Dementia and Depression in Elderly Medical Inpatients

Abstract

The purpose of this study was to examine the prevalence and correlation of cognitive impairments, major depression, and depressive symptoms among elderly medical inpatients, and to compare the degree of depressive symptomatology as well as cognitive deterioration in possible vascular dementia and possible Alzheimer's disease. In a department of internal medicine, 100 (36 male, 64 female) 65-year-old or older patients were examined by a semistructured interview, and assessed by the Hachinski Ischemic Scale, the Hamilton Rating Scale for Depression (HDS), and the Modified Mini-Mental State (MMMS) Examination. In our total sample, the MMMS total score was (±SD) 76.0 ± 15.5 and the HDS total score was (±SD) 12.0 ± 6.1. Based on DSM-IV criteria, major depression was established in 11 patients. Deterioration of cognitive functions was seen in 66 patients; cognitive impairment was mild in 30 patients, moderate in 19, and severe in 17. Forty-six patients had mild depressive symptoms and 27 had severe depressive symptoms. In summary, a high prevalence of cognitive dysfunction and depressive symptomatology was detected in our study, illustrating the importance of psychiatric care in elderly medical inpatients.

Epidemiological studies of cognitive impairment and dementia across Eastern and Middle European countries (epidemiology of dementia in Eastern and Middle European Countries)

“…among people from departments of internal medicine (Linka et al, 2000;Klich-Raczka et al, 2006), residential homes (Vincze et al, 2007), neurological units (Klimkowicz et al, 2002;Klimkowicz-Mrowiec et al, 2006), and memory clinics (Sobow et al, 2006). Most of the studies were cross-sectional and two of them were cohort studies (Klimkowicz-Mrowiec et al, 2006;Vincze et al, 2007).…”

Depressive symptoms among cognitively normal versus cognitively impaired elderly subjects

“…HDRS cut-off points for normal are 7, for mild to moderate (or minor) depression are between 8 and 16, and for severe (major) depression are !17 (Williams et al, 1995;Linka et al, 2000). During clinic visits, all subjects underwent routine medical and neurological examinations as well as neuropsychiatric interviews.…”

Screening for depression in older medical inpatients

“…However, the cost implications for such a programme, particularly in terms of staffing, are potentially enormous. Studies in Europe and North America which used recognised screening tools and standardised diagnostic interviews in older medical inpatients reported between 9% and 42% of inpatients scored above recommended screening cut-points (Magni et al, 1985;Koenig et al, 1988a;Koenig et al, 1989;O'Riordan et al, 1989;Kok et al, 1995;Koenig et al, 1997;Inouye et al, 1998;Covinsky et al, 1999;Linka et al, 2000;Pouget et al, 2000), and between 6% and 36% had clinical depressive disorder (Koenig et al, 1988a;Rapp et al, 1988;O'Riordan et al, 1989;Koenig et al, 1991;Burn et al, 1993;Hammond et al, 1993;Fenton et al, 1994;Kok et al, 1995;Koenig et al, 1997;Linka et al, 2000;Schneider et al, 2000;Borin et al, 2001). This considerable variation is likely to be accounted for by differences in definition of screening, instruments used, variations in the target populations, approaches to sampling and accuracy of estimates.…”