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Lifetime symptoms of depression in Alzheimer's disease

Published online by Cambridge University Press:  16 April 2020

Martin Kockler
Affiliation:
Department of Psychiatry, University of Bonn, Sigmund-Freud-Str. 25, 53105Bonn, Germany
Ursula Ptok
Affiliation:
Department of Psychiatry, University of Bonn, Sigmund-Freud-Str. 25, 53105Bonn, Germany
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Abstract

Introduction

Depression is common in Alzheimer's disease (AD). The symptomatology of depression in dementia may differ from depression alone. Consequently, the reports on lifetime depressive symptoms were compared in AD patients and age-matched non-demented participants.

Methods

Seventy-six AD patients, 109 elderly from the general population and their 189 siblings were examined using the Composite International Diagnostic Interview (CIDI). The presence of individual lifetime depressive symptoms was compared between 76 AD patients, 29 AD patients with comorbid depression, and different control groups using χ2 statistics and logistic regression analysis.

Results

Lifetime depressive symptoms were significantly more frequent in 76 AD patients than in 109 age-matched elderly from the general population. These 76 AD patients complained more about thinking and concentration disturbances, and less about depressed mood or appetite disturbance than the 298 non-demented participants matched for the lifetime presence of major depression (MD). In agreement, the 29 patients comorbid for lifetime diagnoses of AD and MD reported less about depressed mood than the 114 age-matched elderly with MD only. Feelings of worthlessness and suicidal ideas were related to the severity of cognitive decline.

Conclusions

AD influences the reports on lifetime depressive symptoms. This may be caused by additional neurodegeneration, by an overlap of symptoms of depression and dementia or by an altered perception of mood disturbances in AD. Further studies should investigate these alternatives.

Type
Original article
Copyright
Copyright © Éditions scientifiques et médicales Elsevier SAS 2002

