Longitudinal association of initiation/perseveration and severity of geriatric depression.

OBJECTIVE: 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. METHODS: The authors studied the longitudinal covariation of depression severity and IP functioning in 157 depressed older adults with MDD. Patients with and without baseline IP impairment were studied on three occasions over 1 year. RESULTS: Depression severity was associated with concurrent IP scores; however, despite IP improvement, those with impaired baseline IP functioning did not reach the level of their non-impaired counterparts. CONCLUSION: The persistence of IP abnormalities suggests that these patients require careful treatment planning and follow-up, given that earlier studies noted an association of abnormal IP with disability and poor outcomes of depression treatment.     

The pathogenetic significance of C5b-9 in IgA nephropathy

Renal biopsies from 20 patients with IgAN were retrospectivelystudied using monoclonal antibodies against T cells, monocytes/macrophages(MM), HLA-DR-related antigen and the C5b-9 neoantigen. GlomerularC5b-9 deposits were mainly found in the mesangial areas andshowed an association with IgA (P<0.005) and C3 deposits(P<0.001). Interstitial T cells and MM were highly correlatedwith the interstitial DR+ve cells (P<0.001 and P<0.0005respectively). Tubular C5b-9 deposition was observed on thetubular basement membranes and related to the numbers of interstitialT cells (P<0.005), MM (P<0.005) and DR+ve cells (P<0.01)as well as to the tubular DR expression (P <0.025). The severityof tubular atrophy and interstitial fibrosis showed a positivecorrelation with the interstitial T cells, MM and DR+ve cells,as well as with the intensity of tubular C5b-9 deposition (P<0.05and P<0.05 respectively). Plasma creatinine on presentationwas correlated with the numbers of interstitial T cells (P<0.05),MM (P<0.01), interstitial DR+ve cells (P<0.005), and tubularC5b-9 deposits (P<0.005). No correlation between glomerularT cells, MM, and C5b-9 deposits with plasma creatinine was seen.During follow-up, renal function deteriorated in those patientswith the more extensive tubular C5b-9 deposits In conclusion, glomerular C5b-9 deposition seems to be secondaryto the IgA and C3 deposition. In contrast, tubular C5b-9 isrelated to the numbers of interstitial T cells and MM. Activatedinterstitial mononuclear cells may lead to the tubular depositionof C5b-9, which eventually might contribute to the developmentof tubulointerstitial lesions (TIL) and renal function impairment     

Plasma 10-hydroxynortriptyline and ECG changes in elderly depressed patients

Among 18 elderly depressed patients given ECGs before and during nortriptyline treatment, plasma E-10-hydroxynortriptyline and the sum of E-10-hydroxynortriptyline and nortriptyline distinguished the group with conduction/repolarization effects. Plasma nortriptyline, age, drug dose, and baseline cardiovascular status did not.     

Drug-induced dystonia in young and elderly patients

This retrospective study examined the common notion that neuroleptic-induced dystonia is less frequent in elderly patients. The hospital records of 45 young patients and 45 elderly patients were reviewed. Thirty-one percent of the young patients developed dystonia, compared to 2% of the elderly patients. This significant difference did not appear to be the result of types of neuroleptics used, dose, or concomitant administration of anticholinergic drugs.     

Brain changes in geriatric depression

The clinical and neurobiological literature of geriatric depression which focuses on the relationship between depression and dementia is reviewed. The hypothesis that depression of late life and dementia are linked by a spectrum of underlying ageing-associated brain changes is presented, and the implications for future research are discussed.