Hostname: page-component-cd9895bd7-mkpzs Total loading time: 0 Render date: 2024-12-27T13:53:07.307Z Has data issue: false hasContentIssue false
  • English
  • Français

Depression in Taiwanese patients with Alzheimer's disease determined by the National Institutes of Mental Health Provisional Criteria

Published online by Cambridge University Press:  14 February 2012

Pai-Yi Chiu ,
David Steffens ,
Ping-Kun Chen ,
Ya-Chen Hsu ,
Hsiu-Tzu Huang  and
Te-Jen Lai
Pai-Yi Chiu
Affiliation:
Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan Department of Neurology, Taichung Lin-Shin Hospital, Taichung, Taiwan
David Steffens
Affiliation:
Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA
Ping-Kun Chen
Affiliation:
Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
Ya-Chen Hsu
Affiliation:
Department of Psychiatry, Taichung Lin-Shin Hospital, Taichung, Taiwan
Hsiu-Tzu Huang
Affiliation:
Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
Te-Jen Lai*
Affiliation:
Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan Department of Psychiatry, Chung Shan Medical University Hospital, Taichung, Taiwan
*
Correspondence should be addressed to: Dr. Te-Jen Lai, Department of Psychiatry, Chung Shan Medical University Hospital, No. 110, Sec. 1, Jianguo N. Rd., Taichung 402, Taiwan. Phones: +886-916-344326; +886-4-2473-0022, Ext 11011; Fax: +886-4-2475-9950. Email: tejenlai@hotmail.com; ltj3123@ms2.hinet.net.
Get access

Abstract

Background: Depression is a common behavioral and psychological symptom of Alzheimer's disease (AD). The aims of the present study were to determine the rate of depression in Taiwanese patients with AD using the National Institutes of Mental Health Provisional Criteria for Depression in AD (NIMH-dAD criteria) and to investigate the association of depression with other behavioral and psychological symptoms.

Methods: A consecutive series of 302 AD patients registered in a dementia clinic were investigated in this study. All patients met the criteria of the National Institute of Neurological Disorders and Stroke–Alzheimer's Disease and Related Disorders Association for probable AD. The rates of depression were determined according to the criteria of the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders for major depression (DSM-IV), the International Classification of Diseases-9-Clinical Modification (ICD-9-CM) for neurotic depression, the depression subscale of the Neuropsychiatric Inventory (NPI), and the NIMH-dAD criteria. Depression severity was assessed using the 17-item Hamilton Depression Rating Scale. The rates of depression determined by the NIMH-dAD criteria were compared with the rates derived from each of the other instruments. Other behavioral and psychological symptoms were assessed using NPI. A behavioral neurologist or a geriatric psychiatrist interviewed all the patients.

Results: Using the NIMH-dAD criteria, it was found that 90 (29.8%) of the AD patients had depression, and all depressive symptoms in NIMH-dAD were significantly higher among depressed patients. Among other depression instruments, the frequency of depression was lowest using the DSM-IV major depression criteria (9.3%) and highest with the NPI depression subscale (54%). Behavioral and psychological symptoms determined with NPI were significantly higher among depressed patients in all domains except euphoria.

Conclusions: This is the first study of depression in Taiwanese patients with AD using the NIMH-dAD criteria. Our findings suggest that comorbid depression is high in Taiwanese patients with AD. It is clinically important to note the high frequency of most behavioral and psychological symptoms among depressed AD patients.

