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1. Prevalence of Geriatric Depression and Alexithymia and their association with sociodemographic characteristics in a sample of elderly persons living in Buenos Aires, Argentina

Author

María Florencia Tartaglini, Carol Dillon, Paula Daniela Hermida, Carolina Feldberg, Verónica Somale, and Dorina Stefani

Subjects
Depression, Alexithymia, Elderly, Geriatrics, RC952-954.6
Abstract

Abstract Objective: to evaluate the prevalence of Geriatric Depression and Alexithymia and their association with sociodemographic characteristics in independent elderly persons without known depression. Method: a cross-sectional study was conducted, based on a non-probabilistic, intentional type sampling strategy. A total of 176 independent men and women aged over 60 years residing in the city of Buenos Aires, Argentina, were evaluated through individual interviews using the following instruments: a sociodemographic (ad hoc) questionnaire, an adapted version of the questionnaire of the Yesavage Geriatric Depression Scale (V-15) and the Latin American Alexithymia LAC TAS-20 Scale. The Chi-squared and Student's t-tests were used and the Odds Ratio was calculated, with a probability of error less than or equal to 0.05. Results: The mean age was 73 years (+7.1 years) and 72.7% of the participants were women. The prevalence of Geriatric Depression was 35.8%, while that of Alexithymia was 50.6%. The presence of Geriatric Depression was significantly associated with the female gender and with individuals who did not work. High Alexithymia values were observed among those with primary education and a low occupational level. Conclusion: The evaluation of Geriatric Depression and Alexithymia in clinical care is recommended, and the social determinants of the health of the elderly should also be considered in the diagnosis and treatment of these conditions.

Published
2017
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2. The Efficacy of Cognitive Stimulation on Depression and Cognition in Elderly Patients with Cognitive Impairment: A Retrospective Cohort Study

Author

Federerico Filipin, Mónica Feldman, María Martelli, Viviana Sánchez, Virginia García, Graciela Tufro, Cecilia Serrano, Fernando E. Taragano, Silvina Heisecke, and Carol Dillon

Subjects
mild cognitive impairment, Alzheimer Disease, dementia, cognitive stimulation, cognitive reserve, Medicine (General), R5-920
Abstract

Cognitive decline due to neurodegenerative diseases is a prevalent worldwide problem. Both pharmacological and non-pharmacological treatments to improve, delay or stop disease progression are of vital importance. Cognitive stimulation is frequently used in clinical practice; however, there are few studies that demonstrate its efficacy. Aim: To evaluate the efficacy of cognitive stimulation in patients with mild cognitive impairment (CDR = 0.5) and dementia (CDR = 1). Methods: A retrospective cohort study was performed. Patients with cognitive impairment receiving weekly cognitive stimulation (16 or 24 sessions) were evaluated with a complete neuropsychological battery before and after the stimulation program. Each stimulation session was carried out by a trained neuropsychologist. Results: Forty two patients receiving cognitive stimulation were evaluated over a period of 12.53 months (SD 5.5). Patients were grouped as 11 amnesic mild cognitive impairment (aMCI), 23 multi domain mild cognitive impairment (mMCI) and 8 Mild Alzheimer's Dementia (CDR 1). None of the groups improved their cognitive functions after the cognitive stimulation program. MCI group was also divided according to their global intelligence quotient (IQ) into two groups: low (IQ < 98.5) and high (IQ > 98.5). Each group was compared before and after the stimulation program and no significant difference was found (p ≥ 0.05). Moreover, MCI group was also analyzed according to the duration of the stimulation program: less than 9, between 9 and 13 and more than 13 months. Different duration groups were compared before and after the cognitive stimulation program and no significant differences were found. Depression, anxiety and subjective memory symptoms were also analysed and neither improvement nor worsening could be demonstrated. Conclusions: Patients remained stable, both in cognitive and behavioural domains, for more than 18 months. However, no significant cognitive or behavioural improvement can be reported in these patients after the stimulation program (duration time: 12.53 months SD 5.5).

