Late-life depression (LLD), a potentially life-threatening disease that severely impacts older adults’ health and quality of life, is a growing public health concern due to the aging global population. This review explores the challenges of treating LLD, including its unique presentation, underdiagnosis, and limitations of current treatment methods. It also examines the potential mechanisms underlying LLD, including cognitive changes in older adults, social stressors unique to their circumstances, and biological pathways that overlap with those of neurodegenerative diseases. Rather than viewing LLD as a singular medical condition, this review argues that it is the combined manifestation of a variety of underlying issues, including stress and age-related neurological dysregulation, inflammation, and oxidation, as well as social and cognitive alterations. New approaches to treatment and research are necessary, including innovative pharmacological research targeting shared neurobiological pathologies, holistic and personalized treatment plans, and standardized psychotherapy protocols. Some examples of emerging research incorporating this full-bodied approach are presented, and recommendations are given for future research and treatment. In conclusion, this review highlights the significance of recognizing LLD as a multifaceted issue to improve the aging experience.
KeywordsLate-Life Depression
Abdoli, N., Salari, N., Darvishi, N., Jafarpour, S., Solaymani, M., Mohammadi, M., & Shohaimi, S. (2021). The Global Prevalence of Major Depressive Disorder (MDD) among the Elderly: A systematic Review and Meta-Analysis. Neuroscience & Biobehavioral Reviews, 132, 1067-1073. https://doi.org/10.1016/j.neubiorev.2021.10.041
Ahmad, M. H., Fatima, M., & Mondal, A. C. (2019). Role of Hypothalamic-Pituitary-Adrenal Axis, Hypothalamic-Pituitary-Gonadal Axis and Insulin Signaling in the Pathophysiology of Alzheimer’s Disease. Neuropsychobiology, 77, 197-205. https://doi.org/10.1159/000495521
Alexopoulos, G. S. (2019). Mechanisms and Treatment of Late-Life Depression. Translational Psychiatry, 9, Article No. 188. https://doi.org/10.1038/s41398-019-0514-6
Allan, C. E., Valkanova, V., & Ebmeier, K. P. (2014). Depression in Older People Is Underdiagnosed. The Practitioner, 258, 19-22.
Angulo, J., El Assar, M., Bustos, A. á., & Rodríguez-Mañas, L. (2020). Physical Activity and Exercise: Strategies to Manage Frailty. Redox Biology, 35, Article ID: 101513. https://doi.org/10.1016/j.redox.2020.101513
Argyropoulos, K., Saropoulou, A., & Jelastopulu, E. (2018). Late-Life Depression in North Greece: Prevalence and Under-Detection. International Journal of Depression and Anxiety, 1, Article No. 004. https://doi.org/10.23937/ijda-2017/1710004
Barry, L. C., Abou, J. J., Simen, A. A., & Gill, T. M. (2012). Under-Treatment of Depression in Older Persons. Journal of Affective Disorders, 136, 789-796. https://doi.org/10.1016/j.jad.2011.09.038
Berard, L. D. H., Mackenzie, C. S., Reynolds, K. A., Thompson, G., Koven, L., & Beatie, B. (2020). Choice, Coercion, and/or Muddling through: Older Adults’ Experiences in Seeking Psychological Treatment. Social Science & Medicine, 255, Article ID: 113011. https://doi.org/10.1016/j.socscimed.2020.113011
Bobo, W. V., Grossardt, B. R., Lapid, M. I., Leung, J. G., Stoppel, C., Takahashi, P. Y., Hoel, R. W., Chang, Z., Lachner, C., Chauhan, M., Flowers, L., Brue, S. M., Frye, M. A., St. Sauver, J., Rocca, W. A., & Sutor, B. (2019). Frequency and Predictors of the Potential Overprescribing of Antidepressants in Elderly Residents of a Geographically Defined U.S. Population. Pharmacology Research & Perspectives, 7, e00461. https://doi.org/10.1002/prp2.461
Bottino, C. M. C., Barcelos-Ferreira, R., & Ribeiz, S. R. I. (2012). Treatment of Depression in Older Adults. Current Psychiatry Reports, 14, 289-297. https://doi.org/10.1007/s11920-012-0281-z
Brender, R., Mulsant, B. H., & Blumberger, D. M. (2021). An Update on Antidepressant Pharmacotherapy in Late-Life Depression. Expert Opinion on Pharmacotherapy, 22, 1909-1917. https://doi.org/10.1080/14656566.2021.1921736
