Skip to main content
SpringerLink
Log in

The Biology of Late-Life Depression

  • Chapter
Book cover Biology of Depressive Disorders

Part of the book series: The Depressive Illness Series ((DISS,volume 4))

Abstract

Current evidence suggests that depression is clearly not a single entity but a syndrome characterized by a broad spectrum of symptom type and severity, and chronicity of illness. Depression is one of the most frequent psychiatric disorders in the geriatric population, though figures of prevalence have ranged from 5 to 44% depending on the method of identification (Blazer & Williams, 1980). Interestingly, data from the ECA study revealed that the lifetime prevalence of depression was four times lower in persons aged 65 years or older than in individuals aged 25 to 44 at the time of the ECA (Myers, Weissman, Tischer, et al., 1984). However, Berkman et al. (1986) obtained data to support the view that the presence of significant depressive symptoms, but not major depression, are more frequent among the elderly. In that study only 1–2% of the subjects fulfilled DSM III criteria for major depression but more than 10% had depressive symptoms. It is unclear at the present time whether those depressive symptoms are largely due to psychosocial factors, biological factors, or a combination of the two. Several investigators have suggested that depression in late life is a distinct entity from depression in early life. Genetic predisposition seems to play only a modest role in the aethiopathogenesis of geriatric depression when compared with a younger age group (Hopkinson, 1964; Mendlewicz, 1976).

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  • Alexopoulos GS, Lieberman KW, Young RC, et al: Platelet MAO activity and age of onset of depression in elderly depressed women. Am J Psychiatry 1984; 141: 1276–1278.

    PubMed  CAS  Google Scholar 

  • Asberg M, Theren P, Traskman L, Bertilson L, Ringsberger K: Serotonin depression, A biochemical subgroup within the affective disorders? Science 1976; 191: 478.

    Article  PubMed  CAS  Google Scholar 

  • Ashcroft GW, Crawford TBB, Eccleston et al: 5-Hydroxyindole compounds in cerebrospinal fluid of patients with psychiatric or neurological disease. Lancet 1966, ii; 1049.

    Google Scholar 

  • Awad IA, Spetzler RF, Hodak JA, et al: Incidental subcortical lesions identified on magnetic resonance imaging in the elderly. Correlation with age and cerebrovascular risk factors. Stroke 1986; 17: 1084–1089.

    Article  PubMed  CAS  Google Scholar 

  • Banki CM, Bissette GB, Arato MA, O’Connor L, Nemeroff CB: CSF corticotropinreleasing-factor-like immunoreactivity in depression and schizophrenia. Am J Psychiatry 1987; 144: 873–877.

    PubMed  CAS  Google Scholar 

  • Banki CM, Bissette G, Arato M, Nemeroff CB: Elevation of immunoreactive CSF TRH in depressed patients. Am J Psychiatry 1988; 145: 1526–1531.

    PubMed  CAS  Google Scholar 

  • Baron M, Rish N, Hamburger R, et al: Genetic linkage between X-chromosome markers and bipolar affective illness. Nature 1987; 326: 289–292.

    Article  PubMed  CAS  Google Scholar 

  • Berkman LF, Berkman CS, Casl S, et al: Depressive symptoms in relation to physical health and functioning in the elderly. Am J Epidemiol 1986; 124: 372–388.

    PubMed  CAS  Google Scholar 

  • Biegnon A, Grinspoon A, Blumerfeld B, Bleich A, Apter A, Mester R: Increased serotonin 5HT2 receptor binding on blood platelets of suicidal men. Pharmacology 1990; 140: 165–167.

    Google Scholar 

  • Blazer D, Williams CD: Epidemiology of dysphoria and depression in an elderly community population. Am J Psychiatry 1980; 137: 439–444.

    PubMed  CAS  Google Scholar 

  • Bourne HR, Bunney Jr WE, Colburn RW, et al: Noradrenalin, 5-hydroxytrypta-

    Google Scholar 

  • mine and 5HIAA in midbrains of suicidal patients. Lancet 1968; ii: 805. Buysse EW, Blazer DG, Handbook of Geriatric Psychiatry. New York: Van Nostrand Reinhold, 1980.

    Google Scholar 

  • Buysse DJ, Reynolds DF, Houck PR, et al: Age of illness onset and sleep EEG variables in elderly depressives. Biol Psychiatry 1988; 24: 355–359.

    Article  PubMed  CAS  Google Scholar 

  • Carroll BJ, Curtis GC, Davies BM, et al: Urinary free cortisol excretion in depression. Psychol Med 1976; 6: 43–50.

