Biomarkers in geriatric psychiatry: searching for the holy grail?
OBJECTIVE
Biomarkers in clinical medicine are used to detect or diagnose specific illnesses, predict disease progression, and predict the response to treatment. As the proportion of adults over 65 years of age rises, there is a growing need to detect neurodegenerative disease at an earlier stage with the goal of improving treatment for highly prevalent illnesses such as late-life depression and dementia.


RESULTS
The search for biomarkers of late-life mental disorders includes the exploration of structural neuroimaging, functional neuroimaging, genomics, proteomics, noninvasive neurophysiology, cerebrospinal fluid, and plasma analysis. Novel structural and functional neuroimaging techniques that have recently been developed show promise as biomarkers of both late-life depression and specific dementia syndromes. The fields of proteomics and genomics are advancing our ability to identify genes and aberrant proteins that detect preclinical dementia. As depression is often a harbinger of dementia in late life, recent studies are beginning to elucidate the relationship between different types of late-life depression and the subsequent emergence of dementia.


CONCLUSIONS
Biomarker research in late-life mental disorders is progressing at a rapid pace. The application of current biomarkers to clinical practice may be on the horizon with further research that refines their sensitivity and specificity.
Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario, Canada.
Daniel M
DM
Blumberger
Zafiris J
ZJ
Daskalakis
Benoit H
BH
Mulsant
D000368:Aged; D016229:Amyloid beta-Peptides / Q000235:genetics; D015415:Biomarkers; D001921:Brain / Q000473:pathology*; D002097:C-Reactive Protein / Q000378:metabolism; D003704:Dementia / Q000097:blood* / Q000453:epidemiology; D003863:Depression / Q000097:blood* / Q000453:epidemiology; D005852:Geriatric Psychiatry / Q000379:methods*; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D008279:Magnetic Resonance Imaging; D019636:Neurodegenerative Diseases / Q000097:blood* / Q000453:epidemiology; D009752:Nutritional Status; D010446:Peptide Fragments / Q000235:genetics; D012680:Sensitivity and Specificity
D016229:Amyloid beta-Peptides; D015415:Biomarkers; D015850:Interleukin-6; D010446:Peptide Fragments; C075222:amyloid beta-protein (1-42); D002097:C-Reactive Protein