Brickman, A. M., Muraskin, J., & Zimmerman, M. E. (2009). Structural Neuroimaging in Alzheimer’s Disease: Do White Matter Hyperintensities Matter? Dialogues in Clinical Neuroscience, 11, 181-190. https://doi.org/10.31887/DCNS.2009.11.2/ambrickman
Brown, P. J., Ciarleglio, A., Roose, S. P., Montes Garcia, C., Chung, S., Alvarez, J., Stein, A., Gomez, S., & Rutherford, B. R. (2021). Frailty Worsens Antidepressant Treatment Outcomes in Late Life Depression. The American Journal of Geriatric Psychiatry, 29, 870-876. https://doi.org/10.1016/j.jagp.2020.12.024
Burroughs, H., Lovell, K., Morley, M., Baldwin, R., Burns, A., & Chew-Graham, C. (2006). “Justifiable Depression”: How Primary Care Professionals and Patients View Late-Life Depression? A Qualitative Study. Family Practice, 23, 369-377. https://doi.org/10.1093/fampra/cmi115
Butters, M. A., Young, J. B., Lopez, O., Aizenstein, H. J., Mulsant, B. H., Reynolds III, C. F., DeKosky, S. T., & Becker, J. T. (2008). Pathways Linking Late-Life Depression to Persistent Cognitive Impairment and Dementia. Dialogues in Clinical Neuroscience, 10, 345-357. https://doi.org/10.31887/DCNS.2008.10.3/mabutters
Canet, G., Hernandez, C., Zussy, C., Chevallier, N., Desrumaux, C., & Givalois, L. (2019). Is AD a Stress-Related Disorder? Focus on the HPA Axis and Its Promising Therapeutic Targets. Frontiers in Aging Neuroscience, 11, Article 269. https://doi.org/10.3389/fnagi.2019.00269
Caraci, F., Copani, A., Nicoletti, F., & Drago, F. (2010). Depression and Alzheimer’s Disease: Neurobiological Links and Common Pharmacological Targets. European Journal of Pharmacology, 626, 64-71. https://doi.org/10.1016/j.ejphar.2009.10.022
Cassano, T., Calcagnini, S., Carbone, A., Bukke, V. N., Orkisz, S., Villani, R., Romano, A., Avolio, C., & Gaetani, S. (2019). Pharmacological Treatment of Depression in Alzheimer’s Disease: A Challenging Task. Frontiers in Pharmacology, 10, Article 1067. https://doi.org/10.3389/fphar.2019.01067
Catena-Dell’Osso, M., Bellantuono, C., Consoli, G., Baroni, S., Rotella, F., & Marazziti, D. (2011). Inflammatory and Neurodegenerative Pathways in Depression: A New Avenue for Antidepressant Development? Current Medicinal Chemistry, 18, 245-255. https://doi.org/10.2174/092986711794088353
Charles, S. T., Piazza, J. R., Luong, G., & Almeida, D. M. (2009). Now You See It, Now You Don’t: Age Differences in Affective Reactivity to Social Tensions. Psychology and Aging, 24, 645-653. https://doi.org/10.1037/a0016673
Chen, S., Conwell, Y., Xue, J., Li, L., Zhao, T., Tang, W., Bogner, H., & Dong, H. (2022). Effectiveness of Integrated Care for Older Adults with Depression and Hypertension in Rural China: A Cluster Randomized Controlled Trial. PLOS Medicine, 19, e1004019. https://doi.org/10.1371/journal.pmed.1004019
Cuevas, P. E. G., Davidson, P. M., Mejilla, J. L., & Rodney, T. W. (2020). Reminiscence Therapy for Older Adults with Alzheimer’s Disease: A Literature Review. International Journal of Mental Health Nursing, 29, 364-371. https://doi.org/10.1111/inm.12692
Dauwan, M., Begemann, M. J. H., Slot, M. I. E. et al. (2021). Physical Exercise Improves Quality of Life, Depressive Symptoms, and Cognition across Chronic Brain Disorders: A Transdiagnostic Systematic Review and Meta-Analysis of Randomized Controlled Trials. Journal of Neurology, 268, 1222-1246. https://doi.org/10.1007/s00415-019-09493-9
Debette, S., & Markus, H. S. (2010). The Clinical Importance of White Matter Hyperintensities on Brain Magnetic Resonance Imaging: Systematic Review and Meta-Analysis. BMJ, 341, c3666. https://doi.org/10.1136/bmj.c3666
Diniz, B. S., Mendes-Silva, A. P., Silva, L. B., Bertola, L., Vieira, M. C., Ferreira, J. D., Nicolau, M., Bristot, G., da Rosa, E. D., Teixeira, A. L., & Kapczinski, F. (2018). Oxidative Stress Markers Imbalance in Late-Life Depression. Journal of Psychiatric Research, 102, 29-33. https://doi.org/10.1016/j.jpsychires.2018.02.023
