June 19, 2018
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Research targets depression among older people

By Harry Jackson Jr., St. Louis Post-Dispatch

ST. LOUIS — Caroll Marlow, 71, said she has been rescued from clinical depression by researchers at Washington University who want to help people older than 60.
After more than 40 years of living with depression, she said, experiences and feelings that are routine for most other people are new for her.
She goes to lunch to laugh with her sisters; she’s closer to her children and friends. She dates her husband.
And she found a job. She’s a cashier at a Cracker Barrel restaurant in St. Louis County, Mo.

“It’s like a bolt of lightning,” said Pat Marlow, 73, of Frontenac, Mo., and Caroll’s husband of 50 years. “She’s a different person.”
Dr. Eric Lenze, a geriatric psychiatrist with Washington University School of Medicine, is conducting two studies. One seeks a drug regimen that addresses depression in people older than 60. The other looks at mindfulness meditation to ease depression and anxiety disorders in people older than 65.
Lenze says the studies originated because when he sought depression and anxiety remedies for his patients, “There were few evidence-based options for treatments of elders with anxiety disorders and clinical depression.”
Almost all of the studies for drug and other mental health remedies, “were on young, healthy people; nothing included older adults.
“Our lab is looking at dosages, side effects, and other ways the treatments might affect older people differently,” Lenze said.
The late-life depression study is testing two drugs, venlafaxine, a popular generic antidepressant drug with minimal side effects, and Abilify, which is supposed to enhance the effectiveness of antidepressant medicines. Abilify’s generic name is aripiprazole.
All participants get the venlafaxine for a time. If their conditions don’t improve, they will get Abilify or a placebo.
They stay on the regimen for several months.
The foundation of the mindfulness meditation study “has shown promise as a treatment for depression and anxiety disorders based on studies in younger adults,” Lenze said.
Mindfulness meditation, calming the mind by concentrating on something in the moment, has shown promise to have beneficial emotional and physical effects, Lenze said.
As part of the anti-stress component of meditation, it reduces the level of cortisol, the “fight or flight” hormone that elevates when someone is under stress, he said.
Cortisol serves a necessary short-term purpose, he said. But it’s harmful if it’s produced steadily for prolonged periods, Lenze said.
A particularly bad effect for older people is that too much cortisol hampers memory and thinking functions and can increase the risk of dementia, Lenze said.
“Our evidence is that if you can reduce [cortisol] there’s a memory improvement, people think better; their minds actually work better and they feel better,” he said.

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