Published
2015
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3. Late- versus early-onset geriatric depression in a memory research center

Author

Carol Dillon, Ricardo F Allegri, Cecilia M Serrano, and et al

Subjects
Neurosciences. Biological psychiatry. Neuropsychiatry, RC321-571, Neurology. Diseases of the nervous system, RC346-429
Abstract

Carol Dillon1, Ricardo F Allegri2, Cecilia M Serrano1, Mónica Iturry1, Pablo Salgado1, Frank B Glaser1, Fernando E Taragano21Memory Research Center, Department of Neurology, Hospital General Abel Zubizarreta, GCBA Buenos Aires, Argentina; 2Department of Neuropsychology (SIREN), CEMIC University, Buenos Aires, ArgentinaObjective: To contrast early-onset (60 years) depression in geriatric patients by evaluating differences in cognition, vascular comorbidity and sociological risk factors. Both patient groups were compared with normal subjects.Materials and methods: We recruited 76 patients with depressive symptoms (37 late onset and 39 early onset) and 17 normal controls matched by age and educational level. All subjects were assessed using a semistructured neuropsychiatric interview and an extensive neuropsychological battery. Vascular and sociological risk factors were also evaluated.Results: We found a significant variation in performance between depressive patients and normal controls in most cognitive functions, especially memory (P < 0.0001), semantic fluency (P < 0.0001), verbal fluency, and digit-symbol (P < 0.0001). Late-onset depression patients scored lower and exhibited more severe impairment in memory domains than early-onset depression patients (P < 0.05). Cholesterol levels and marital status were significantly (P < 0.05) different between the depressive groups. Both depressed groups (early- and lateonset) were more inactive than controls (P < 0.05; odds ratio: 6.02).Conclusion: Geriatric depression may be a manifestation of brain degeneration, and the initial symptom of a dementia. It is important to consider this in the treatment of patients that exhibit late-onset depressive symptoms.Keywords: early- and late-onset depression, geriatrics, cognition

Published
2009

4. Role of cognitive reserve in progression from mild cognitive impairment to dementia

Author

Ricardo F. Allegri, Fernando E. Taragano, Hugo Krupitzki, Cecilia M. Serrano, Carol Dillon, Diego Sarasola, Mónica Feldman, Graciela Tufró, María Martelli, and Viviana Sanchez

Subjects
mild cognitive impairment, risk factors, dementia, cognitive reserve, Neurosciences. Biological psychiatry. Neuropsychiatry, RC321-571
Abstract

Abstract Cognitive reserve is the ability to optimize performance through differential recruitment of brain networks, which may reflect the use of alternative cognitive strategies. Objectives: To identify factors related to cognitive reserve associated with progression from mild cognitive impairment (MCI) to degenerative dementia. Methods: A cohort of 239 subjects with MCI (age: 72.2±8.1 years, 58% women, education: 12 years) was assessed and followed for five years (2001 to 2006). Results: In the first year, 13.7% of MCI converted to dementia and 34.7% converted within three years (78.3% converted to Alzheimer's dementia). Risk factors for those who converted were education less than 12 years, MMSE score less than 27, Boston naming test score less than 51, IQ (Intelligence Quotient) less than 111, age over 75 years, lack of occupation at retirement, and presence of intrusions in memory recall (all account for 56% of the variability of conversion). Conclusions: MCI patients are a population at high risk for dementia. The study of risk factors (e.g. IQ, education and occupation), particularly those related to cognitive reserve, can contribute important evidence to guide the decision-making process in routine clinical activity and public health policy.

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5. The economic cost of Alzheimer's disease: Family or public-health burden?

Author

Diego M. Castro, Carol Dillon, Gerardo Machnicki, and Ricardo F. Allegri

Subjects
Alzheimer's disease, economic costs, health economics, Neurosciences. Biological psychiatry. Neuropsychiatry, RC321-571
Abstract

Abstract Alzheimer's disease (AD) patients suffer progressive cognitive, behavioral and functional impairment which result in a heavy burden to patients, families, and the public-health system. AD entails both direct and indirect costs. Indirect costs (such as loss or reduction of income by the patient or family members) are the most important costs in early and community-dwelling AD patients. Direct costs (such as medical treatment or social services) increase when the disorder progresses, and the patient is institutionalized or a formal caregiver is required. Drug therapies represent an increase in direct cost but can reduce some other direct or indirect costs involved. Several studies have projected overall savings to society when using drug therapies and all relevant cost are considered, where results depend on specific patient and care setting characteristics. Dementia should be the focus of analysis when public health policies are being devised. South American countries should strengthen their policy and planning capabilities by gathering more local evidence about the burden of AD and how it can be shaped by treatment options.