Djernes, J. K. (2006). Prevalence and Predictors of Depression in Populations of Elderly: A Review. Acta Psychiatrica Scandinavica, 113, 372-387. https://doi.org/10.1111/j.1600-0447.2006.00770.x
Du, X., & Pang, T. Y. (2015). Is Dysregulation of the HPA-Axis a Core Pathophysiology Mediating Co-Morbid Depression in Neurodegenerative Diseases? Frontiers in Psychiatry, 6, Article 32. https://doi.org/10.3389/fpsyt.2015.00032
Falgàs, N., Sánchez-Valle, R., Bargalló, N., Balasa, M., Fernández-Villullas, G., Bosch, B., Olives, J., Tort-Merino, A., Antonell, A., Muñoz-García, C., León, M., Grau, O., Castellví, M., Coll-Padrós, N., Rami, L., Redolfi, A., & Lladó, A. (2019). Hippocampal Atrophy Has Limited Usefulness as a Diagnostic Biomarker on the Early Onset Alzheimer’s Disease Patients: A Comparison between Visual and Quantitative Assessment. NeuroImage: Clinical, 23, Article ID: 101927. https://doi.org/10.1016/j.nicl.2019.101927
Fernandes, M., Ross, M., Wiegand, M., & Schryer, E. (2008). Are the Memories of Older Adults Positively Biased? Psychology and Aging, 23, 297-306. https://doi.org/10.1037/0882-7974.23.2.297
Fiske, A., Wetherell, J. L., & Gatz, M. (2009). Depression in Older Adults. Annual Review of Clinical Psychology, 5, 363-389. https://doi.org/10.1146/annurev.clinpsy.032408.153621
Forbes, M. P., O’Neil, A., Lane, M., Agustini, B., Myles, N., & Berk, M. (2021). Major Depressive Disorder in Older Patients as an Inflammatory Disorder: Implications for the Pharmacological Management of Geriatric Depression. Drugs & Aging, 38, 451-467. https://doi.org/10.1007/s40266-021-00858-2
Forsat, N. D., Palmowski, A., Palmowski, Y., Boers, M., & Buttgereit, F. (2020). Recruitment and Retention of Older People in Clinical Research: A Systematic Literature Review. Journal of the American Geriatrics Society, 68, 2955-2963. https://doi.org/10.1111/jgs.16875
Gaboda, D., Lucas, J., Siegel, M., Kalay, E., & Crystal, S. (2011). No Longer Undertreated? Depression Diagnosis and Antidepressant Therapy in Elderly Long-Stay Nursing Home Residents, 1999 to 2007. Journal of the American Geriatrics Society, 59, 673-680. https://doi.org/10.1111/j.1532-5415.2011.03322.x
Galts, C. P. C., Bettio, L. E. B., Jewett, D. C., Yang, C. C., Brocardo, P. S., Rodrigues, A. L. S., Thacker, J. S., & Gil-Mohapel, J. (2019). Depression in Neurodegenerative Diseases: Common Mechanisms and Current Treatment Options. Neuroscience and Biobehavioral Reviews, 102, 56-84. https://doi.org/10.1016/j.neubiorev.2019.04.002
Gao, Y., Tan, L., Yu, J.-T., & Tan, L. (2018). Tau in Alzheimer’s Disease: Mechanisms and Therapeutic Strategies. Current Alzheimer Research, 15, 283-300. https://doi.org/10.2174/1567205014666170417111859
Geerlings, M. I., & Gerritsen, L. (2017). Late-Life Depression, Hippocampal Volumes, and Hypothalamic-Pituitary-Adrenal Axis Regulation: A Systematic Review and Meta-Analysis. Biological Psychiatry, 82, 339-350. https://doi.org/10.1016/j.biopsych.2016.12.032
Golomb, B. A., Chan, V. T., Evans, M. A., Koperski, S., White, H. L., & Criqui, M. H. (2012). The Older the Better: Are Elderly Study Participants More Non-Representative? A Cross-Sectional Analysis of Clinical Trial and Observational Study Samples. BMJ Open, 2, e000833. https://doi.org/10.1136/bmjopen-2012-000833
Gooding, P. A., Hurst, A., Johnson, J., & Tarrier, N. (2012). Psychological Resilience in Young and Older Adults. International Journal of Geriatric Psychiatry, 27, 262-270. https://doi.org/10.1002/gps.2712
Gray, V., Douglas, K., & Porter, R. (2021). Emotion Processing in Depression and Anxiety Disorders in Older Adults: Systematic Review. BJPsych Open, 7, E7. https://doi.org/10.1192/bjo.2020.143
Gross, J. J., Carstensen, L. L., Pasupathi, M., Tsai, J., Götestam Skorpen, C., & Hsu, A. Y. C. (1997). Emotion and Aging: Experience, Expression, and Control. Psychology and Aging, 12, 590-599. https://doi.org/10.1037/0882-7974.12.4.590
