Co-Occurrence of Affective and Cognitive Symptoms: The Epidemiological Evidence

Henderson, A. S.

doi:10.1159/000107130

Cited by 18 publications

(18 citation statements)

References 14 publications

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“…It should also be noted that, in accordance with other studies (Henderson, 1990;Wragg and Jeste, 1989), we found depressive features in about 40% of patients. However, it has been suggested that the use of self-rating depression scales in dementia may be of questionable reliability because of possible patient denial or lack of insight (Mahurin et al, 1991).…”

Section: Discussionsupporting

confidence: 93%

Determinants of disability in alzheimer's disease

Zanetti

Bianchetti

Frisoni

et al. 1993

Int J Geriat Psychiatry

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RENZO ROZZINI MARC0 TRABUCCHI SUMMARYThe aim of the study is to evaluate risk factors of disability in a population of 64 patients affected by Alzheimer's disease. The subjects were consecutively recruited at the day hospital service of an Alzheimer's dementia care unit. The associations between activities of daily living and age, cognitive status, affective status, cognitive symptoms duration and number of diseases were evaluated within a multidimensional assessment programme. Cognitive performance, as detected by the Mini-Mental Status Examination, was the main independent predictor of disability; other independent predictors of disability were age and cognitive disease duration. Number of diseases-physical and mental-and self-rated depression scores were not independently associated with disability. It is concluded that, in a population of Alzheimer's patients, cognitive impairment has a high impact on the aetiology of disability, but other variables such as age and disease duration should be taken into account. It is also suggested that cognitive performance is the most important indicator of performance in activities of daily living.

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Section: Discussionsupporting

confidence: 93%

Determinants of disability in alzheimer's disease

Zanetti

Bianchetti

Frisoni

et al. 1993

Int J Geriat Psychiatry

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“…In clinical samples of dementia patients, a high prevalence of depression has been reported [2]. In general population Included only episodes of depression occurring before age 55.…”

Section: Introductionmentioning

confidence: 99%

Is Depression a Risk Factor for Dementia or Cognitive Decline?

2000

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Background: It is generally accepted that depression can be associated with significant cognitive deficits and that depression can be comorbid with dementia. Objective: This review seeks to go further and ask whether depression earlier in life can be a risk factor for subsequent dementia or for cognitive decline. Methods: A review was made of the epidemiological evidence from case-control and prospective studies that depression is a risk factor. The literature was also reviewed in relation to six hypotheses that might explain an association: (1) depression treatments are a risk factor for dementia, (2) dementia and depression share common risk factors, (3) depression is a prodrome of dementia, (4) depression is an early reaction to cognitive decline, (5) depression affects the threshold for manifesting dementia, and (6) depression is a causal factor in dementia. Results: A meta-analysis found that depression was associated with an increased risk of subsequent dementia in both case-control studies (95% CI for relative risk: 1.16–3.50) and prospective studies (95% CI: 1.08–3.20). There was little support for hypotheses 1 and 2. The other hypotheses have limited support, but warrant further research. Conclusion: There is sufficient evidence to take seriously the possibility that depression is a risk factor for dementia and cognitive decline. Further work is needed to examine depression as a prodrome of vascular dementia, depression as an early reaction to perceived cognitive decline, the effects of depression on the threshold for manifesting dementia, and depression as a source of hippocampal damage through a glucocorticoid cascade.

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“…Most of such information comes from clinic-based studies of treated series. The outcome variables have typically included the rate of recovery, the coexistence of depression with dementia and the progression of depression to dementia (Cole, 1990;Baldwin and Jolley, 1986;Baldwin, 1988;Gordon, 1981;Reding et al, 1985;Reifler et al, 1986;Henderson, 1990;Blazer et al, 1980;Post, 1972;Murphy, 1983;Burvill et al, 1989). However, clinic based studies have limitations.…”

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confidence: 99%

Outcome of depression in demented and non‐demented elderly: Observations from a three‐year follow‐up in a community‐based study

Forsell

Jorm

Winblad

1994

Int J Geriat Psychiatry

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SUMMARYIn the Kungsholmen project, a longitudinal study of a total population, samples of non-demented and demented elderly persons with a depressive disorder were followed over 3 years. Of 668 persons who received a full medical examination, 62 were found to have a depressive disorder. Of these, 28 were demented and 34 non-demented. Two-thirds of the 62 had not been previously recognized as having a depressive disorder. There was no difference in this regard between the demented and non-demented samples. After 3 years, only two out of 20 non-demented cases had recovered from their depressive disorder. This is in contrast to the demented cases, where only one of 11 were still depressed. These results indicate the need for greater attention to the recognition and management of depressive disorders in the elderly.KEY woms-Depression, dementia, elderly, longitudinal study.Knowledge of the outcome of depression in community samples is limited. Most of such information comes from clinic-based studies of treated series. The outcome variables have typically included the rate of recovery, the coexistence of depression with dementia and the progression of depression to dementia (Cole, 1990;Baldwin and Jolley, 1986;Baldwin, 1988;Gordon, 1981;Reding et al., 1985;Reifler et al., 1986;Henderson, 1990;Blazer et al., 1980;Post, 1972;Murphy, 1983;Burvill et al., 1989). However, clinic based studies have limitations. They cover only a subset of all the cases in the population. Cases that are unrecognized and untreated are excluded. Population-based studies are rare, but in a community study by O'Connor et al. (1990), 12/18 non-demented depressed cases were depressed 1 year later and two had developed a dementia. It is notable that in this study the sample excluded persons with good cognitive function and its follow-up period was relatively short.The present article uses data from the Kungsholmen study, which partly overcomes these limitations. This is a longitudinal community study that includes the full range of cognitive function with a follow-up time of 3 years. The aim of the present article is to examine the following issues:1. The recognition of depressive disorders in a community sample of elderly, with and without comorbid dementia 2. Whether the co-occurrence of dementia influences recovery 3. Whether depression progresses to dementia

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Co-Occurrence of Affective and Cognitive Symptoms: The Epidemiological Evidence

Cited by 18 publications

References 14 publications

Determinants of disability in alzheimer's disease

Determinants of disability in alzheimer's disease

Is Depression a Risk Factor for Dementia or Cognitive Decline?

Outcome of depression in demented and non‐demented elderly: Observations from a three‐year follow‐up in a community‐based study

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