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Prognosis of Late-Life Depression: Clinical and Immunological Characteristics

  • Clinical Presentation and Treatment of Nervous and Mental Diseases
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Objectives. To study the outcomes of depression in late age in a three-year prospective follow-up study in patients with different immunophenotypes. Materials and methods. A cohort of patients with depressive disorders who were treated in a geriatric psychiatric hospital were followed up at one and three years. A group with immunophenotype A (with increased leukocyte elastase (LE) activity and complex depression comorbid with anxiety and senestho-hypochondriacal disorders) consisted of 20 patients: six men (30.0%) and 14 women (70.0%), median age 68 years. Depressive episode (DE) as part of recurrent depressive disorder (RDD) was diagnosed in 13 patients (65.0%) and as part of bipolar affective disorder (BAD) in seven patients (35.0%). A group with immunophenotype B (with reduced LE activity and prolonged apathetic- adynamic depression) consisted of 31 patients: 10 (32.3%) men and 21 (67.7%) women, median age 68 years. Twenty patients (64.5%) were diagnosed with DE in the framework of RDD and nine patients (29.0%) in the framework of BAD, while two patients (6.5%) had single-episode DE. Patients were examined using clinical, psychometric, immunological, and clinical follow-up methods (at one and three years). Results. A more favorable course of illness with high-quality remissions was observed in patients with immunophenotype A (in 95% of cases at one and three years; χ2 = 10.44; p = 0.001 and χ2 = 11.97; p = 0.001, respectively). Patients with immunophenotype B showed a prevalence of an unfavorable course of illness (in 83.9% and 87.1% of cases at one and three years; χ2 = 11.32; p = 0.001 and χ2 = 11.77; p = 0.001, respectively), with low-quality remissions (with residual depressive disorders, developing on the background of repeated depressive episodes and chronicization of depression). Conclusions. This study revealed a relationship between clinical and biological features and the course of late-life depression.

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References

  1. UN World Population Ageing 2019, United Nations Department of Economic and Social Affairs, New York: (2019), https://www.un.org/en/development/desa/population/publications/pdf/ageing/WorldPopulationAgeing2019-Highlights.pdf.

  2. Andreas, S., Schulz, H., Volkert, J., et al., “Prevalence of mental disorders in elderly people: The European MentDis_ICF65+ study,” Br. J. Psychiatry, 210, No. 2, 125–131 (2017), https://doi.org/10.1192/bjp.bP.115.180463.

    Article  PubMed  Google Scholar 

  3. Kok, R. M. and Reynolds, C. F., 3rd, “Management of depression in older adults: A review,” JAMA, 20, 2114–2122 (2017), https://doi.org/10.1001/jama.2017.5706.

    Article  CAS  Google Scholar 

  4. Alexopoulos, G. S., “Mechanisms and treatment of late-life depression,” Transl. Psychiatry, 9, 188 (2019), https://doi.org/10.1038/s41398-019-0514-6.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Wei, J., Hou, R., Zhang, X., et al., “The association of late-life depression with all-cause and cardiovascular mortality among community-dwelling older adults: systematic review and meta-analysis,” Br. J. Psychiatry, 215, No. 2, 449–455 (2019), https://doi.org/10.1192/bjp.2019.74.

    Article  PubMed  Google Scholar 

  6. Kułak-Bejda, A., Bejda, G., and Waszkiewicz, N., “Mental disorders, cognitive impairment and the risk of suicide in older adults,” Front. Psychiatry, 25, No. 12, 695286 (2021), https://doi.org/10.3389/fpsyt.2021.695286.

  7. Jeuring, H. W., Stek, M. L., Huisman, M., et al., “A six-year prospective study of the prognosis and predictors in patients with late-life depression,” Am. J. Geriatr. Psychiatry, 26, No. 9, 985–997 (2018), https://doi.org/10.1016/j.jagp.2018.05.005.

    Article  PubMed  Google Scholar 

  8. Pitsillou, E., Bresnehan, S. M., Kagarakis, E. A., et al., “The cellular and molecular basis of major depressive disorder: towards a unified model for understanding clinical depression,” Mol. Biol. Rep., 47, No. 1, 753–770 (2020), https://doi.org/10.1007/s11033-019-05129-3.

    Article  CAS  PubMed  Google Scholar 

  9. Kuo, C. Y., Lin, C. H., and Lane, H. Y., “Molecular basis of late-life depression,” Int. J. Mol. Sci., 22, No. 14, 7421 (2021), https://doi.org/10.3390/ijms22147421.

  10. Schiepers, O. J., Wichers, M. C., and Maes, M., “Cytokines and major depression,” Prog. Neuropsychopharmacol. Biol. Psychiatry, 29, No. 2, 201–217 (2005), https://doi.org/10.1016/j.pnpbp.2004.11.003.