Guerra, M., Prina, A. M., Ferri, C. P., Acosta, D., Gallardo, S., Huang, Y., Jacob, K. S., Jimenez-Velazquez, I. Z., Llibre Rodriguez, J. J., Liu, Z., Salas, A., Sosa, A. L., Williams, J. D., Uwakwe, R., & Prince, M. (2016). A Comparative Cross-Cultural Study of the Prevalence of Late Life Depression in Low and Middle Income Countries. Journal of Affective Disorders, 190, 362-368. https://doi.org/10.1016/j.jad.2015.09.004
Gundersen, E., & Bensadon, B. (2023). Geriatric Depression. Primary Care, 50, 143-158. https://doi.org/10.1016/j.pop.2022.10.010
Gutsmiedl, K., Krause, M., Bighelli, I., Schneider-Thoma, J., & Leucht, S. (2020). How Well Do Elderly Patients with Major Depressive Disorder Respond to Antidepressants: A Systematic Review and Single-Group Meta-Analysis. BMC Psychiatry, 20, Article No. 102. https://doi.org/10.1186/s12888-020-02514-2
Gutzmann, H., & Qazi, A. (2015). Depression Associated with Dementia. Zeitschrift fur Gerontologie und Geriatrie, 48, 305-311. https://doi.org/10.1007/s00391-015-0898-8
Hall, C. A., & Reynolds-III, C. F. (2014). Late-Life Depression in the Primary Care Setting: Challenges, Collaborative Care, and Prevention. Maturitas, 79, 147-152. https://doi.org/10.1016/j.maturitas.2014.05.026
Hegeman, J. M., Kok, R. M., van der Mast, R. C., & Giltay, E. J. (2012). Phenomenology of Depression in Older Compared with Younger Adults: Meta-Analysis. British Journal of Psychiatry, 200, 275-281. https://doi.org/10.1192/bjp.bp.111.095950
Horackova, K., Kopecek, M., Machů, V., Kagstrom, A., Aarsland, D., Motlova, L., & Cermakova, P. (2019). Prevalence of Late-Life Depression and Gap in Mental Health Service Use across European Regions. European Psychiatry, 57, 19-25. https://doi.org/10.1016/j.eurpsy.2018.12.002
Hsieh, H.-F., & Wang, J.-J. (2003). Effect of Reminiscence Therapy on Depression in Older Adults: A Systematic Review. International Journal of Nursing Studies, 40, 335-345. https://doi.org/10.1016/S0020-7489(02)00101-3
Hu, T., Zhao, X., Wu, M., Li, Z., Luo, L., Yang, C., & Yang, F. (2022). Prevalence of Depression in Older Adults: A Systematic Review and Meta-Analysis. Psychiatry Research, 311, Article ID: 114511. https://doi.org/10.1016/j.psychres.2022.114511
Hultsch, D. F., MacDonald, S. W. S., Hunter, M. A., Maitland, S. B., & Dixon, R. A. (2002). Sampling and Generalisability in Developmental Research: Comparison of Random and Convenience Samples of Older Adults. International Journal of Behavioral Development, 26, 345-359. https://doi.org/10.1080/01650250143000247
Husain-Krautter, S., & Ellison, J. M. (2021). Late Life Depression: The Essentials and the Essential Distinctions. FOCUS: The Journal of Lifelong Learning in Psychiatry, 19, 282-293. https://doi.org/10.1176/appi.focus.20210006
Indorewalla, K. K., O’Connor, M. K., Budson, A. E., Guess (DiTerlizzi), C., & Jackson, J. (2021). Modifiable Barriers for Recruitment and Retention of Older Adults Participants from Underrepresented Minorities in Alzheimer’s Disease Research. Journal of Alzheimer’s Disease, 80, 927-940. https://doi.org/10.3233/JAD-201081
Ionescu-Tucker, A., & Cotman, C. W. (2021). Emerging Roles of Oxidative Stress in Brain Aging and Alzheimer’s Disease. Neurobiology of Aging, 108, 125-134. https://doi.org/10.1016/j.neurobiolaging.2021.07.014
Jelinek, M., Jurajda, M., & Duris, K. (2021). Oxidative Stress in the Brain: Basic Concepts and Treatment Strategies in Stroke. Antioxidants, 10, Article 1886. https://doi.org/10.3390/antiox10121886
Juszczyk, G., Mikulska, J., Kasperek, K., Pietrzak, D., Mrozek, W., & Herbet, M. (2021). Chronic Stress and Oxidative Stress as Common Factors of the Pathogenesis of Depression and Alzheimer’s Disease: The Role of Antioxidants in Prevention and Treatment. Antioxidants, 10, Article 1439. https://doi.org/10.3390/antiox10091439
Kales, H. C., & Valenstein, M. (2002). Complexity in Late-Life Depression: Impact of Confounding Factors on Diagnosis, Treatment, and Outcomes. Journal of Geriatric Psychiatry and Neurology, 15, 147-155. https://doi.org/10.1177/089198870201500306
Katz, I. R. (1996). On the Inseparability of Mental and Physical Health in Aged Persons: Lessons from Depression and Medical Comorbidity. The American Journal of Geriatric Psychiatry, 4, 1-16. https://doi.org/10.1097/00019442-199600410-00001