    Article  PubMed  CAS  Google Scholar 

  • Carroll BJ: The dexamethasone suppression test for melancholia. Br J Psychiatry 1982; 140: 292–304.

    Article  PubMed  CAS  Google Scholar 

  • Checkley SA, Slade AP, Shur P: Growth hormone and other responses to clonidine in patients with endogenous depression. Br J Psychiatry 1988; 138: 51–55.

    Article  Google Scholar 

  • Coffey CE, Figiel GS, Djang WT, et al: Leukoencephalopathy in elderly depressed patients referred to ECT. Biol Psychiatry 1988; 24: 143–161.

    Article  PubMed  CAS  Google Scholar 

  • Cohn CK, Dunner DL, Axelrod J: Reduced catechol-O-methyltransferase activity in red blood cells of women with primary affective disorder. Science 1970; 170: 1323.

    Article  PubMed  CAS  Google Scholar 

  • Davis KL, et al: Physostigmine: Improvement of long term memory processes in normal humans. Science 1978; 201: 272.

    Article  PubMed  CAS  Google Scholar 

  • Deicken RF, Reus VI, Manfredi L, Wolkowitz O: MRI deep white matter hyper- intensity in a psychiatric population. Biol Psychiatry 1991; 29: 918–922.

    Article  PubMed  CAS  Google Scholar 

  • Dencker SJ, Malm M, Roos BE, Werdinius B: Acid monoamine metabolites of cerebrospinal fluid in mental depression and mania. J Neurochem 1966; 13: 1545.

    Article  PubMed  CAS  Google Scholar 

  • Doraiswamy M, Shah SA, Figiel GS, et al: Hippocampal pathology in major depression. American Psychiatry Association 143rd New York (Abstract). 1990.

    Google Scholar 

  • Dunner DL, Levitt M, Kumbaraci T, Fieve RR: Erythrocyte catechol-O-methyltransferase activity in primary affective disorder. Biol Psychiatry 1977; 12: 237.

    PubMed  CAS  Google Scholar 

  • Evans DL, Burnett GB, Nemeroff CB: The dexamethasone suppression test in the clinical setting. Am J Psychiatry 1983; 140: 586–589.

    PubMed  CAS  Google Scholar 

  • Evans DL, Nemeroff CB: The clinical use of the dexamethasone suppression test in DSM-II affective disorders: Correlation with the severe depressive subtypes of melancholia and psychosis. J Psychiat Res 1987; 21: 185–194.

    Article  PubMed  CAS  Google Scholar 

  • Figiel GS, Krishnan KRR, Breitner JC, and Nemeroff CB: Radiologic correlates of antidepressant-induced delirium: the possible significance of basal ganglia lesions. J Neuropsychiat Clin Neurosci 1989; 1: 188–190.

    CAS  Google Scholar 

  • Figiel GS, Krishnan KRR, Doraiswamy M, and Nemeroff CB: Caudate hyper-intensities in elderly depressed patients with neuroleptic-induced parkinsonism. J Geriat Psychiat Neurol 1991; 4: 86–89.

    Article  CAS  Google Scholar 

  • Fukushima DK, Gallagher RF: Disrupted 24-hour patterns of cortisol secretion in psychotic depression. Arch Gen Psychiatry 1970; 28: 289–298.

    Google Scholar 

  • Gold MS, Pottash AC, and Extein I: Symptomless autoimmune thyroiditis in depression. Psychiat Res 1982; 6: 261–289.

    Article  CAS  Google Scholar 

  • Gold PW, Chrousos GP, Kellner CH, et al: Psychiatric implications of basic and clinical studies with corticotropin-releasing factor. Am J Psychiatry 1984; 141: 619–627.

    PubMed  CAS  Google Scholar 

  • Goodwin FK, Prange AJ, Post RM: L-triiodothyronine converts tricyclic antide- pressant nonresponders to responders. Am J Psychiatry 1982; 139: 37–42.

    Google Scholar 

  • Haggerty JJ, Simon JS, Evans DL, and Nemeroff CB: Relationship of serum TSH concentration and antithyroid antibodies to diagnosis and DST response in psychiatric inpatients. Am J Psychiatry 1987; 144: 1591–1594.

    Google Scholar 

  • Haggerty JJ, Evans DL, Golden RN, Pedersen CA, Simon JS, and Nemeroff CB: The presence of anti-thyroid antibodies in patients with affective and non-affective psychiatric disorders. Biol Psychiatry 1990; 27: 51–60.