    Article  CAS  PubMed  Google Scholar 

  11. Rozing, M. P., Veerhuis, R., Westendorp, R. G. J., et al., “Inflammation in older subjects with early- and late-onset depression in the NESDO study: a cross-sectional and longitudinal case-only design,” Psychoneuroendocrinology, 99, 20–27 (2019), https://doi.org/10.1016/j.psyneuen.2018.08.029.

    Article  CAS  PubMed  Google Scholar 

  12. Bondy, E., Norton, S. A., Voss, M., et al., “Inflammation is associated with future depressive symptoms among older adults,” Brain Behav. Immun. Health, 13, 100226 (2021), https://doi.org/10.1016/j.bbih.2021.100226.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Safarova, T. P., “Outcomes of late-life depression (clinical and follow-up study),” Psikhiatriya, 20, No. 3, 39–46 (2022), https://doi.org/10.30629/2618-6667-2022-20-3-39-46.

  14. Safarova, T. P., Yakovleva, O. B., Androsova, L. V., et al., “Some factors of inflammation and the immunophenotype in depression in the elderly,” Zh. Nevrol. Psikhiat., 120, No. 2, 53–58 (2020), https://doi.org/10.17116/jnevro202012002153.

  15. Gallagher, D., Kiss, A., Lanctot, K., et al., “Depression with inflammation: Longitudinal analysis of a proposed depressive subtype in community dwelling older adults,” Int. J. Geriatr. Psychiatry, 32, No. 12, 18–24 (2017), https://doi.org/10.1002/gps.4645.

    Article  Google Scholar 

  16. Wiels, W., Baeken, C., and Engelborghs, S., “Depressive symptoms in the elderly – an early symptom of dementia? A systematic review,” Front. Pharmacol., 11, 34 (2020), https://doi.org/10.3389/fphar.2020.00034.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Mourao, R. J., Mansur, G., Malloy-Diniz, L. F., et al., “Depressive symptoms increase the risk of progression to dementia in subjects with mild cognitive impairment: systematic review and meta-analysis,” Int. J. Geriatr. Psychiatry, 31, No. 8, 905–911 (2016), https://doi.org/10.1002/gps.4406.

    Article  PubMed  Google Scholar 

  18. Yang, H., Kimberly, E. H., Doré, S., et al., “Neuroinflammatory mechanisms of blood–brain barrier damage in ischemic stroke,” Am. J. Physiol. Cell Physiol., 316, 135–153 (2019), https://doi.org/10.1152/ajpcell.00136.2018.

    Article  CAS  Google Scholar 

  19. Huang, X., Hussain, B., and Chang, J. J., “Peripheral inflammation and blood–brain barrier disruption: effects and mechanisms,” CNS Neurosci. Ther., 27, No. 1, 36–47 (2021), https://doi.org/10.1111/cns.13569.

    Article  CAS  PubMed  Google Scholar 

  20. Yao, H. W. and Kuan, C. Y., “Early neutrophil infiltration is critical for inflammation-sensitized hypoxic-ischemic brain injury in newborns,” J. Cereb. Blood Flow Metab., 40, No. 11, 2188–2200 (2020), https://doi.org/10.1177/0271678X19891839.

    Article  CAS  PubMed  Google Scholar 

  21. Smyth, L. C. D., Murray, H. C., Hill, M., et al., “Neutrophil-vascular interactions drive myeloperoxidase accumulation in the brain in Alzheimer’s disease,” Acta Neuropathol. Commun., 10, No. 1, 38 (2022), https://doi.org/10.1186/s40478-022-01347-2.

  22. Prinz, M. and Priller, J., “The role of peripheral immune cells in the CNS in steady state and disease,” Nat. Neurosci., 20, No. 2, 136–144 (2017), https://doi.org/10.1038/nn.4475.

    Article  CAS  PubMed  Google Scholar 

  23. Cahilog, Z., Zhao, H., Wu, L., et al., “The role of neutrophil NETosis in organ injury: Novel inflammatory cell death mechanisms,” Inflammation, 43, No. 6, 2021–2032 (2020), https://doi.org/10.1007/s10753-020-01294-x.

    Article  PubMed  Google Scholar 

  24. Klyushnik, T. P., Zozulya, S. A., and Oleichik, I. V., et al., “State of the leukocyte-inhibitory inflammation system in endogenous depression in patients of different age groups,” Zh. Nevrol. Psikhiatr., 121, No. 2, 67–74 (2021), https://doi.org/10.17116/jnevro202112105267.

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  1. Mental Health Research Center, Moscow, Russia

    T. P. Safarova & T. P. Klyushnik

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  1. T. P. Safarova
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Correspondence to T. P. Safarova.

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Translated from Zhurnal Nevrologii i Psikhiatrii imeni S. S. Korsakova, Vol. 123, No. 9, pp. 69–75, September, 2023.

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Safarova, T.P., Klyushnik, T.P. Prognosis of Late-Life Depression: Clinical and Immunological Characteristics. Neurosci Behav Physi 54, 222–227 (2024). https://doi.org/10.1007/s11055-024-01588-9

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