Kim, Y.-K., & Han, K.-M. (2020). Neural Substrates for Late-Life Depression: A Selective Review of Structural Neuroimaging Studies. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 104, Article ID: 110010. https://doi.org/10.1016/j.pnpbp.2020.110010
Knechel, N. A. (2013). The Challenges of Enrolling Older Adults into Intervention Studies. The Yale Journal of Biology and Medicine, 86, 41-47.
Knight, B. G., & Durbin, K. (2015). Aging and the Effects of Emotion on Cognition: Implications for Psychological Interventions for Depression and Anxiety. PsyCh Journal, 4, 11-19. https://doi.org/10.1002/pchj.84
Kok, R. M., & Reynolds, C. F. (2017). Management of Depression in Older Adults. JAMA, 317, 2114-2222. https://doi.org/10.1001/jama.2017.5706
Krause, M., Gutsmiedl, K., Bighelli, I., Schneider-Thoma, J., Chaimani, A., & Leucht, S. (2019). Efficacy and Tolerability of Pharmacological and Non-Pharmacological Interventions in Older Patients with Major Depressive Disorder: A Systematic Review, Pairwise and Network Meta-Analysis. European Neuropsychopharmacology, 29, 1003-1022. https://doi.org/10.1016/j.euroneuro.2019.07.130
Kuo, C.-Y., Lin, C.-H., & Lane, H.-Y. (2021). Molecular Basis of Late-Life Depression. International Journal of Molecular Sciences, 22, Article 7421. https://doi.org/10.3390/ijms22147421
Laird, K. T., Krause, B., Funes, C., & Lavretsky, H. (2019). Psychobiological Factors of Resilience and Depression in Late Life. Translational Psychiatry, 9, Article No. 88. https://doi.org/10.1038/s41398-019-0424-7
Lenze, E. J., Sheffrin, M., Driscoll, H. C., Mulsant, B. H., Pollock, B. G., Dew, M. A., Lotrich, F., Devlin, B., Bies, R., & Reynolds III, C. F. (2008). Incomplete Response in Late-Life Depression: Getting to Remission. Dialogues in Clinical Neuroscience, 10, 419-430. https://doi.org/10.31887/DCNS.2008.10.4/jlenze
Li, Y., & Ow, Y. S. Y. (2022). Development of Resilience Scale for Older Adults. Aging & Mental Health, 26, 159-168. https://doi.org/10.1080/13607863.2020.1861212
Linnemann, C., & Lang, U. E. (2020). Pathways Connecting Late-Life Depression and Dementia. Frontiers in Pharmacology, 11, Article 279. https://doi.org/10.3389/fphar.2020.00279
Liu, Z., Yang, F., Lou, Y., Zhou, W., & Tong, F. (2021). The Effectiveness of Reminiscence Therapy on Alleviating Depressive Symptoms in Older Adults: A Systematic Review. Frontiers in Psychology, 12, Article 709853. https://doi.org/10.3389/fpsyg.2021.709853
Livingstone, K. M., & Isaacowitz, D. M. (2018). The Roles of Age and Attention in General Emotion Regulation, Reappraisal, and Expressive Suppression. Psychology and Aging, 33, 373-383. https://doi.org/10.1037/pag0000240
Lök, N., Bademli, K., & Selçuk-Tosun, A. (2019). The Effect of Reminiscence Therapy on Cognitive Functions, Depression, and Quality of Life in Alzheimer Patients: Randomized Controlled Trial. International Journal of Geriatric Psychiatry, 34, 47-53. https://doi.org/10.1002/gps.4980
Luca, M., & Luca, A. (2019). Oxidative Stress-Related Endothelial Damage in Vascular Depression and Vascular Cognitive Impairment: Beneficial Effects of Aerobic Physical Exercise. Oxidative Medicine and Cellular Longevity, 2019, Article ID: 8067045. https://doi.org/10.1155/2019/8067045
Luca, M., Guzik, T., & Luca, A. (2020). Oxidative Stress as a Link between Cerebrocardiovascular and Psychiatric Disorders. Oxidative Medicine and Cellular Longevity, 2020, Article ID: 5685317. https://doi.org/10.1155/2020/5685317
Ludvigsson, M., Milberg, A., Marcusson, J., & Wressle, E. (2014). Normal Aging or Depression? A Qualitative Study on the Differences between Subsyndromal Depression and Depression in Very Old People. The Gerontologist, 55, 760-769. https://doi.org/10.1093/geront/gnt162
Luo, X., Mao, Q., Shi, J., Wang, X., & Li, C. R. (2019). Putamen Gray Matter Volumes in Neuropsychiatric and Neurodegenerative Disorders. World Journal of Psychiatry and Mental Health Research, 3, Article 1020.
