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Molecular Basis of Late-Life Depression
Chien-Yi Kuo, Chieh-Hsin Lin, Hsien-Yuan Lane. International journal of molecular sciences, 2021-07-10
Topic: Gut, metabolism and diet
Late-life depression (LLD), compared to depression at a young age, is more likely to have poor prognosis and high risk of progression to dementia. A recent systemic review and meta-analysis of the present antidepressants for LLD showed that the treatment response rate was 48% and the remission rate was only 33.7%, thus implying the need to improve the treatment with other approaches in the future. Recently, agents modulating the glutamatergic system have been tested for mental disorders such as schizophrenia, dementia, and depressive disorder. Ketamine, a noncompetitive NMDA receptor (NMDAR) antagonist, requires more evidence from randomized clinical trials (RCTs) to prove its efficacy and safety in treating LLD. The metabotropic receptors (mGluRs) of the glutamatergic system are family G-protein-coupled receptors, and inhibition of the Group II mGluRs subtypes (mGlu2 and mGlu3) was found to be as effective as ketamine in exerting rapid antidepressant activity in some animal studies. Inflammation has been thought to contribute to depression for a long time. The cytokine levels not only increase with age but also decrease serotonin. Regarding LLD, interleukin 6 (IL-6) and tumor necrosis factor α (TNF-α) released in vivo are likely to contribute to the reduced serotonin level. Brain-derived neurotrophic factor (BDNF), a growth factor and a modulator in the tropomyosin receptor kinase (Trk) family of tyrosine kinase receptors, probably declines quantitatively with age. Recent studies suggest that BDNF/TrkB decrement may contribute to learning deficits and memory impairment. In the process of aging, physiological changes in combination with geriatric diseases such as vascular diseases result in poorer prognosis of LLD in comparison with that of young-age depression. Treatments with present antidepressants have been generally unsatisfactory. Novel treatments such as anti-inflammatory agents or NMDAR agonists/antagonists require more studies in LLD. Last but not least, LLD and dementia, which share common pathways and interrelate reciprocally, are a great concern. If it is possible to enhance the treatment of LDD, dementia can be prevented or delated.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Kuo, C.-Y., Lin, C.-H., & Lane, H.-Y. (2021). Molecular Basis of Late-Life Depression. International journal of molecular sciences. https://doi.org/10.3390/ijms22147421
Vancouver
Kuo C.-Y, Lin C.-H, Lane H.-Y. Molecular Basis of Late-Life Depression. International journal of molecular sciences. 2021. doi:10.3390/ijms22147421. PMID: 34299040.
BibTeX
@article{kuo2021-34299040,
author = {Kuo, Chien-Yi and Lin, Chieh-Hsin and Lane, Hsien-Yuan},
title = {{Molecular Basis of Late-Life Depression}},
journal = {International journal of molecular sciences},
year = {2021},
doi = {10.3390/ijms22147421},
pmid = {34299040},
url = {https://doi.org/10.3390/ijms22147421}
}
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Key findings
- Late-life depression (LLD), compared to depression at a young age, is more likely to have poor prognosis and high risk of progression to dementia.
- A recent systemic review and meta-analysis of the present antidepressants for LLD showed that the treatment response rate was 48% and the remission rate was only 33.7%, thus implying the need to improve the treatment with other approaches in the future.
- Recent studies suggest that BDNF/TrkB decrement may contribute to learning deficits and memory impairment.
- In the process of aging, physiological changes in combination with geriatric diseases such as vascular diseases result in poorer prognosis of LLD in comparison with that of young-age depression.
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Study details
- Study designmeta-analysis
- Effect size33.7%
- Evidence strengthHigh
How this study scored 73/100
Published in a peer-reviewed journal, and it is a meta-analysis pooling many studies. Scored zero for sample size and studied in people because the record does not state it. We have no data on journal's citation record, times cited, citations per year, impact for its field and year, cited by studies here, still being cited, senior author's track record, institution's track record, multi-centre collaboration and free to read, so those were left out: it earned 41 of the 56 points we could judge it on, which is 73 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (International journal of molecular sciences) |
| Journal's citation record | — / 4 | No journal record from OpenAlex — left out of this score |
| Study design | 12 / 12 | A meta-analysis pooling many studies |
| Strength of evidence | 5 / 5 | Rated “high” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 3 / 5 | 2021 — within 6 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | A review of other studies — randomisation is not credited here |
| Times cited | — / 7 | No citation count (not found in OpenAlex) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | — / 6 | Not yet checked against this library's citation graph — left out of this score |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | — / 3 | Institutions not listed — left out of this score |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 34299040) |
| Free to read | — / 2 | Access not recorded — left out of this score |
| Points | 41 / 56 | Scored on 10 of 20 parts. We have no data for the rest, so they are left out: 41 of the 56 points we could judge it on is 73 out of 100. |
| Total | 73 / 100 | — |
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