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6. Biomarkers in Mild Stages of Alzheimer’s disease: Utility in clinical practice and their relation with nutritional and lifestyle factors

Author

Leandro Lon, Patricio Perez Leguizamon, Jorge Santiago López Camelo, Veronica Guelar, Fernando E. Taragano, Silvina L Heisecke, Cecilia Serrano, Carol Dillon, and Diego Castro

Subjects
medicine.medical_specialty, Alternative medicine, MEDLINE, Medicine (miscellaneous), lcsh:TX341-641, Disease, Clinical practice, Biochemistry, 03 medical and health sciences, 0302 clinical medicine, Utility, Early treatment, medicine, Dementia, Intensive care medicine, Nutritional and Lifestyle Factors, lcsh:R5-920, Nutrition and Dietetics, business.industry, medicine.disease, 030227 psychiatry, Clinical Practice, Clinical trial, Clinical research, Physical therapy, Biomarker (medicine), business, lcsh:Medicine (General), Alzheimer’s disease, lcsh:Nutrition. Foods and food supply, 030217 neurology & neurosurgery, Biomarkers, Food Science
Abstract

Background : The use of biomarkers in basic and clinical research as well as in clinical practice has become so common that their presence as primary endpoints in clinical trials is now accepted. A biomarker refers to a broad subcategory of medical signs. The aims of this article are to consider the of use biomarkers in Mild stages of Alzheimer’s disease (AD) in research and clinical settings, in addition to defining their utility in clinical practice relating this with nutritional and lifestyle factors as possible treatment. Methods : We searched MEDLINE, PubMed, and AgeLine databases using different keywords. Conclusions : A summary of the utility of biomarkers in AD and nutritional and lifestyle factors used as treatment in mild stages are described. Key words : Biomarkers, Alzheimer’s disease , Dementia, Utility, Clinical practice, Nutritional

Published
2016

7. P3‐523: PREVALENCE OF GERIATRIC DEPRESSION AND ALEXITHYMIA IN WIFE CAREGIVERS OF PATIENTS WITH DEMENTIA

Author

Paula Daniela Hermida, Carol Dillon, Veronica Somale, Carolina Feldberg, Dorina Stefani, and María Florencia Tartaglini

Subjects
medicine.medical_specialty, Epidemiology, business.industry, Health Policy, media_common.quotation_subject, medicine.disease, Psychiatry and Mental health, Cellular and Molecular Neuroscience, Developmental Neuroscience, Alexithymia, Wife, Medicine, Dementia, Neurology (clinical), Geriatrics and Gerontology, business, Psychiatry, Depression (differential diagnoses), media_common
Published
2018
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8. The Efficacy of Cognitive Stimulation on Depression and Cognition in Elderly Patients with Cognitive Impairment: A Retrospective Cohort Study

Author

Maria Catalina Martelli, Fernando E. Taragano, Federerico Filipin, Viviana Sanchez, Silvina Lidia Heisecke Peralta, Carol Dillon, Monica Feldman, Virginia Garcia, Graciela Tufró, and Cecilia M. Serrano

Subjects
medicine.medical_specialty, MILD COGNITIVE IMPAIRMENT, CIENCIAS MÉDICAS Y DE LA SALUD, Medicina Clínica, cognitive stimulation, mild cognitive impairment, Alzheimer Disease, purl.org/becyt/ford/3.2 [https], medicine, Dementia, Psychiatry, Cognitive impairment, ALZHEIMER DISEASE, Depression (differential diagnoses), Cognitive reserve, lcsh:R5-920, Cognitive stimulation, DEMENTIA, Neurología Clínica, Cognition, Retrospective cohort study, General Medicine, medicine.disease, cognitive reserve, purl.org/becyt/ford/3 [https], COGNITIVE STIMULATION, Alzheimer's disease, Psychology, lcsh:Medicine (General), Clinical psychology, dementia
Abstract