    Article  PubMed  Google Scholar 

  • Haggarty JJ Jr, Garbutt JC, Simon JS, et al: Subclinical hypothyroidism: a review of neuropsychiatric aspects. Int J Psychiat Med 1990; 20: 193–208.

    Article  Google Scholar 

  • Hock CC, Reynolds CF, Houck RP, et al: Predicting mortality in mixed depression and dementia using sleep EEG variables. J Neuropsychiat Clin Neurosci 1989; 1: 366–371.

    Google Scholar 

  • Holsboer F, von Bardeleben U, Gerken A, et al: Blunted corticotropin and normal cortisol response to human corticotropin releasing factor in depression. N Engl J Med 1984; 311: 1137.

    Article  Google Scholar 

  • Hopkinson GA: A genetic study of affective illness in patients over 50. Br J Psychiatry 1964; 110: 244.

    Article  PubMed  CAS  Google Scholar 

  • Husain MM, Doraiswamy PM, Figiel GS, et al: Platelet 13H1-imipramine binding and leukoencephalopathy in geriatric depression. Biol Psychiatry 1991; 29: 665–670.

    Article  PubMed  CAS  Google Scholar 

  • Janowsky DS, et al: Cholinergic reversal of manic symptoms. Lancet 1972; is 1236. Janowsky DS, Davis JM, El-Yousef MK, Sekerte HJ: Acetylcholine and depression. Psychosomatic Med 1973; 35: 568.

    Google Scholar 

  • Jungue C, Pujor J, Vendrell P, et al: Leukoaraiosis on magnetic resonance imaging and speed of mental processing. Arch Neurol 1990; 47: 151–156.

    Article  Google Scholar 

  • Kastin AJ, Schalch DS, Ehrensing RH, Anderson MS: Improvement in mental depression with decreased thyrotropin response after administration of thyrotropin-releasing hormone. Lancet 1972; 2: 740–742.

    Article  PubMed  CAS  Google Scholar 

  • Kirkegaard C, Faber J, Hummer L, Rogowski P: Increased levels of TRH in cerebrospinal fluid from patients with endogenous depression. Psychoneuroendocrinology 1979; 4: 227–235.

    Article  PubMed  CAS  Google Scholar 

  • Krishnan KRR: Neuropathology of depression in the elderly: Neuroanatomical substrates. J Geriat Psychiatry (in press).

    Google Scholar 

  • Krishnan KRR, Manepalli AN, Ritchie JC, et al: Growth hormone-releasing factor stimulation test in depression. Am J Psychiatry 1987; 145: 90–92.

    Google Scholar 

  • Krishnan KRRR, Goli V, Ellinwood, et al: Leukoencepthalopathy in patients diagnosed as major depressive. Biol Psychiatry 1988; 23: 519–522.

    Article  PubMed  CAS  Google Scholar 

  • Krishnan KRR: Organic bases of depression in the elderly. Ann Rev Med 1990; 42: 261–266.

    Article  Google Scholar 

  • Kupfer DJ, Reynolds CF: Sleep and affective disorders. In: Paykel E (Ed.), Handbook of Affective Disorders: Second Edition, New York: Churchill Livingstone, 1992, pp 311–323.

    Google Scholar 

  • Lesch KP, Laux G, Pfuller H, Erb A, Beckmann H: Growth hormone response to GH-releasing hormone in depression. J Clin Endocrinol Metab 1987; 65: 1278–1281.

    Article  PubMed  CAS  Google Scholar 

  • Lipton MA, Nemeroff CB: The biology of aging and its role in depression. In: Usdin G, Hofling CK (Eds.) Aging: The Process and the People New York: Brunner/Mazel, 1978, 47–95.

    Google Scholar 

  • Lloyd KG, Farley IJ, Deck LHN, et al: Serotonin and 5HIAA in discrete areas of the brainstem of suicide victims and control patients. Adv Biochem Psychopharmacol 1974; 11: 387.

    PubMed  CAS  Google Scholar 

  • Lonergan ET, Ed: Enhancing Life. Committee on a National Research Agenda on Aging. Washington, D.C., Institute of Medicine, National Academy of Science Press, 1991.

    Google Scholar 

  • Mann JJ, Stanley M, McBride PA, McEwen BS: Increased serotonin2 and ßadrenergic receptor binding in the frontal cortices of suicide victims. Arch Gen Psychiatry 1986; 43: 954–959.

    Article  PubMed  CAS  Google Scholar 

  • Maubach M, Diebold K, Friedl W, Propping P: Platelet MAO activity in patients with affective psychosis and their first degree relatives. Pharmacopsychiatry 1981; 14: 87.