Macleod, S., Musich, S., Hawkins, K., Alsgaard, K., & Wicker, E. R. (2016). The Impact of Resilience among Older Adults. Geriatric Nursing, 37, 266-272. https://doi.org/10.1016/j.gerinurse.2016.02.014
Mallery, L., MacLeod, T., Allen, M., McLean-Veysey, P., Rodney-Cail, N., Bezanson, E., Steeves, B., LeBlanc, C., & Moorhouse, P. (2019). Systematic Review and Meta-Analysis of Second-Generation Antidepressants for the Treatment of Older Adults with Depression: Questionable Benefit and Considerations for Frailty. BMC Geriatrics, 19, Article No. 306. https://doi.org/10.1186/s12877-019-1327-4
Marcantonio, E. R., Aneja, J., Jones, R. N., Alsop, D. C., Fong, T. G., Crosby, G. J., & Inouye, S. K. (2008). Maximizing Clinical Research Participation in Vulnerable Older Persons: Identification of Barriers and Motivators. Journal of the American Geriatrics Society, 56, 1522-1527. https://doi.org/10.1111/j.1532-5415.2008.01829.x
McKinney, B. C., & Sibille, E. (2013). The Age-by-Disease Interaction Hypothesis of Late-Life Depression. The American Journal of Geriatric Psychiatry, 21, 418-432. https://doi.org/10.1016/j.jagp.2013.01.053
McRae-McKee, K., Evans, S., Hadjichrysanthou, C., Wong, M. M., de Wolf, F., & Anderson, R. M. (2019). Combining Hippocampal Volume Metrics to Better Understand Alzheimer’s Disease Progression in At-Risk Individuals. Scientific Reports, 9, Article No. 7499. https://doi.org/10.1038/s41598-019-42632-w
Miller, K. J., Gonçalves-Bradley, D. C., Areerob, P., Hennessy, D., Mesagno, C., & Grace, F. (2019). Comparative Effectiveness of Three Exercise Types to Treat Clinical Depression in Older Adults: A Systematic Review and Network Meta-Analysis of Randomised Controlled Trials. Ageing Research Reviews, 58, Article ID: 100999. https://doi.org/10.1016/j.arr.2019.100999
Moreno, X., Gajardo, J., & Monsalves, M. J. (2022). Gender Differences in Positive Screen for Depression and Diagnosis among Older Adults in Chile. BMC Geriatrics, 22, Article No. 54. https://doi.org/10.1186/s12877-022-02751-y
Nair, P., Bhanu, C., Frost, R., Buszewicz, M., & Walters, K. R. (2019). A Systematic Review of Older Adults’ Attitudes towards Depression and Its Treatment. The Gerontologist, 60, e93-e104. https://doi.org/10.1093/geront/gnz048
Nelson, J. C. (2018). Management of Late-Life Depression. In M. Macaluso, & S. H. Preskorn (Eds.), Antidepressants (pp. 389-413). Springer. https://doi.org/10.1007/164_2018_170
Newton, P., Tchounguen, J., Pettigrew, C., Lim, C., Lin, Z., Lu, H., Moghekar, A., Albert, M., Soldan, A., & the BIOCARD Research Team (2023). Regional White Matter Hyperintensities and Alzheimer’s Disease Biomarkers among Older Adults with Normal Cognition and Mild Cognitive Impairment. Journal of Alzheimer’s Disease, 92, 323-339. https://doi.org/10.3233/JAD-220846
Parkar, S. (2015). Elderly Mental Health: Needs. Mens Sana Monographs, 13, 91-99. https://doi.org/10.4103/0973-1229.153311
Piel, C., & Quante, A. (2023). Therapy Strategies for Late-Life Depression: A Review. Journal of Psychiatric Practice, 29, 15-30. https://doi.org/10.1097/PRA.0000000000000678
Power, C., Greene, E., & Lawlor, B. A. (2017). Depression in Late Life: Etiology, Presentation, and Management. In H. Chiu, & K. Shulman (Eds.), Mental Health and Illness of the Elderly (pp. 187-218). Springer.