Cognitive decline due to neurodegenerative diseases is a prevalent worldwide problem. Both pharmacological and non-pharmacological treatments to improve, delay or stop disease progression are of vital importance. Cognitive stimulation is frequently used in clinical practice; however, there are few studies that demonstrate its efficacy. Aim: To evaluate the efficacy of cognitive stimulation in patients with mild cognitive impairment (CDR = 0.5) and dementia (CDR = 1). Methods: A retrospective cohort study was performed. Patients with cognitive impairment receiving weekly cognitive stimulation (16 or 24 sessions) were evaluated with a complete neuropsychological battery before and after the stimulation program. Each stimulation session was carried out by a trained neuropsychologist. Results: Forty two patients receiving cognitive stimulation were evaluated over a period of 12.53 months (SD 5.5). Patients were grouped as 11 amnesic mild cognitive impairment (aMCI), 23 multi domain mild cognitive impairment (mMCI) and 8 Mild Alzheimer’s Dementia (CDR 1). None of the groups improved their cognitive functions after the cognitive stimulation program. MCI group was also divided according to their global intelligence quotient (IQ) into two groups: low (IQ < 98.5) and high (IQ > 98.5). Each group was compared before and after the stimulation program and no significant difference was found (p ≥ 0.05). Moreover, MCI group was also analyzed according to the duration of the stimulation program: less than 9, between 9 and 13 and more than 13 months. Different duration groups were compared before and after the cognitive stimulation program and no significant differences were found. Depression, anxiety and subjective memory symptoms were also analysed and neither improvement nor worsening could be demonstrated. Conclusions: Patients remained stable, both in cognitive and behavioural domains, for more than 18 months. However, no significant cognitive or behavioural improvement can be reported in these patients after the stimulation program (duration time: 12.53 months SD 5.5). Fil: Filipin, Federerico. Centro de Educaciones Médicas e Investigación Clínica "Norberto Quirno"; Argentina Fil: Feldman, Monica. Centro de Educaciones Médicas e Investigación Clínica "Norberto Quirno"; Argentina Fil: Taragano, Fernando Emilio. Centro de Educaciones Médicas e Investigación Clínica "Norberto Quirno"; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina Fil: Martelli, Maria Catalina. Centro de Educaciones Médicas e Investigación Clínica "Norberto Quirno"; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina Fil: Sanchez, Viviana. Centro de Educaciones Médicas e Investigación Clínica "Norberto Quirno"; Argentina Fil: Garcia, Virginia. Centro de Educaciones Médicas e Investigación Clínica "Norberto Quirno"; Argentina Fil: Tufro, Graciela. Centro de Educaciones Médicas e Investigación Clínica "Norberto Quirno"; Argentina Fil: Heisecke Peralta, Silvina Lidia. Centro de Educaciones Médicas e Investigación Clínica "Norberto Quirno"; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina Fil: Serrano, Cecilia Mariela. Centro de Educaciones Médicas e Investigación Clínica "Norberto Quirno"; Argentina Fil: Dillon, Carol. Centro de Educaciones Médicas e Investigación Clínica "Norberto Quirno"; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina

Published
2015

9. Late- versus early-onset geriatric depression in a memory research center

Author

Pablo Salgado, Cecilia M. Serrano, Carol Dillon, Frank B. Glaser, Ricardo F. Allegri, Fernando E. Taragano, and Monica Iturry

Subjects
Geriatrics, cognition, medicine.medical_specialty, Neuropsychiatric Disease and Treatment, geriatrics, business.industry, Cognition, Late onset, early- and late-onset depression, Odds ratio, medicine.disease, Comorbidity, Psychiatry and Mental health, Internal medicine, medicine, Dementia, Verbal fluency test, business, Biological Psychiatry, Depression (differential diagnoses), Original Research
Abstract

