Geriatric Depression and Cognitive Impairment: A Follow up Study

Abstract

Introduction: Depression in older adults has become a major problem for public health. A high percentage of this population is under-diagnosed in primary care. The objectives of this work were firstly, to investigate the causes, risk factors, cognitive profile, functional status and quality of life of patients with geriatric depression, and secondly, to make a follow up of these patients. Materials and methods: Patients who consulted for memory problems associated with depression were recruited during the years 2005-2007. A semi-structured neuropsychiatric interview, an extensive neuropsychological battery, and complementary studies were performed. Results: One hundred and one depressive patients and 25 normal controls were evaluated. There was a significant prevalence and incidence of depression in the geriatric population. Significant differences (p<0.05) were found between depressive patients and controls in dyslipidemia, heart disease, cerebrovascular disease, inadequate family support, family history of depression and inactivity (OR 6.5). A global cognitive impairment was frequently associated with depression. Depression caused an alteration in functional status. Follow up results: From the 101 patients evaluated only 61 attended to the follow up visit (61.4%). All patients were indicated antidepressant treatment. Of these, only 36 patients continue with the treatment indicated in the baseline visit. Of the patients who were in antidepressant treatment (n=36) 46.6% had an excellent to good response, and 13.3% had a response from fair to poor. The main causes of poor response were adverse effects, low-dose and treatment neglect. Of the reevaluated patients, 56.6% improved in cognition or mood. The greatest improvement was observed in depression and anxiety affective symptoms. Within the cognitive profile, memory and attention trend to improve with medical treatment. Conclusion: Depression is a prevalent disease in the elderly population. It is important to implement health policies to inform the community, prevent associated risk factors, and promote appropriate treatments and rehabilitation. This condition not only affects the patient but also their environment.