Saragih, I. D., Tonapa, S. I., Yao, C.-T., Saragih, I. S., & Lee, B.-O. (2022). Effects of Reminiscence Therapy in People with Dementia: A Systematic Review and Meta-Analysis. Journal of Psychiatric and Mental Health Nursing, 29, 883-903. https://doi.org/10.1111/jpm.12830
Scazufca, M., Nakamura, C. A., Seward, N., Moreno-Agostino, D., van de Ven, P., Hollingworth, W., Peters, T. J., & Araya, R. (2022). A Task-Shared, Collaborative Care Psychosocial Intervention for Improving Depressive Symptomatology among Older Adults in a Socioeconomically Deprived Area of Brazil (PROACTIVE): A Pragmatic, Two-Arm, Parallel-Group, Cluster-Randomised Controlled Trial. The Lancet Healthy Longevity, 3, e690-e702. https://doi.org/10.1016/S2666-7568(22)00194-5
Scheiblich, H., Trombly, M., Ramirez, A., & Heneka, M. T. (2020). Neuroimmune Connections in Aging and Neurodegenerative Diseases. Trends in Immunology, 41, 300-312. https://doi.org/10.1016/j.it.2020.02.002
Schulz, R., Drayer, R. A., & Rollman, B. L. (2002). Depression as a Risk Factor for Non-Suicide Mortality in the Elderly. Biological Psychiatry, 52, 205-225. https://doi.org/10.1016/S0006-3223(02)01423-3
Shao, A., Lin, D., Wang, L., Tu, S., Lenahan, C., & Zhang, J. (2020). Oxidative Stress at the Crossroads of Aging, Stroke and Depression. Aging and Disease, 11, 1537-1566. https://doi.org/10.14336/AD.2020.0225
Shiota, M. N., & Levenson, R. W. (2009). Effects of Aging on Experimentally Instructed Detached Reappraisal, Positive Reappraisal, and Emotional Behavior Suppression. Psychology and Aging, 24, 890-900. https://doi.org/10.1037/a0017896
Sneed, J. R., Culang, M. E., Keilp, J. G., Rutherford, B. R., Devanand, D. P., & Roose, S. P. (2010). Antidepressant Medication and Executive Dysfunction: A Deleterious Interaction in Late-Life Depression. The American Journal of Geriatric Psychiatry, 18, 128-135. https://doi.org/10.1097/JGP.0b013e3181c796d2
Subramanian, S., Oughli, H. A., Gebara, M. A., Palanca, B. J. A., & Lenze, E. J. (2023). Treatment-Resistant Late-Life Depression: A Review of Clinical Features, Neuropsychology, Neurobiology, and Treatment. The Psychiatric Clinics of North America, 46, 371-389. https://doi.org/10.1016/j.psc.2023.02.008
Sultana, J., Spina, E., & Trifirò, G. (2015). Antidepressant Use in the Elderly: The Role of Pharmacodynamics and Pharmacokinetics in Drug Safety. Expert Opinion on Drug Metabolism & Toxicology, 11, 883-892. https://doi.org/10.1517/17425255.2015.1021684
Swaab, D. F., Bao, A.-M., & Lucassen, P. J. (2005). The Stress System in the Human Brain in Depression and Neurodegeneration. Ageing Research Reviews, 4, 141-194. https://doi.org/10.1016/j.arr.2005.03.003
Szczerbińska, K., Hirdes, J. P., & Życzkowska, J. (2012). Good News and Bad News: Depressive Symptoms Decline and Undertreatment Increases with Age in Home Care and Institutional Settings. The American Journal of Geriatric Psychiatry, 20, 1045-1056. https://doi.org/10.1097/JGP.0b013e3182331702
Tam, W., Poon, S. N., Mahendran, R., Kua, E. H., & Wu, X. V. (2020). The Effectiveness of Reminiscence-Based Intervention on Improving Psychological Well-Being in Cognitively Intact Older Adults: A Systematic Review and Meta-Analysis. Archives of Gerontology and Geriatrics, 94, Article ID: 104325. https://doi.org/10.1016/j.ijnurstu.2020.103847
Taylor, W. D. (2014). Depression in the Elderly. New England Journal of Medicine, 371, 1228-1236. https://doi.org/10.1056/NEJMcp1402180
