Late life depression and concepts of aging: an emerging paradigm

Frontiers in Medicine

Medicine

Yakir Rottenberg¹  Eli Sapir²  Lea Baider³  Gil Goldzweig⁴  Jeremy M. Jacobs⁵ 

[1] Department of Oncology, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel;Department of Radiation Oncology, Samson Assuta Ashdod University Hospital, Ashdod, Israel;Oncology Institute, Assuta Medical Center, Tel Aviv, Israel;School of Behavioral Sciences, Academic College of Tel Aviv-Yaffo, Tel Aviv, Israel;The Jerusalem Institute of Aging Research, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel;Department of Geriatric Rehabilitation and the Center for Palliative Care, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel;

关键词: late life depression;    aging models;    brain aging;    intrinsic capacity;    resilience;   

DOI  :  10.3389/fmed.2023.1218562

 received in 2023-05-07, accepted in 2023-07-17,  发布年份 2023

来源: Frontiers

【 摘 要 】

Late life depression (LLD) is an emerging challenge, and recognized as a significant barrier to long-term healthy aging. Viewed within the context of the medical/biological model, advances in brain sciences over the last several decades have led to a deeper understanding of the biology of LLD. These advances in current knowledge include the description of aging brain pathophysiology; the biology and biochemistry of neurotransmitters; the correspondence between changes in neurological structure, function, and neural network; the description of neural, hormonal and inflammatory biomarkers; and identification of typical phenotypic subtypes of LLD. Despite these advances, current treatment of LLD, which remains largely pharmacological with accompanying cognitive and behavioral interventions, has poor success rate for long-term remission among older people. A wider perspective, in keeping with several emerging aging concepts, is suggested as an alternative framework within which to view LLD. A growing body of research supports the important role in LLD of frailty, resilience, intrinsic capacity, and functional integrity. Similarly, important social determinants need to be addressed in the etiology of LLD, rooted largely in negative stereotypes of aging, with consequent repercussions of reduced participation and inclusion, growing social isolation, with loss of identity, meaning and hope. This perspective suggests the importance of a wider integrative conceptualization of depression, set against a background of emerging aging concepts.

【 授权许可】

Unknown   
Copyright © 2023 Jacobs, Baider, Goldzweig, Sapir and Rottenberg.