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References

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 3rd ed., revised. Washington (DC: American Psychiatric Association; 1987.Google Scholar
Ballard, CG, Cassidy, G, Bannister, C, Mohan, RN.Prevalence, symptom profile and aetiology of depression in dementia sufferers. J Affect Disorders 1993;29:1–6.CrossRefGoogle ScholarPubMed
Berger, AK, Fratiglioni, L, Forsell, Y, Winblad, B, Backman, L.The occurrence of depressive symptoms in the preclinical phase of AD: a population-based study. Neurology 1999;53:1998–2002.CrossRefGoogle ScholarPubMed
Burgener, SC, Dickerson-Putman, J.Assessing patients in the early stages of irreversible dementia. The relevance of patient perspectives. J Gerontol Nurs 1999;25:33–41.CrossRefGoogle ScholarPubMed
Burke, WJ, Rubin, EH, Morris, JC, Berg, L.Symptoms of dementia of the Alzheimer type. Alz Dis Assoc Dis 1988;2:356–62.CrossRefGoogle ScholarPubMed
Carpenter, BD, Strauss, ME, Kennedy, JS.Personal history of depression and its appearance in Alzheimer’s disease. Int J Geriatr Psychiatry 1995;10:669–78.CrossRefGoogle Scholar
Devanand, DP, Sano, M, Tang, MX, Taylor, S, Gurland, BJ, Wilder, D, et al. Depressed mood and the incidence of Alzheimer’s disease in the elderly living in the community. Arch Gen Psychiatry 1996;53:175–82.CrossRefGoogle ScholarPubMed
DesRosiers, G.Primary or depressive dementia: clinical features. Int J Geriatr Psychiatry 1992;7:629–38.CrossRefGoogle Scholar
Draper, B, MacCuspie-Moore, C, Brodaty, H.Suicidal ideation and the ‘wish to die’ in dementia patients: the role of depression. Age Ageing 1998;27:503–7.CrossRefGoogle ScholarPubMed
Fischer, P, Simanyi, M, Danielczyk, W.Depression in dementia of the Alzheimer type and in multi-infarct dementia. Am J Psychiatry 1990; 147:1484–7.Google ScholarPubMed
Folstein, MF, Folstein, SE, McHugh, PR.Mini mental state. J Psychiat Res 1975;44:925.Google Scholar
Forsell, Y, Jorm, AF, Fratiglioni, L, Grut, M,Winblad, B.Application of DSM-II-R criteria for major depressive episode to elderly subjects with and without dementia. Am J Psychiatry 1993;150:1199–202.Google Scholar
Forsell, Y, Jorm, AF, Winblad, B.Association of age, sex, cognitive dysfunction and disability with major depressive symptoms in an elderly sample. Am J Psychiatry 1994;151:1600–4.Google Scholar
Forsell, Y, Winblad, B.Major depression in a population of demented and nondemented older people: prevalence and correlated. J Am Geriatr Soc 1998;46:27–30.CrossRefGoogle Scholar
Förstl, H, Burns, A, Luthert, P, Cairns, N, Lantos, P, Levy, R.Clinical and neuropathological correlates of depression in Alzheimer's disease. Psychol Med 1992;22:877–84.CrossRefGoogle ScholarPubMed
Gonzalez-Salvador, T, Lyketsos, CG, Baker, A, Hovanec, L, Roques, C, Brandt, J, et al. Quality of life in dementia patients in long-term care. Int J Geriatr Psychiatry 2000;15:181–9.3.0.CO;2-I>CrossRefGoogle Scholar
Hargrave, R, Reed, B, Mungas, D.Depressive syndromes and functional disability in dementia. J Geriatr Psych Neur 2000;13:72–7.CrossRefGoogle ScholarPubMed
Heun, R, Papassotiropoulos, A, Jessen, F, Maier, W, Breitner, JCS.A family study on the relationship between Alzheimer's disease, earlyonset and late-onset depression in the elderly. Arch Gen Psychiatry 2001;58:190–6.CrossRefGoogle Scholar
Kennedy, GJ, Kelman, HR, Thomas, C.The emergence of depressive symptoms in late life: the importance of declining health and increasing disability. J Community Health 1990;15:93–104.CrossRefGoogle ScholarPubMed
Kringlen, E, Torgersen, S, Cramer, VA.Norwegian psychiatric epidemiological study. Am J Psychiatry 2001;158:1091–8.CrossRefGoogle ScholarPubMed
Lazarus, LW, Newton, N, Cohler, B.Frequency and presentation of depressive symptoms in patients with primary degenerative dementia. Am J Psychiatry 1987;144:41–5.Google ScholarPubMed
Li, Y, Meyer, JS, Thornby, J.Depressive symptoms among cognitively normal versus cognitively impaired elderly subjects. Int J Geriatr Psychiatry 2001;16:455–61.CrossRefGoogle ScholarPubMed
Lindeman, S, Hamalainen, J, Isometsa, E, Kaprio, J, Poikolainen, K, Heikkinen, M, et al. The 12-month prevalence and risk factors for major depressive episode in Finland: representative sample of 5993 adults. Acta Psychiatr Scand 2000;102:178–84.CrossRefGoogle ScholarPubMed
Logie, SA, Murphy, JB, Brooks, DN,Wylie, S, Barron, ET,McCulloch, J.The diagnosis of depression in patients with dementia: use of the Cambridge mental disorders of the elderly examination (Camdex). Int J Geriatr Psychiatry 1992;7:363–8.CrossRefGoogle Scholar
Lyketsos, CG, Steele, C, Baker, L, Galik, E, Kopunek, S, Stienberg, M, et al. Major and minor depression in Alzheimer’s disease: prevalence and impact. J Neuropsychiat Clin Neurosci 1997;9: 556–61.Google ScholarPubMed
Newman, SC.The prevalence of depression in Alzheimer’s disease and vascular dementia in a population sample. J Affect Disorders 1999;52:169–76.CrossRefGoogle Scholar
Neundorfer, MM, McClendon, MJ, Smyth, KA, Stuckey, JC, Strauss, ME, Patterson, MB.A longitudinal study of the relationship between levels of depression among persons with Alzheimer's disease and levels of depression among their family caregivers. J Gerontol B Psychol Sci Soc Sci 2001;56:301–13.CrossRefGoogle ScholarPubMed
Migliorelli, R, Teson, A, Sabe, L, Petracchi, M, Leiguarda, R, Starkstein, SE.Prevalence and correlates of dysthymia and major depression among patients with Alzheimer's disease. Am J Psychiatry 1995; 152:37–44.Google ScholarPubMed
Papassotiropoulos, A, Heun, R.Screening for depression in the elderly: a study on misclassification by screening instruments and improvement of scale performance. Progr Neuropsychopharmacol Biol Psychiatry 1999;23:431–46.CrossRefGoogle Scholar
Payne, JL, Lyketsos, CG, Steele, C, Baker, L, Galik, E, Kopunek, S, et al. Relationship of cognitive and functional impairment to depressive features in Alzheimer's disease and other dementias. J Neuropsychiat Clin Neurosci 1998;10:440–7.CrossRefGoogle ScholarPubMed
Rovner, BW, Broadhead, J, Spencer, M, Carson, K, Folstein, MF.Depression and Alzheimer's disease. Am J Psychiatry 1989;146: 350–3.Google ScholarPubMed
Reichman, WE, Coyne, AC.Depressive symptoms in Alzheimer's disease and multi-infarct dementia. J Geriatr Psychiatry Neurol 1995; 8:96–9.CrossRefGoogle ScholarPubMed
Turvey, CL, Wallace, RB, Herzog, R.A revised CES-D measure of depressive symptoms and a DSM-based measure of major depressive episodes in the elderly. Int Psychogeriat 1999;11:139–48.CrossRefGoogle Scholar
Weiner, MF, Edland, SD, Luszczynska, H.Prevalence and incidence of major depression in Alzheimer's disease. Am J Psychiatry 1994;151: 1006–9.Google ScholarPubMed
Weiner, MF, Svetlik, D, Risser, RC.What depressive symptoms are reported in Alzheimer's patients? Int J Geriatr Psychiatry 1997;12: 648–52.3.0.CO;2-C>CrossRefGoogle ScholarPubMed
World Health Organization. Composite International Diagnostic Interview. Geneva: World Health Organization, Division of Mental Health; 1990.Google Scholar
Wittchen, HU.Reliability and validity studies of the WHO-Composite International Diagnostic Interview (CIDI): a critical review. J Psychiat Res 1994;28:57–84.CrossRefGoogle ScholarPubMed
Wittchen, HU, Carter, RM, Pfister, H, Montgomery, SA, Kessler, RC.Disabilities and quality of life in pure and comorbid generalized anxiety disorder and major depression in a national survey. Int Clin Psychopharmacol 2000;15:319–28.CrossRefGoogle ScholarPubMed
Zankd, S, Leipold, B.The relationship between severity of dementia and subjective well-being. Aging Ment Health 2001;5:191–6.CrossRefGoogle ScholarPubMed
Zubenko, GS, Moossy, J, Kopp, U.Neurochemical correlates of major depression in primary dementia. Arch Neurol 1990;47:209–14.CrossRefGoogle ScholarPubMed
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