Fountoulakis Konstantinos N, Siamouli Melina, Magiria Stamatia, Kaprinis George
3rd Department of Psychiatry, Aristotle University of Thessaloniki, 1 St. Kyriakidi Street, 546 36 Thessaloniki, Greece.
Med Hypotheses. 2008;70(3):493-6. doi: 10.1016/j.mehy.2007.01.093. Epub 2007 Sep 7.
Geriatric depression is considered to be a major health problem in the elderly. Passing the age, the speed of mental process is decreasing and personality obtains more mature functioning (better coping) while most of its traits remain stable. Empirical studies have shown that fear of death is most prominent during midlife and not late-life. Neuroimaging studies led to the "vascular depression" hypothesis. Depression was found to be a strong predictive factor leading to stroke, while religiosity seemed to be a 'protective' factor. A possible interpretation of these reports could consider late-life depression to be an early symptomatology of an undergoing vascular disease. Religiosity could be interpreted as absence of depression, and therefore, mainly as absence of vascular lesions. The above have profound implications in the understanding of late-life depression and to the therapeutic design, especially in the primary care setting.
老年抑郁症被认为是老年人的一个主要健康问题。随着年龄增长，心理过程的速度在减慢，人格获得更成熟的功能（更好的应对能力），而其大多数特质保持稳定。实证研究表明，对死亡的恐惧在中年而非晚年最为突出。神经影像学研究导致了“血管性抑郁”假说。抑郁症被发现是导致中风的一个强有力的预测因素，而宗教信仰似乎是一个“保护”因素。对这些报告的一种可能解释是，可将晚年抑郁症视为正在发生的血管疾病的早期症状。宗教信仰可被解释为无抑郁，因此，主要可解释为无血管病变。上述内容对理解晚年抑郁症以及治疗设计具有深远意义，尤其是在初级保健环境中。