Carol Dillon1, Ricardo F Allegri2, Cecilia M Serrano1, Mónica Iturry1, Pablo Salgado1, Frank B Glaser1, FernandoE Taragano21Memory Research Center, Department of Neurology, Hospital General Abel Zubizarreta, GCBA Buenos Aires, Argentina; 2Department of Neuropsychology (SIREN), CEMIC University, Buenos Aires, ArgentinaObjective: To contrast early-onset (60 years) depression in geriatric patients by evaluating differences in cognition, vascular comorbidity and sociological risk factors. Both patient groups were compared with normal subjects.Materials and methods: We recruited 76 patients with depressive symptoms (37 late onset and 39 early onset) and 17 normal controls matched by age and educational level. All subjects were assessed using a semistructured neuropsychiatric interview and an extensive neuropsychological battery. Vascular and sociological risk factors were also evaluated.Results: We found a significant variation in performance between depressive patients and normal controls in most cognitive functions, especially memory (P < 0.0001), semantic fluency (P < 0.0001), verbal fluency, and digit-symbol (P < 0.0001). Late-onset depression patients scored lower and exhibited more severe impairment in memory domains than early-onset depression patients (P < 0.05). Cholesterol levels and marital status were significantly (P < 0.05) different between the depressive groups. Both depressed groups (early- and lateonset) were more inactive than controls (P < 0.05; odds ratio: 6.02).Conclusion: Geriatric depression may be a manifestation of brain degeneration, and the initial symptom of a dementia. It is important to consider this in the treatment of patients that exhibit late-onset depressive symptoms.Keywords: early- and late-onset depression, geriatrics, cognition

Published
2009

10. Insurance Status and Demographic and Clinical Factors Associated with Pharmacologic Treatment of Depression: Associations in a Cohort in Buenos Aires

Author

Carol Dillon, Ricardo F. Allegri, and Gerardo Machnicki

Subjects
medicine.medical_specialty, Cross-sectional study, Argentina, Logistic regression, Risk Assessment, Drug Costs, Health Services Accessibility, Insurance Coverage, Cohort Studies, Risk Factors, Internal medicine, medicine, Odds Ratio, Humans, Hypnotics and Sedatives, Healthcare Disparities, Practice Patterns, Physicians', Psychiatry, Depression (differential diagnoses), Aged, Medically Uninsured, Chi-Square Distribution, Insurance, Health, business.industry, Depression, Hospitals, Public, Health Policy, Memory clinic, Public Health, Environmental and Occupational Health, Odds ratio, Middle Aged, Antidepressive Agents, Drug Utilization, Latin America, Cross-Sectional Studies, Logistic Models, Outcome and Process Assessment, Health Care, Treatment Outcome, Socioeconomic Factors, antidepressants, Cohort, Cholinesterase Inhibitors, Health Services Research, business, Chi-squared distribution, insurance, Cohort study, Antipsychotic Agents
Abstract

Objective There is a paucity of evidence about insurance status and the likelihood of receiving medical services in Latin America. The objective of this analysis was to examine the association between insurance status and pharmacologic treatment for depression. Methods Patients referred to a memory clinic of a public hospital in Buenos Aires, Argentina, and identified with any of four types of depression (subsyndromal, dysthymia, major, and due to dementia) were included. Age, years of education, insurance status, Beck Depression Inventory score, and number of comorbidities were considered. Associations between these factors and not receiving pharmacologic treatment for depression were examined with logistic regression. Use of prescription neuroleptics, hypnotics, and anticholinesterase inhibitors was also explored. Results Out of 100 patients, 92 with insurance status data were used. Sixty-one patients (66%) had formal insurance and 31 patients (34%) lacked insurance. Twenty-seven (44%) insured patients and 23 (74%) uninsured patients did not receive antidepressants ( P = 0.001). Controlling for other factors, uninsured patients had 7.12 higher odds of not receiving treatment compared to insured patients (95% confidence interval 1.88–28.86). Older patients and those with more comorbidities had higher odds of not receiving treatment. More educated patients, those with higher Beck Depression Inventory score, and those without subsyndromal depression had lower odds of not receiving treatment. None of those associations were statistically significant. Conclusions These results suggest a potential negative effect of the lack of formal insurance regarding pharmacologic treatment for depression. These findings should be confirmed with larger samples, and for other diseases.

Published
2011
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