This five-year longitudinal project will study the clinical presentation, outcomes, and predictors of outcomes of geriatric depression with a focus on the effect of age of illness onset. The hypothesis is that patients with first occurrence of depression in late life (LLD) differ from subjects have first occurrence of depression in early life (ELD) in the following ways: 1) more LLD subjects have delusion, medical morbidity, and/or cognitive dysfunction during episodes; 2) LLD subjects have poorer outcome, including more relapses, dementia, and medical morbidity; and 3) LLD subjects have different demographic, clinical, and psychosocial predictors for specific outcomes. This hypothesis is based on findings, including our preliminary data, which suggest that clinical, biological and family history differences exist between LLD and ELD. Three groups will be studied: 1) the LLD group (N = 65), which consists of subjects who first had depression between age 65 and 85 years; 2) the old- ELD group (N = 65), which will include subjects age-matched with the old ELD group and first experienced depression between age 20-64 years. After an extensive initial evaluation, the subjects will have a person-to-person assessment every six months and will also be contacted by telephone between person-to-person assessments. The study will use recently developed methods for longitudinal investigations (Longitudinal Interval Follow-Up Evaluation, LIFE, for assessment; Life Table Method for data analysis) which provide clinically relevant information such as outcome probabilities for individual patients. The study is expected to yield information that clinicians can use to: 1) determine prognosis of geriatric depression; 2) assess risk-benefit ratio of therapeutic or preventive interventions; 3) identify periods of highest risk for adverse outcomes, and plan treatment accordingly. We anticipate that findings from this study will stimulate clinical research testing new treatment and prevention models, and will comprise the background for studies seeking to identify subtypes of geriatric depression with different clinical and biological characteristics.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Research Project (R01)
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Life Course and Prevention Research Review Committee (LCR)
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Weill Medical College of Cornell University
Schools of Medicine
New York
United States
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Kiosses, D N; Alexopoulos, G S (2013) The prognostic significance of subsyndromal symptoms emerging after remission of late-life depression. Psychol Med 43:341-50
Murphy, Christopher F; Alexopoulos, George S (2006) Attention network dysfunction and treatment response of geriatric depression. J Clin Exp Neuropsychol 28:96-100
Alexopoulos, George S; Kiosses, Dimitris N; Heo, Moonseong et al. (2005) Executive dysfunction and the course of geriatric depression. Biol Psychiatry 58:204-10
Murphy, Christopher F; Alexopoulos, George S (2004) Longitudinal association of initiation/perseveration and severity of geriatric depression. Am J Geriatr Psychiatry 12:50-6
Alexopoulos, George S; Kiosses, Dimitris N; Murphy, Christopher et al. (2004) Executive dysfunction, heart disease burden, and remission of geriatric depression. Neuropsychopharmacology 29:2278-84
Kalayam, Balu; Alexopoulos, George S (2003) A preliminary study of left frontal region error negativity and symptom improvement in geriatric depression. Am J Psychiatry 160:2054-6
Alexopoulos, George S; Raue, Patrick; Arean, Patricia (2003) Problem-solving therapy versus supportive therapy in geriatric major depression with executive dysfunction. Am J Geriatr Psychiatry 11:46-52
Alexopoulos, George S; Borson, Soo; Cuthbert, Bruce N et al. (2002) Assessment of late life depression. Biol Psychiatry 52:164-74
Katz, Ira R; Reynolds 3rd, Charles F; Alexopoulos, George S et al. (2002) Venlafaxine ER as a treatment for generalized anxiety disorder in older adults: pooled analysis of five randomized placebo-controlled clinical trials. J Am Geriatr Soc 50:18-25
Alexopoulos, George S; Kiosses, Dimitris N; Klimstra, Sibel et al. (2002) Clinical presentation of the ""depression-executive dysfunction syndrome"" of late life. Am J Geriatr Psychiatry 10:98-106

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