Clinically significant depressive symptoms and very mild to mild dementia of the Alzheimer type

• Published in: International journal of geriatric psychiatry Vol. 16; no. 7; pp. 694 - 701
• Main Authors: Rubin, Eugene H., Veiel, Lori L., Kinscherf, Dorothy A., Morris, John C., Storandt, Martha
• Format: Journal Article
• Language: English
• Published: Chichester, UK John Wiley & Sons, Ltd 01-07-2001; Wiley
• Subjects: Adult and adolescent clinical studies; affective symptoms; Aged; Alzheimer Disease - psychology; Alzheimer's disease; Analysis of Variance; Biological and medical sciences; Cross-Sectional Studies; dementia; Depression; Depression - diagnosis; Depression - epidemiology; Female; Humans; Male; Medical sciences; Missouri - epidemiology; Mood disorders; Multivariate Analysis; Organic mental disorders. Neuropsychology; Proxy; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Self-Assessment; Missouri; Human; Mood disorder; Geriatric Depression Scale Yesavage; Nervous system diseases; Questionnaire; Alzheimer disease; Depression; Psychometrics; Cerebral disorder; Affective disorder; Symptomatology; Concomitant disease; Cross sectional study; Central nervous system disease; Directive interview; Degenerative disease; Severity score; Diagnosis; Elderly; Comparative study
• ISSN: 0885-6230; 1099-1166
• DOI: 10.1002/gps.408

Objective
To compare depressive symptoms reported by persons with very mild or mild dementia of the Alzheimer type (DAT) with those reported for the person by a collateral source.
Design
Cross‐sectional evaluation.
Setting
Washington University Alzheimer's Disease Research Center.
Participants
Consecutive series of elderly volunteers (n = 156) enrolled in longitudinal studies with a Clinical Dementia Rating (CDR) of 0.5 (very mild) or 1 (mild). Twenty‐one per cent (n = 33) exhibited clinically significant depressive symptoms for which treatment was recommended.
Main outcome measures
Presence and frequency of DSM‐IV depressive symptoms within the last year and last month reported by the participant or collateral source as ascertained by clinical examination and structured interviews.
Results
Collateral source information is essential in diagnosing clinically significant depressive symptoms. The Geriatric Depression Scale scores correlate with participant information only and therefore may substantially underestimate depression. Depressive symptoms fluctuate in individuals with DAT. The most consistent depressive symptoms are depressed mood, fatigue and indecision.
Conclusions
Clinically significant depressive symptoms may be common in individuals with very mild or mild DAT, although they may fluctuate. Information from both a knowledgeable collateral source and the participant is important for detection of depressive symptoms. Copyright © 2001 John Wiley & Sons, Ltd.