George S Alexopoulos

..The authors used diffusion tensor imaging to test the hypothesis that depressed elders who fail to achieve remission have microstructural white matter abnormalities in cortico-striato-limbic networks implicated in geriatric depression...

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..This paper examines whether age-related and comorbid disease-related immune deregulation is an etiologic contributor to geriatric depression...

..If replicated, PID-C may serve as a care model for patients with both depression and medical illnesses with a deteriorating course...

..This is a preliminary study of its efficacy...

..This study examined whether functional connectivity at rest (FC) within these networks characterizes late-life depression and predicts antidepressant response...

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..The effect of risperidone augmentation of citalopram for relapse prevention in older patients with antidepressant-resistant depression was evaluated...

..There is early evidence that psychosocial interventions aimed at improving the behavioral deficits of DED patients may also be effective in increasing remission rates and reducing depressive symptoms and disability...

..Thus, these findings suggest that two distinct conflict-processing functions of the anterior cingulate are important for antidepressant response of geriatric depression...

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..This study examined the relationship of executive impairment to the course of depressive symptoms among elderly patients with major depression...

..However, in North America at least, public insurance covers these services inadequately...

..The findings of this study provide the rationale for investigation of the role of specific frontostriatal-limbic pathways in predisposing to geriatric depression or worsening its course...

..Disability, hopelessness, lack of acceptance of antidepressant treatment, and limited problem-solving skills contribute to poor treatment adherence, compromised outcomes, and chronically experienced adversity...

..Although several brain abnormalities have been identified in geriatric depression, their relationship to the pathophysiological mechanisms leading to the development and perpetuation of this syndrome remain unclear...

..In addition, it sought to identify risk factors for nonremission that could guide treatment planning and referral to care managers or specialists...

..This is the first report of outcomes over a 2-year period...

..To serve as a conceptual map of the role of new interventions designed to reduce the burden of late-life depression...

..This study compared microstructural abnormalities in depressed elders and controls and studied the association of the serotonin transporter gene status to white matter abnormalities and to remission of depression...

..Non-pharmacological approaches addressing their behavioral deficits may reduce disability and experienced stress and improve depression...

..This study tested the hypothesis that microstructural abnormalities in white matter areas of the brain containing frontostriatal tracts are associated with a low rate of remission of geriatric depression...

..Older patients with depression and executive dysfunction represent a population with significant disability and a high likelihood of failing pharmacotherapy...

..This study tested the hypothesis that microstructural white matter abnormalities in frontostriatal-limbic tracts are associated with poor response inhibition on the Stroop task in depressed elders...

..The intervention's effectiveness in reducing suicidal ideation, regardless of depression severity, reinforces its role as a prevention strategy to reduce risk factors for suicide in late life...

..Our hope is that continued scientific discussion of and testing of visual inspection methods will lead to the development of improved, cost-effective fMRI denoising procedures...

..The objective of this study was to examine the association between social support, self-efficacy, and functioning among a sample of depressed older adults with chronic obstructive pulmonary disease (COPD)...

..This study used neuropsychological measures of executive skills to examine the functioning of frontostriatal networks in elderly bipolar patients...

..Problem-solving therapy was modified to be accessible to this population. Participants were randomly assigned to 12 weekly sessions of problem-solving therapy or supportive therapy and assessed at weeks 3, 6, 9, and 12...

..Cautions and limitations regarding the reliance on randomized, controlled trials, meta-analyses, and systematic reviews also are presented...

..We hypothesized that patients who failed to remit during a 12-week controlled treatment trial of escitalopram would exhibit smaller anterior cingulate gray matter volumes than patients who remitted...

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..Improvement of depression may be the result of behavioral interventions rather than the use of antidepressant drugs...

..The authors argue that the available methods provide complementary information and that, when combined judiciously, can increase the knowledge gained from neuroimaging findings and conceptually advance the field of geriatric depression...

..This study tested the hypothesis that frontal error negative wave amplitude on EEG during Stroop test activation predict change in depressive symptoms in depressed elders...

..This study examined whether there is a relationship among BDNF genotype, hippocampal volumes, and MDD in older adults...

..Although depressive conditions in later life are a major public health problem, the outcomes of minor and subsyndromal depression are largely unknown...

..These findings may aid clinicians in identifying patients needing vigilant follow-up, because depression with executive dysfunction was found to be associated with disability, poor treatment response, relapse, and recurrence...

..We hypothesized that patients who failed to remit during a 12-week controlled treatment trial of escitalopram would exhibit greater SH burden than patients who remitted...

..The objective of this study was to identify subtle white matter abnormalities in late-life depression...

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..This study tests the hypothesis that the use of semantic organizational strategy during the free-recall phase of a verbal memory task predicts remission of geriatric depression...

..This study focused on the placebo lead-in phase and examines whether change in severity of depression during placebo lead-in predicts change in depressive symptoms during antidepressant treatment...

..The intervention supplements antidepressant therapy for depression with an individualized care manager who targets psychological barriers that interfere with treatment participation...

..e., Sexual Interest, Increased Activity-Energy, Speech--Rate and Amount, and Disruptive-Aggressive Behavior...

..A new intervention is needed in this population as antidepressant treatment is effective in only a minority of these patients...

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..This report considers the conceptual and methodological concerns confronting clinical investigators seeking to generate knowledge regarding the tolerability and benefits of pharmacotherapy in geriatric bipolar disorder (BD) patients...

..Interventions that not only address the depressive syndrome but also manage social adversity are sorely needed to help this patient population recover from depression...

..Prevention and treatment trials are underway to detect the effectiveness of improved treatment of depression by primary care physicians as a means of reducing the prevalence of depressive symptoms, hopelessness and suicidal ideation...