    Article  CAS  Google Scholar 

  • Mayer-Gross W, Slater E, Roth M: Clinical Psychiatry. Baltimore, MD: William and Wilkins 1954.

    Google Scholar 

  • Mendlewicz J: The age factor in depressive illness: Some genetic considerations. J Gerontol 1976; 31: 300.

    Article  PubMed  CAS  Google Scholar 

  • Mendlewicz J, Simon P, Sevy S, et al: Polymorphic DNA marker on X chromosome and manic depression. Lancet 1987; is 1230–1232.

    Google Scholar 

  • Murphy DL, Weiss R: Reduced platelet monoamine oxidase activity in blood platelet from bipolar depressed patients. Am J Psychiatry 1972; 128: 1351.

    PubMed  CAS  Google Scholar 

  • Myers JK, Weissman M, Tischler GC, et al: Six-month prevalence of psychiatric disorders in three communities. Arch Gen Psychiatry 1984; 41: 959–969.

    Article  PubMed  CAS  Google Scholar 

  • Nemeroff CB, Widerlov E, Bissette G, et al: Elevated concentration of CSF corticotropin-releasing-factor-like immunoreactivity in depressed patients. Science 1984; 226: 1342–1344.

    Article  PubMed  CAS  Google Scholar 

  • Nemeroff CB, Simon JS, Haggerty JJ, Evans DL: Antithyroid antibodies in depressed patients. Am J Psychiatry 1985; 142: 840–843.

    PubMed  CAS  Google Scholar 

  • Nemeroff CB: The neurobiology of aging and the neurobiology of depression: Is there a relationship? Neurobiol Aging 1988; 9: 120–122.

    Article  PubMed  CAS  Google Scholar 

  • Nemeroff CB, Knight DL, Krishman KRR, et al: Marked reduction in the number of platelet-titriated imipramine binding sites in geriatric depression. Arch Gen Psychiatry 1988; 45: 919–923.

    Article  PubMed  CAS  Google Scholar 

  • Nemeroff CB, Owens MJ, Bissette G, et al: Reduced corticotropin-releasing factor binding sites in the frontal cortex of suicides. Arch Gen Psychiatry 1988; 45: 577–579.

    Article  PubMed  CAS  Google Scholar 

  • Nemeroff CB, Evans DL: Thyrotropin-releasing hormone (TRH), the thyroid axis and affective disorder. Ann NY Acad Sci 1989; 533: 304–310.

    Article  Google Scholar 

  • Perry EK, et al: Necropsy evidence of central cholinergic deficits in senile dementia. Lancet 1977; 1: 189.

    Article  PubMed  CAS  Google Scholar 

  • Prange AJ, Wilson IC, Rabon AM, and Lipton MA: Enhancement of imipramine antidepressant activity by thyroid hormone. Am J Psychiatry 1969; 126: 457–469.

    PubMed  CAS  Google Scholar 

  • Prange AJ, Wilson IC, Lara PP, Alltop LB, Breese GR: Effects of thyrotropinreleasing hormone in depression. Lancet 1972; 1: 999–1002.

    Article  Google Scholar 

  • Prange AJ, Wilson IC, Lynn CW, Alltop LB, Strikeleather RA: L-tryptophan in mania: Contribution to the permissive hypothesis of affective disorders. Arch Gen Psychiatry 1974; 30: 56–62.

    Article  PubMed  Google Scholar 

  • Prinz PN, Peskind ER, Vitaliano PR, et al: Changes in the sleep and waking EEG’s of nondemented and demented elderly subjects. J Am Geriat Soc 1982; 30: 86–93.

    PubMed  CAS  Google Scholar 

  • Rao VP, Krishnan KRR, Goli V, Saunders WB, et al: Neuroanatomic changes and hypothalamo-pituitary-adrenal axis abnormalities. Biol Psychiatry 1989; 26: 729–732.

    Article  PubMed  CAS  Google Scholar 

  • Rao SM, Mittenberg W, Bernandin L, et al: Neuropsychological test findings in subjects with leukoaraiosis. Arch Neurol 1989; 46: 40–44.

    Article  PubMed  CAS  Google Scholar 

  • Reus VI, Joseph MS, Dallman MF: ACTH levels after the dexamethasone suppression test in depression. N Engl J Med 1982; 303: 228–229.

    Google Scholar 

  • Reynolds CF, Kupfer DJ: Sleep research in affective illness: State of the art circa 1987. Sleep 1987; 10: 199–215.

    PubMed  Google Scholar 

  • Reynolds CF, Kupfer DJ, Houck PR, et al: Reliable discrimination of elderly depressed and demented patients by EEG sleep data. Arch Gen Psychiatry 1988; 45: 258–264.

