. Although CVS accounted for relatively little general performance variation, the findings are relevant to the understanding of normal variation in late-life cognitive performance. Finally, CVS increased with age and accounted for a sizable proportion of the age-related cognitive variation. [ABSTRACT FROM AUTHOR]

The authors examined a community-based sample of 303 clinically nondepressed individuals aged 75 through 96 years on 4 recall tasks: free recall of rapidly presented random words, free recall of slowly presented random words, free recall of organizable words, and cued recall of organizable words. Using a classification taxonomy that identified mood- and motivation-related symptoms of depression, it was found that motivation-related symptoms had a negative effect on performance across all tasks, whereas mood-related symptoms had no effects. In addition, motivation-related symptoms negatively influenced the ability to benefit from more study time but had no effect on the ability to make use of item organization or category cues. An analysis of the specific motivation-related symptoms suggested that symptoms that may affect the ability to focus and sustain attention (e.g., concentration difficulties, lack of interest) were most strongly associated with performance deficits. [ABSTRACT FROM AUTHOR]

Population-based samples of normal old adults and people with major depression (MD), Alzheimer's disease (AD), and coexisting MD and AD (MD + AD) between 90 and 100 years of age were assessed in face recognition, word recall, and object recall. Results indicated a consistent pattern across tasks: no differences between the normal old and the MD participants or between the AD and MD + AD participants in any task, a clear performance decrement in the AD and MD + AD participants in all task variables reflecting long-term episodic memory, and no group differences in those variables reflecting short-term memory. These data suggest that depression in very old age may not exacerbate the episodic memory deficit that accompanies AD. Further, differences between normal old and MD participants in episodic memory tasks appear to be negligible among the oldest old. The general lack of effects of MD may be due to the fact that those symptoms of this disease that are most likely to affect memory functioning (e.g., loss of energy, concentration difficulties) are common in AD as well as in nondepressed people in the 10th decade of life. [ABSTRACT FROM AUTHOR]