Zhao Yuanzhi, Wu Xiangping, Tang Min, Shi Lingli, Gong Shuang, Mei Xi, Zhao Zheng, He Jiayue, Huang Ling, Cui Wei
Ningbo Kangning Hospital, Ningbo, Zhejiang, China.
Department of Neurology, Ningbo Rehabilitation Hospital, Ningbo, Zhejiang, China.
Front Psychiatry. 2023 Apr 6;14:1017203. doi: 10.3389/fpsyt.2023.1017203. eCollection 2023.
Late-life depression (LLD) is one of the most common mental disorders among the older adults. Population aging, social stress, and the COVID-19 pandemic have significantly affected the emotional health of older adults, resulting in a worldwide prevalence of LLD. The clinical phenotypes between LLD and adult depression differ in terms of symptoms, comorbid physical diseases, and coexisting cognitive impairments. Many pathological factors such as the imbalance of neurotransmitters, a decrease in neurotrophic factors, an increase in β-amyloid production, dysregulation of the hypothalamic-pituitary-adrenal axis, and changes in the gut microbiota, are allegedly associated with the onset of LLD. However, the exact pathogenic mechanism underlying LLD remains unclear. Traditional selective serotonin reuptake inhibitor therapy results in poor responsiveness and side effects during LLD treatment. Neuromodulation therapies and complementary and integrative therapies have been proven safe and effective for the treatment of LLD. Importantly, during the COVID-19 pandemic, modern digital health intervention technologies, including socially assistive robots and app-based interventions, have proven to be advantageous in providing personal services to patients with LLD.
老年期抑郁症(LLD)是老年人中最常见的精神障碍之一。人口老龄化、社会压力和新冠疫情严重影响了老年人的情绪健康,导致LLD在全球范围内流行。LLD与成人抑郁症的临床表型在症状、共病躯体疾病和并存的认知障碍方面存在差异。许多病理因素,如神经递质失衡、神经营养因子减少、β-淀粉样蛋白生成增加、下丘脑-垂体-肾上腺轴失调以及肠道微生物群变化,据称与LLD的发病有关。然而,LLD的确切致病机制仍不清楚。传统的选择性5-羟色胺再摄取抑制剂疗法在LLD治疗期间反应性差且有副作用。神经调节疗法以及补充和综合疗法已被证明对LLD的治疗安全有效。重要的是,在新冠疫情期间,包括社交辅助机器人和基于应用程序的干预措施在内的现代数字健康干预技术已被证明在为LLD患者提供个性化服务方面具有优势。
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