    Article  PubMed  Google Scholar 

  • Reynolds CF, Perel JM, Frank E, et al: Open-trial maintenance nortriptyline in late-life depression: Survival analysis and preliminary data on the use of REM latency as a predictor of recurrence. Psychopharmacol Bull 1989; 25: 129–132.

    PubMed  Google Scholar 

  • Risch SC, Lewine RJ, Kahn NH, et al: Limbic-hypothalamic-pituitary-adrenal axis activity and ventricular-to-brain ratio studies in affective illness and schizophrenia Neuropsychopharmacology 1992; 6 (2): 95–100.

    PubMed  CAS  Google Scholar 

  • Robinson DS, Nies A, Davis JN, et al: Aging, monoamines and monoamine oxidase. Lancet 1972; 1: 290.

    Article  PubMed  CAS  Google Scholar 

  • Robinson DS, Sourkes TL, Nies A, et al: Monoamine metabolism in human brain. Arch Gen Psychiatry 1977; 34: 89.

    Article  PubMed  CAS  Google Scholar 

  • Rush AJ, Erman MK, Giles DG, et al: Polysomnographic findings in recently drug-free and clinically remitted depressed patients. Arch Gen Psychiatry 1986; 43: 878–884.

    Article  PubMed  CAS  Google Scholar 

  • Sachar EJ, Hellman L, Fukushima DK, Gallager RF: Cortisol production in depressive illness. Arch Gen Psychiatry 1970; 23: 189–298.

    Article  Google Scholar 

  • Salomon A, Yeates AE, Burger PC, Heinz R: Subcortical arteriosclerotic encephalopathy: Brainstem findings with MR imaging. Radiology 1987; 165: 625–629.

    PubMed  CAS  Google Scholar 

  • Samorajski T, Rodsten C, Ordy JM: Changes in behavior, brain, and neuroendocrine chemistry with age and stress in C57BL/6J male mice. J Gerontol 1971; 26: 168.

    Article  PubMed  CAS  Google Scholar 

  • Schildkraut JJ: Catecholamine hypothesis of affective disorders. Am J Psychiatry 1965; 122: 509.

    PubMed  CAS  Google Scholar 

  • Sherman B, Pfohl B, Winokur G: Circadian analysis of plasma cortisol levels before and after dexamethasone administration in depressed patients. Arch Gen Psychiatry 1984; 41: 271–275.

    Article  PubMed  CAS  Google Scholar 

  • Slater E, Cowie V: The Genetics of Mental Disorders. London: Oxford University Press, 1971.

    Google Scholar 

  • Slotkin TA, Whitmore WL, Barnes GA, et al: Reduced inhibitory effect of imipramine on radiolabeled serotonin uptake into platelets in geriatric depression. Biol Psychiatry 1989; 25: 687–691.

    Article  PubMed  CAS  Google Scholar 

  • Vijayashankar N, Brodie H: A quantitative study of the pigmented neurons in the nuclei locus coeruleus and subcoeruleus in man as related to aging. J Neuropathol Exper Neurol 1979; 38: 490–497.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia, 30322-4990, USA

    Charles B. Nemeroff

  2. Department of Psychiatry, Duke University Medical Center, Durham, North Carolina, 27710, USA

    P. Rodrigo Escalona, K. Ranga & R. Krishnan

  3. Department of Psychiatry, University of Pittsburgh, Western Psychiatric Institute and Clinic, Pittsburgh, Pennsylvania, 15213-2593, USA

    Charles F. Reynolds III

Authors
  1. Charles B. Nemeroff
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. P. Rodrigo Escalona
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. K. Ranga
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. R. Krishnan
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Charles F. Reynolds III
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. University of Pittsburgh, Pittsburgh, Pennsylvania, USA

    J. John Mann M.D.  & David J. Kupfer M.D.  & 

Rights and permissions

Reprints and permissions

Copyright information

© 1993 Springer Science+Business Media New York

About this chapter

Cite this chapter

Nemeroff, C.B., Escalona, P.R., Ranga, K., Krishnan, R., Reynolds, C.F. (1993). The Biology of Late-Life Depression. In: Mann, J.J., Kupfer, D.J. (eds) Biology of Depressive Disorders. The Depressive Illness Series, vol 4. Springer, Boston, MA. https://doi.org/10.1007/978-1-4757-9501-1_3

Download citation

  • DOI: https://doi.org/10.1007/978-1-4757-9501-1_3

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4757-9503-5

  • Online ISBN: 978-1-4757-9501-1

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation