Published in

Lippincott, Williams & Wilkins, International Clinical Psychopharmacology, 4(38), p. 223-230, 2023

DOI: 10.1097/yic.0000000000000472



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Age or age of onset: which is the best criterion to classify late-life depression?

Journal article published in 2023 by Paolo Olgiati, Giuseppe Fanelli ORCID, Alessandro Serretti
This paper was not found in any repository, but could be made available legally by the author.
This paper was not found in any repository, but could be made available legally by the author.

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In late-life depression (LLD), several differences between patients whose first episode is reported after age 65 (late-onset depression, LOD) and those with early-onset depression (EOD) might reflect the effects of brain ageing. To test this hypothesis, we analysed the impact of current age and age at illness onset on a number of clinical and cognitive manifestations in 438 outpatients with major depressive disorder aged >60 years, treated with venlafaxine for 12 weeks. When compared to the EOD group, patients with LOD were older (P < 0.00001) and associated with lower depression severity (P = 0.0029), lower global cognitive functioning [Mini-Mental State Examination (MMSE): P = 0.0001; Repeatable Battery for the Assessment of Neuropsychological Status: immediate memory, P = 0.0009, and delayed memory, P < 0.00001; Delis-Kaplan Executive Function System measuring executive functions: Trail-Making Test (TMT) – P = 0.0004 and Colour-Word Interference Test, Inhibition – P = 0.0063], and more dyskinesias (Abnormal Involuntary Movement Scale: P = 0.0006). After controlling for its interactions with age of onset, current age was inversely correlated with Montgomery Åsberg Depression Rating Scale scores at baseline (P < 0.00001) and week 12 (P = 0.0066), MMSE (P < 0.00001), delayed memory (P < 0.00001), and TMT (P = 0.0021). Age of onset predicted impairment in immediate (P = 0.023) and delayed memory (P = 0.0181), and dyskinesias (P = 0.0006). Although most features of LLD are related to ageing rather than to late-onset, LOD is a possible separate diagnostic entity characterised by memory dysfunction and increased liability to movement disorders.