..There have been mixed findings regarding the prognostic significance of age of onset, executive dysfunction, and hyperintensity burden on treatment outcome in late-life depression...

..Care managers working together with primary care physicians can improve the recognition and treatment of depressed elderly patients by obtaining the training in using validated instruments and treatment algorithms...

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..It has been hypothesized that depressive symptoms and dementia may be attributable to underlying vascular disease in some older persons...

..This article describes a novel treatment model designed to target specific neurocognitive deficits in geriatric depression with neuroplasticity-based computerized cognitive remediation (NBCCR)...

..Conversely, disengagement strategies involve the withdrawal of these resources from obsolete or unattainable health goals, combined with goal restructuring...

..Our results suggest that such compensatory mechanisms are not restricted to later higher-order cognitive processes but may also be a feature of early sensory-perceptual processes...

..The objective of this study is to document the rates of depression and correlates among a population of homebound elders...

..The successful treatment of comorbid conditions that increase central nervous system inflammatory responses has general health benefits and should be part of clinical practice...

..If these findings are confirmed, PST may become an important therapeutic alternative for a patient population who may otherwise remain symptomatic and disabled...

..The authors assessed frontal and subcortical SH in elderly bipolar manic patients and the comparison group, and hypothesized that SH scores would be greater in the patient group...

..The few treatment studies that have been conducted in the geriatric population since the publication of the guidelines have had mixed results and high placebo response rates. More large controlled trials are needed...

..CONCLUSIONS: These relationships may provide the background for developing interventions targeting functional deficits associated with specific cognitive dysfunctions and depression...

..To estimate the projected population of US adults aged 18 years or older with lifetime experience of doctor-diagnosed depressive disorder from 2005-2050...

..Timely identification of attentional and executive processes fundamental to the daily functioning of depressed older adults may lead to compensatory strategies that will improve the outcomes of late-life depression...

..The TIP is an individualized, early intervention to address older adults' attitudes (e.g., perceived need for care and stigma) about depression and treatment...

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..Many older adults with major depression (MDD) present with impairment in initiation and perseveration (IP) tests. However, it remains unclear how these abnormalities change during the course of depression...

..Plasma DbetaH is under genetic control by the structural locus encoding DbetaH protein, DBH. This study tested the hypothesis that diagnosis-specific allelic variation at DBH accounts for lower plasma DbetaH in UDPF...

..Structural magnetic resonance imaging (MRI) can be used to identify and quantify non-disease-related aging of the cerebral white matter...

..Collaborative depression care management (DCM), by addressing barriers disproportionately affecting patients of racial/ethnic minority and low education, may reduce disparities in depression treatment and outcomes...

..In this small sample of patients, increased depressive symptoms at 6 months after surgery appear to be associated with the occurrence of subsequent major cardiac morbidity/ mortality...

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..CONCLUSION: Venlafaxine ER is equally safe and well tolerated by and shows similar efficacy in younger and older patients in the treatment of GAD...

..The anticipated growth in the population of older persons with mental disorders underscores the need for a strategy to facilitate the systematic and effective implementation of evidence-based practices in geriatric mental health care...

..The authors described the influence of specific medical conditions on clinical remission and response of major depression (MDD) in a clinical trial evaluating a care-management intervention among older primary-care patients...

..This study evaluated the efficacy and safety of escitalopram versus duloxetine in the acute treatment of patients with moderate to severe major depressive disorder...

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..Within the limits of expert opinion and with the expectation that new research data will take precedence, these guidelines may provide direction for clinicians offering care to patients with dementia...

..To describe the influence of domains of cognition on remission and response of depression in an intervention trial among older primary care patients...

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..Studies on the course of major depressive disorder (MDD) among elderly persons are limited to short periods of follow-up, seldom provide comparisons with younger cohorts, and raise other methodological concerns...

..Clinicians should keep in mind that no guidelines can address the complexities of an individual patient and that sound clinical judgment based on clinical experience should be used in applying these recommendations...

..If CM-PST were found efficacious, it may be offered by trained case-workers of social services to large numbers of depressed, homebound, low-income elders. ..

..Finally, we believe that our approach to the care of depressed, medically ill patients can generate a practice model that has the ability to rapidly incorporate advances made in clinical science. ..

..Beyond a Core Curriculum, we guide and support our trainees in conducting their own research studies, in preparing competitive funding applications, and in publishing data-based papers. ..

..If CM-PST were found efficacious, it may be offered by trained case-workers of social services to large numbers of depressed, homebound, low-income elders. ..

..We are confident that our work will both advance scientific knowledge and have a broad impact on the care of depressed, disabled elders. ..

..Such patients could be targeted for a vigilant clinical follow-up and a comprehensive treatment plan including a plan for successive pharmacological trials. ..

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..If CM-PST were found efficacious, it may be offered by trained case-workers of social services to large numbers of depressed, homebound, low-income elders. ..

..Such patients could be targeted for a vigilant clinical follow-up and a comprehensive treatment plan including a plan for successive pharmacological trials. ..

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..The clinical significance of the proposed study is that it can guide research leading to physiologically meaningful, novel antidepressant therapies aimed at aging-related frontal system dysfunction. ..

..Data will also be collected to document the impact of intervention on patient care, and on physician knowledge, attitudes, and satisfaction and test hypotheses derived from preliminary studies of the three IRCs. ..

..Accordingly, we are well positioned to meet the challenges inherent in this difficult but important area of research. ..

..Accordingly, we are well positioned to meet the challenges inherent in this difficult but important area of research. ..

..Such patients could be targeted for a vigilant clinical follow-up and a comprehensive treatment plan including a plan for successive pharmacological trials. ..