Follow-up study of depression in the elderly. Clinical and SPECT data.
BACKGROUND
Imaging studies in depression of the elderly are often small and highly selective.


OBJECTIVE
To investigate a large group of elderly depressed patients in order to assess changes in clinical, imaging and neuropsychological variables at follow-up.


METHODS
Patients (n = 175, age range 65-91 years) with clinical depression were identified from consecutive local referrals. Clinical interviews, neuropsychological tests and SPECT scans were carried out at referral and at two-year follow-up.


RESULTS
Of 84 re-examined patients, 46.5% were well, 9.5% were ill, 33% partially recovered and 11% had developed dementia. Duration of illness before index assessment was the only factor to predict outcome. Thirty-nine patients could be scanned and followed up. There were no differences between patients with good or poor depressive outcome on SPECT. Ten clinically improved patients could be re-examined with SPECT. There were relative increases in right cingulate gyrus and right cerebellum at follow-up.


CONCLUSIONS
The patients group was comparable with other studies showing high levels of residual depressive symptoms. Activity changes in limbic cortex are implicated in depression of old age.
Halloran
E
E
MRC Brain Metabolism Unit, Royal Edinburgh Hospital.
Prentice
N
N
Murray
C L
CL
O'Carroll
R E
RE
Glabus
M F
MF
Goodwin
G M
GM
Ebmeier
K P
KP
D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000627:therapeutic use; D003072:Cognition Disorders / Q000000981:diagnostic imaging / Q000209:etiology; D003704:Dementia / Q000000981:diagnostic imaging / Q000209:etiology; D003866:Depressive Disorder / Q000000981:diagnostic imaging* / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011939:Mental Recall; D009483:Neuropsychological Tests; D011379:Prognosis; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods
D000928:Antidepressive Agents