Taylor, W. D., MacFall, J. R., Steffens, D. C., Payne, M. E., Provenzale, J. M., & Krishnan, K. R. (2003). Localization of Age-Associated white Matter Hyperintensities in Late-Life Depression. Progress in Neuro-Psychopharmacology & Biological Psychiatry, 27, 539-544. https://doi.org/10.1016/S0278-5846(02)00358-5
Thomas, J. M., & Sezgin, D. (2021). Effectiveness of Reminiscence Therapy in Reducing Agitation and Depression and Improving Quality of Life and Cognition in Long-Term Care Residents with Dementia: A Systematic Review and Meta-Analysis. Geriatric Nursing, 42, 1497-1506. https://doi.org/10.1016/j.gerinurse.2021.10.014
Unützer, J., Katon, W., Callahan, C. M., Williams, J. W., Hunkeler, E., Harpole, L., Hoffing, M., Della Penna, R. D., Noël, P. H., Lin, E. H., Areán, P. A., Hegel, M. T., Tang, L., Belin, T. R., Oishi, S., Langston, C., & IMPACT Investigators Improving Mood-Promoting Access to Collaborative Treatment (2002). Collaborative Care Management of Late-Life Depression in the Primary Care Setting: A Randomized Controlled Trial. JAMA, 288, 2836-2845. https://doi.org/10.1001/jama.288.22.2836
Van Orden, K., & Conwell, Y. (2011). Suicides in Late Life. Current Psychiatry Reports, 13, 234-241. https://doi.org/10.1007/s11920-011-0193-3
Vannoy, S. D., Duberstein, P., Cukrowicz, K., Lin, E., Fan, M.-Y., & Unützer, J. (2007). The Relationship between Suicide Ideation and Late-Life Depression. The American Journal of Geriatric Psychiatry, 15, 1024-1033. https://doi.org/10.1097/JGP.0b013e3180cc2bf1
Veronese, N., Solmi, M., Basso, C., Smith, L., & Soysal, P. (2019). Role of Physical Activity in Ameliorating Neuropsychiatric Symptoms in Alzheimer Disease: A Narrative Review. International Journal of Geriatric Psychiatry, 34, 1316-1325. https://doi.org/10.1002/gps.4962
Vieira, E. L., Mendes-Silva, A. P., Ferreira, J. D., Bertola, L., Barroso, L., Vieira, M., Teixeira, A. L., & Diniz, B. S. (2021). Oxidative DNA Damage Is Increased in Older Adults with a Major Depressive Episode: A Preliminary Study. Journal of Affective Disorders, 279, 106-110. https://doi.org/10.1016/j.jad.2020.09.084
Wagner, J., Henderson, S., Hoeft, T. J., Gosdin, M., & Hinton, L. (2022). Moving beyond Referrals to Strengthen Late-Life Depression Care: A Qualitative Examination of Primary Care Clinic and Community-Based Organization Partnerships. BMC Health Services research, 22, Article No. 605. https://doi.org/10.1186/s12913-022-07997-1
Wetherell, J. L., Petkus, A. J., McChesney, K., Stein, M. B., Judd, P. H., Rockwell, E., Sewell, D. D., & Patterson, T. L. (2009). Older Adults Are Less Accurate than Younger Adults at Identifying Symptoms of Anxiety and Depression. The Journal of Nervous and Mental Disease, 197, 623-626. https://doi.org/10.1097/NMD.0b013e3181b0c081
Yasuno, F., Kazui, H., Morita, N., Kajimoto, K., Ihara, M., Taguchi, A., Yamamoto, A., Matsuoka, K., Kosaka, J., Kudo, T., Iida, H., Kishimoto, T., & Nagatsuka, K. (2016). High Amyloid-β Deposition Related to Depressive Symptoms in Older Individuals with Normal Cognition: A Pilot Study. International Journal of Geriatric Psychiatry, 31, 920-928. https://doi.org/10.1002/gps.4409
Zenebe, Y., Akele, B., W/Selassie, M., & Necho, M. (2021). Prevalence and Determinants of Depression among Old Age: A Systematic Review and Meta-Analysis. Annals of General Psychiatry, 20, Article No. 55. https://doi.org/10.1186/s12991-021-00375-x
Zunszain, P. A., Anacker, C., Cattaneo, A., Carvalho, L. A., & Pariante, C. M. (2011). Glucocorticoids, Cytokines and Brain Abnormalities in Depression. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 35, 722-729. https://doi.org/10.1016/j.pnpbp.2010.04.011