Keywords

depressionAlzheimer's diseaseNational Institutes of Mental Health Provisional Criteriabehavioral and psychological symptoms
Type
Research Article
Information
International Psychogeriatrics , Volume 24 , Special Issue 8: Focus on late life depression , August 2012 , pp. 1299 - 1305
Copyright
Copyright © International Psychogeriatric Association 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Barca, M. L., Engedal, K. and Selbaek, G. (2010). A reliability and validity study of the Cornell Scale among elderly inpatients, using various clinical criteria. Dementia and Geriatric Cognitive Disorders, 29, 438–447.CrossRefGoogle ScholarPubMed
Berger, A. K., Fratiglioni, L., Forsell, Y., Winblad, B. and Bäckman, L. S.O. (1999). The occurrence of depressive symptoms in the preclinical phase of AD. Neurology, 53, 1998–2002.CrossRefGoogle ScholarPubMed
Butters, M. A. et al. (2000). Changes in cognitive functioning following treatment of late life depression. American Journal of Psychiatry, 157, 1949–1954.CrossRefGoogle ScholarPubMed
Chong, M. Y. et al. (2001). Community study of depression in old age in Taiwan: prevalence, life events and socio-demographic correlates. British Journal of Psychiatry, 178, 29–35.CrossRefGoogle ScholarPubMed
Cummings, J. L., Mega, M., Gray, K., Rosenberg-Thompson, S., Carusi, D. A. and Gornbein, J. (1994). Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia. Neurology, 4, 2308–2314.CrossRefGoogle Scholar
Draper, B. (1999). The diagnosis and treatment of depression in dementia. Psychiatric Services, 50, 1151–1153.CrossRefGoogle ScholarPubMed
Dubois, B., Slachevsky, A., Litvan, I. and Pillon, B. (2000). The FAB: a Frontal Assessment Battery at bedside. Neurology, 55, 1621–1626.CrossRefGoogle ScholarPubMed
Folstein, M., Folstein, S. and McHugh, P. (1975). “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.CrossRefGoogle ScholarPubMed
Fuh, J. L. (2006). Study of behavioral and psychological symptoms of dementia in Taiwan. Acta Neurologica Taiwanica, 15, 154–160.Google ScholarPubMed
Gilley, D. W. and Wilson, R. S. (1997). Criterion-related validity of the Geriatric Depression Scale in Alzheimer's disease. Journal of Clinical and Experimental Neuropsychology, 19, 489–499.CrossRefGoogle ScholarPubMed
Hachinski, V. C. et al. (1975). Cerebral blood flow in dementia. Archive of Neurology, 32, 632–637.CrossRefGoogle ScholarPubMed
Jorm, A. F. (2000). Is depression a risk factor for dementia or cognitive decline? A review. Gerontology, 46, 219–227.CrossRefGoogle ScholarPubMed
Kertzman, S. G., Treves, I. A., Treves, T. A., Vainder, M. and Korczyn, A. D. (2002). Hamilton Depression Scale in Dementia. International Journal of Psychiatry in Clinical Practice, 6, 91–94.CrossRefGoogle ScholarPubMed
Krishnan, K. R. et al. (2004). Clinical characteristics of magnetic resonance imaging-defined subcortical ischemic depression. Biological Psychiatry, 55, 390–397.CrossRefGoogle ScholarPubMed
Liu, C. Y. et al. (1999). Depressive disorders in Chinese patients with Alzheimer's disease. Acta Psychiatrica Scandinavica, 100, 451–455.CrossRefGoogle ScholarPubMed
Luchsinger, J. A., Honig, L. S., Tang, M. X. and Devanand, D. P. (2008). Depressive symptoms, vascular risk factors, and Alzheimer's disease. International Journal of Geriatric Psychiatry, 23, 922–928.CrossRefGoogle ScholarPubMed
Lyketsos, C. G., Steinberg, M., Tschantz, J., Norton, M., Steffens, D. and Breitner, J.C.S. (2000). Mental and behavioral disturbances in dementia: findings from the Cache County Study on Memory in Aging. American Journal of Psychiatry, 157, 708–714.CrossRefGoogle Scholar
Mahoney, F. I. and Barthel, D. (1965). Functional evaluation: the Barthel Index. Maryland State Medical Journal, 14, 56–61.Google ScholarPubMed
Morris, J. C. (1993). The Clinical Dementia Rating (CDR): current version and scoring rules. Neurology, 43, 2412–2414.CrossRefGoogle ScholarPubMed
Naarding, P., Leentjens, A. F. G., Kooten, F. and Verhey, F. R. J. (2002). Disease-specific properties of the Hamilton Rating Scale for Depression in patients with stroke, Alzheimer's dementia, and Parkinson's disease. Journal of Neuropsychiatry and Clinical Neuroscience, 14, 329–334.CrossRefGoogle ScholarPubMed
Olin, J. T., Katz, I. R., Meyers, B. S., Schneider, L. S. and Lebowitz, B. D. (2002). Provisional diagnostic criteria for depression of Alzheimer's disease: rationale and background. American Journal of Geriatric Psychiatry, 10, 129–141.CrossRefGoogle ScholarPubMed
Raffaele, R. et al. (2002). Citalopram in the treatment of depression in the elderly. Archives of Gerontology and Geriatrics, 8 (Suppl.), 303–308.CrossRefGoogle ScholarPubMed
Starkstein, S. E. and Mizrahi, R. (2006). Depression in Alzheimer's disease. Expert Review of Neurotherapeutics, 6, 887–895.CrossRefGoogle ScholarPubMed
Teng, E. L. et al. (1994). The Cognitive Abilities Screening Instrument (CASI): a practical test for cross-cultural epidemiological studies of dementia. International Psychogeriatrics, 6, 45–58.CrossRefGoogle Scholar
Teng, E. et al. (2008). Diagnosing depression in Alzheimer's disease with the National Institute of Mental Health Provisional Criteria. American Journal of Geriatric Psychiatry, 16, 469–477.CrossRefGoogle ScholarPubMed
Vasconcelos Cunha, U. G., Rocha, F. L. and Melo, R. A. (2007). A placebo-controlled double-blind randomized study of venlafaxine in the treatment of depression in dementia. Dementia and Geriatric Cognitive Disorders, 24, 36–41.CrossRefGoogle ScholarPubMed
Vilalta-Franch, J. et al. (2006). Comparison of different clinical diagnostic criteria for depression in Alzheimer's disease. American Journal of Geriatric Psychiatry, 14, 589–597.CrossRefGoogle Scholar
Vilalta-Franch, J. et al. (2012). Depression subtypes and 5-year risk of mortality in aged 70 years: a population-based cohort study. International Journal of Geriatric Psychiatry, 27, 67–75.CrossRefGoogle Scholar
Wilson, R. S., Schneider, J. A., Bianias, J. L., Arnold, S. E., Evans, D. A. and Bennett, D. A. (2003). Depressive symptoms, clinical AD, and cortical plaques and tangles in older persons. Neurology, 61, 1102–1107.CrossRefGoogle ScholarPubMed
Zubenko, G. S. et al. (2003). A collaborative study of the emergence and clinical features of the major depressive syndrome of Alzheimer's disease. American Journal of Psychiatry, 160, 857–866.CrossRefGoogle ScholarPubMed