Anti-Aging Medicine

by Ronald Klatz, MD, DO, and Robert Goldman, MD, PhD, DO, FAASP

American Academy of Anti-Aging Medicine (A4M; www.worldhealth.net)

An Anti-Aging Approach to Depression

Feeling sad is a part of life, but those of us for whom the feeling persists beyond a day or two may be experiencing the clinical medical disorder of depression. A common but serious illness, people with depressive illnesses do not all experience the same symptoms. The severity, frequency and duration of symptoms will vary depending on the individual and his or her particular illness. Symptoms include:

• persistent sad, anxious, or “empty” feelings

• feelings of hopelessness and/or pessimism

• feelings of guilt, worthlessness, and/or helplessness

• irritability, restlessness

• loss of interest in activities or hobbies once pleasurable, including sex

• fatigue and decreased energy

• difficulty concentrating, remembering details, and making decisions

• insomnia, early-morning wakefulness, or excessive sleeping

• overeating, or appetite loss

• thoughts of suicide, suicide attempts

• persistent aches or pains, headaches, cramps, or digestive problems that do not ease even with treatment

Disability-adjusted life years (DALYs) represent the total burden of disability of a disease, signifying the total number of years lost to illness, disability, or premature death within a given population. The World Health Organization (WHO) estimates that depression makes up more than one-third of the DALYs in the category of neuropsychiatric disorders, and on its own represents 10% of all DALYs in the US and Canada.

The first step to getting appropriate treatment for depression is to visit a doctor. Certain medications taken for other medical conditions, vitamin B12 deficiency, some viruses, or a thyroid disorder can cause symptoms similar to depression. A complete physical exam, interview, and lab tests will facilitate an accurate diagnosis. In this article, we review recent the latest study findings suggesting lifestyle and dietary modifications that may help to manage the symptoms of depression.

National Institute of Mental Health. Depression [Web page]. http://www.nimh.nih.gov/health/topics/depression/index.shtml. Accessed 5 July 2011.

———. Disorders within the Neuropsychiatric Category [Web page]. http://www.nimh.nih.gov/statistics/2CDNC.shtml. Accessed 5 July 2011.

Tai Chi Improves Symptoms of Depression

The Chinese wellness practice of tai chi is an important adjunctive therapy that improves quality of life among seniors affected by depression. Helen Lavretsky and colleagues from the University of California/Los Angeles (UCLA; California, USA) investigated the role of tai chi, a Chinese wellness practice that has been previously associated with a variety of physical and mental health benefits, in ameliorating the symptoms of depression in seniors. The team combined a weekly tai chi exercise class with a standard depression treatment for a group of depressed elderly adults, finding a greater improvement in the level of depression – along with improved quality of life, better memory and cognition, and more overall energy – than that achieved by a different group in which the standard treatment was paired with a weekly health education class. The researchers conclude that: “Complementary use of a mind-body exercise, such as [tai chi], may provide additional improvements of clinical outcomes in the pharmacologic treatment of geriatric depression.”

Lavretsky H, Alstein LL, Olmstead RE, et al. Complementary use of tai chi chih augments escitalopram treatment of geriatric depression: a randomized controlled trial. Am J Geriatr Psychiatry. 6 March 2011.

Omega-3 May Offset Depression

Daily omega-3 supplements may reduce the occurrence of the symptoms of depression in elderly women. University of Pavia (Italy) researchers add data suggesting that the nutrients may ameliorate the symptoms of depression. Mariangela Rondanelli and colleagues recruited 46 depressed senior women at a nursing home in Pavia and randomly assigned each to receive omega-3 supplements, or a placebo, for two months. The depressed women who received daily supplements containing 2.5 grams of omega-3 experienced significant reductions in their symptoms. Further, omega-3 supplements providing a daily EPA (eicosapentaenoic acid) dose of 1.67 grams and a daily DHA (docosahexaenoic acid) dose of 0.83 grams significantly improved self-reported quality of life. No adverse effects were reported. The researchers conclude: “Supplementation of [omega-3 fatty acids] in elderly female patients reduces the occurrence of depressive symptoms, improves phospholipids fatty acids profile and health-related quality of life.”

