Neurological findings in late-onset depressive disorder: comparison of individuals with and without depression.
BACKGROUND
Organic factors are thought to be important in late-life depressive disorder but there have been few studies specifically of neurological signs.


OBJECTIVE
To compare neurological signs in a group of patients with late-onset depression and in healthy controls.


METHODS
A case-control study comparing 50 patients with depression and 35 controls on three measures of central nervous system (CNS) signs: a structured CNS examination, the Neurological Evaluation Scale (NES) and the Webster rating scale for parkinsonism.


RESULTS
After adjusting for major depression at the time of evaluation and prescription of tranquillisers, ratings on two of the NES sub-scales (complex motor sequencing and 'other' signs) and on the Webster scale were significantly higher (more impaired) in patients compared with controls (P<0.05). With logistic regression, the NES was the main measure predictive of group outcome. There were no differences in scores of vascular risk or white matter but patients had patients had more atrophy.


CONCLUSIONS
The findings add to the evidence that late-life depression is associated with organic brain dysfunction, perhaps mediated by neurodegeneration or subtle vascular impairment. The use of the NES in subjects with depression should be replicated.
Baldwin
Robert
R
Department of Old Age Psychiatry, York House, Manchester Mental Health & Social Care NHS Trust, Manchester Royal Infirmary, Oxford Rd, Manchester M13 9BX, UK. robert.baldwin@man.ac.uk
Jeffries
Suzanne
S
Jackson
Alan
A
Sutcliffe
Caroline
C
Thacker
Neil
N
Scott
Marietta
M
Burns
Alistair
A
D017668:Age of Onset; D000368:Aged; D001927:Brain Diseases / Q000473:pathology*; D016022:Case-Control Studies; D015331:Cohort Studies; D003866:Depressive Disorder / Q000473:pathology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D020734:Parkinsonian Disorders / Q000473:pathology; D012044:Regression Analysis