Background: It is difficult, but important, to distinguish between dementia and depression in old age because senile depression has atypical symptoms, including cognitive impairment and memory disorder. Now brain computed tomography, magnetic resonance imaging, single photon emission computed tomography, and positron emission tomography can be used to differentiate between these two conditions. However, these methods are expensive and not always available. In the present case series, we assessed the potential of monitoring the bispectral index to distinguish between dementia and depression. Methods: A processed electroencephalogram monitor (bispectral index (BSI) monitor) was used to assess brain activity during relaxed wakefulness in 12 participants (seven with Alzheimer's disease (AD), three with depression, and two healthy volunteers). Each recording lasted 5 min and four variables (i.e. BSI, 95% spectral edge frequency, electromyogram activity, and signal quality index) were monitored. Results: The BSI was significantly smaller in AD patients than in patients with depression (P < 0.05) and the 95% spectral edge frequency tended to be lower in AD patients than in patients with depression (P = 0.26). Slow waves were found in patients with AD and beta waves were predominant in patients with depression and healthy volunteers. Conclusion: In conclusion, the BSI and 95% spectral edge frequency were slightly smaller in dementia patients than in patients with depression. Paroxysmal slow waves may account for the low bispectral index. Thus, BSI monitoring may become a useful tool with which to distinguish AD from depression.
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