Rondanelli M, Giacosa A, Opizzi A, et al. Long chain omega 3 polyunsaturated fatty acids supplementation in the treatment of elderly depression: Effects on depressive symptoms, on phospholipids fatty acids profile and on health-related quality of life. J Nutr Health Aging. 2011;15(1):37–44.

Bright Light Therapy Eases Depression

A light therapy box helps to alleviate depressive symptoms in older adults. Ritsaert Lieverse and colleagues from VU University Medical School (the Netherlands) enrolled 89 men and women, ages 60-plus, assigning each randomly to one of two groups: in the first group, participants utilized a light-therapy box, which emitted pale blue light, each morning for one hour for 3 weeks; the rest of the study participants (control group) were assigned boxes that emitted a dim red light, which has no known effects on the human body. After three weeks of treatment, the researchers found that the light-therapy group showed a greater improvement in scores on a standard measure of depression symptoms. Three weeks after the therapy ended, more people in the light-therapy group exhibited marked drops in depression scores: 50% of the light-therapy patients, compared with 34% of controls. The team concluded: “In elderly patients with [major depressive disorder], [bright light therapy] improved mood, enhanced sleep efficiency, and increased the upslope melatonin level gradient. In addition, [bright light therapy] produced continuing improvement in mood … after discontinuation of treatment.”

Lieverse R, Van Someren EJW, Nielen MMA, et al. Bright light treatment in elderly patients with nonseasonal major depressive disorder: a randomized placebo-controlled trial. Arch Gen Psychiatry. Jan 2011;68:61–70.

Outdoor Activities Promote Well-Being

People who engage in physical activities in the outdoor setting experience mental and emotional revitalization with reduced feelings of tension, confusion, anger, and depression. Peninsula College of Medicine and Dentistry (UK) researchers conducted a meta-analysis of 11 clinical studies involving 833 adult subjects, each of which assessed the effects of outdoor exercise initiatives against indoor activities and reported at least one physical or mental well-being outcome. The team found that most of studies involving outdoor-located activities correlated to improvements in mental well-being: compared with exercising indoors, exercising in natural environments was associated with greater feelings of revitalization, increased energy, and positive engagement, together with decreases in tension, confusion, anger, and depression. Participants also reported greater enjoyment and satisfaction with outdoor activity and stated that they were more likely to repeat the activity at a later date. The team observes: “[These findings add] significant weight to the case for spending more time in the natural environment as members of the public and their clinicians fight to counteract the negative outcomes of modern living, such as obesity and depression.”

Coon JT, Boddy K, Stein K, Whear R, Barton J, Depledge MH. does participating in physical activity in outdoor natural environments have a greater effect on physical and mental wellbeing than physical activity indoors? A systematic review. Environ Sci Technol. February 3, 2011; DOI:10.1021/es102947t.

Depression is estimated to affect 6.7% of all US adults, and the condition is classified as “severe” in 30.4% of these cases. As well, the condition is financially burdensome. Data from the Agency for Healthcare Research and Quality’s (AHRQ’s) Medical Expenditure Panel Survey (MEPS) reports that 36.2 million Americans paid for mental health services totaling $57.5 billion in 2006 – averaging to a per-person expenditure of $1591.

National Institute of Mental Health. Mental healthcare cost data for all Americans (2006) [Web page]. http://www.nimh.nih.gov/statistics/4COST_AM2006.shtml. Accessed 5 July 2011.

———. Major depressive disorder among adults [Web page]. http://www.nimh.nih.gov/statistics/1MDD_ADULT.shtml. Accessed 5 July 2011.

To stay updated on the latest breakthroughs in natural, nutritional and lifestyle approaches to help you to manage the symptoms of depression, visit the World Health Network (www.worldhealth.net), the official educational website of the A4M and your one-stop resource for authoritative anti-aging information. Be sure to sign up for the free Longevity Magazine e-Journal, the A4M’s award-winning weekly health newsletter featuring wellness, prevention, and biotech advancements in longevity.