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Depressive symptoms and depression in people screened positive for dementia in primary care – results of the DelpHi-study

Published online by Cambridge University Press:  20 January 2016

Jochen René Thyrian ,
Tilly Eichler ,
Melanie Reimann ,
Diana Wucherer ,
Adina Dreier ,
Bernhard Michalowsky  and
Wolfgang Hoffmann
Jochen René Thyrian*
Affiliation:
German Center for Neurodegenerative Diseases (DZNE), site Rostock/Greifswald, Ellernholzstr. 1-2, 17489 Greifswald, Germany
Tilly Eichler
Affiliation:
German Center for Neurodegenerative Diseases (DZNE), site Rostock/Greifswald, Ellernholzstr. 1-2, 17489 Greifswald, Germany
Melanie Reimann
Affiliation:
German Center for Neurodegenerative Diseases (DZNE), site Rostock/Greifswald, Ellernholzstr. 1-2, 17489 Greifswald, Germany
Diana Wucherer
Affiliation:
German Center for Neurodegenerative Diseases (DZNE), site Rostock/Greifswald, Ellernholzstr. 1-2, 17489 Greifswald, Germany
Adina Dreier
Affiliation:
Institute for Community Medicine, University of Greifswald, Epidemiology of Health Care and Community Health, Ellernholzstr. 1-2, 17489 Greifswald, Germany
Bernhard Michalowsky
Affiliation:
German Center for Neurodegenerative Diseases (DZNE), site Rostock/Greifswald, Ellernholzstr. 1-2, 17489 Greifswald, Germany
Wolfgang Hoffmann
Affiliation:
German Center for Neurodegenerative Diseases (DZNE), site Rostock/Greifswald, Ellernholzstr. 1-2, 17489 Greifswald, Germany Institute for Community Medicine, University of Greifswald, Epidemiology of Health Care and Community Health, Ellernholzstr. 1-2, 17489 Greifswald, Germany
*
Correspondence should be addressed to: Jochen René Thyrian, German Center for Neurodegenerative Diseases (DZNE), site Rostock/Greifswald, Ellernholzstr. 1-2, 17489 Greifswald, Germany. Phone: +49 3834 867592; Fax: +49 3834 86 19551. Email: rene.thyrian@dzne.de.
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Abstract

Background:

Dementia and depression are common syndromes in the elderly. There is lack of knowledge concerning the frequency of depressive symptoms in people with dementia (PWD) and factors associated with depression. The aim of this analysis is to (a) describe the frequency of depressive symptoms in people screened positive for dementia, (b) describe differences between PWD with and without depressive symptoms, and (c) analyze associations between depressive symptoms and other dementia-related variables.

Methods:

Analyses are based on data of the GP-based intervention trial DelpHi-MV. A sample of 430 (6.29%) people screened positive for dementia in primary care was analyzed regarding depression according to the German version of the Geriatric Depression Scale (GDS, 15-items), demographic variables, and dementia/depression-related variables. Multivariate analyses were conducted to identify factors associated with depressive symptoms.

Results:

The mean GDS-score of depressive symptoms in n = 430 PWD was m = 3.21 (SD 2.45) with 67 PWD (15.55%) showing clinically relevant depression (GDS < 5) m = 7.71 (SD = 1.92). A total of n = 72 (16.74%) received a formal diagnosis of depression and n = 62 (14.42%) received antidepressive drug treatment. Depressive symptoms are significantly associated with age (OR = 0.93), functional impairment (OR = 1.36), and quality of life (OR = 0.01, CI: 0.00–0.06).

Conclusion:

Our results support previous findings that clinically relevant depressive symptoms are more common in people screened positive for dementia than in the general population and are often missed or mismanaged. Our findings underline the importance of managing quality of life, functional status, or depressive symptoms. Also, the results highlight the benefit of including the partner (and probably other carers) for adequate treatment of PWD.

Keywords

depressiondementiaprimary careprimary healthcare
Type
Research Article
Information
International Psychogeriatrics , Volume 28 , Issue 6 , June 2016 , pp. 929 - 937
Copyright
Copyright © International Psychogeriatric Association 2016 

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References

Aalten, P., de Vugt, M. E., Jaspers, N., Jolles, J. and Verhey, F. R. (2005). The course of neuropsychiatric symptoms in dementia. Part I: findings from the two-year longitudinal Maasbed study. International Journal of Geriatric Psychiatry, 20, 523–530.CrossRefGoogle ScholarPubMed
Alzheimer's Disease International (ADI) (2012). Dementia: A Public Health Priority. Geneva: World Health Organisation (WHO).Google Scholar
Busch, M. A., Maske, U. E., Ryl, L., Schlack, R. and Hapke, U. (2013). Prevalence of depressive symptoms and diagnosed depression among adults in Germany: results of the German health interview and examination survey for adults (DEGS1). Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz, 56, 733–739.CrossRefGoogle ScholarPubMed
Byers, A. L. and Yaffe, K. (2011). Depression and risk of developing dementia. Nature Reviews Neurology, 7, 323–331.CrossRefGoogle ScholarPubMed
Calabrese, P. and Kessler, J. (2000). Screening for cognitive impairment in dementia - the DemTect procedure. European Neuropsychopharmacology, 10, 369.CrossRefGoogle Scholar
Cooper, C., Sommerlad, A., Lyketsos, C. G. and Livingston, G. (2015). Modifiable predictors of dementia in mild cognitive impairment: a systematic review and meta-analysis. American Journal of Psychiatry, 172, 323–334.CrossRefGoogle ScholarPubMed
Cummings, J. L. (1997). The neuropsychiatric inventory: assessing psychopathology in dementia patients. Neurology, 48, S10–S16.CrossRefGoogle ScholarPubMed
Curran, E. M. and Loi, S. (2013). Depression and dementia. Medical Journal of Australia., 199, S40–S44.CrossRefGoogle ScholarPubMed
Deutsche Alzheimer Gesellschaft e.V (2014). Frequency of Dementia. www.deutsche-alzheimer.de/fileadmin/alz/pdf/factsheets/infoblatt1_haeufigkeit_demenzerkrankungen-dalzg.pdf Google Scholar
Eichler, T. et al. (2014). Rates of formal diagnosis in people screened positive for dementia in primary care: results of the DelpHi-Trial. Journal of Alzheimers Disease, 42, 451–458.CrossRefGoogle ScholarPubMed
Erzigkeit, H. et al. (2001). The bayer-activities of daily living scale (B-ADL): results from a validation study in three European countries. Dementia and Geriatric Cognitive Disorders, 12, 348–358.CrossRefGoogle ScholarPubMed
Fiss, T. et al. (2013). Medication management for people with dementia in primary care: description of implementation in the DelpHi study. BMC Geriatrics, 13, 121.CrossRefGoogle ScholarPubMed
Fydrich, T., Sommer, G. and Brähler, E. (2007). F-SozU. Fragebogen zur Sozialen Unterstützung. Göttingen: Hogrefe.Google Scholar
Gauggel, S. and Birkner, B. (1999). Validity and reliability of a German version of the geriatric depression scale (GDS). Zeitschrift für Klinische Psychologie-Forschung und Praxis, 28, 18–27.CrossRefGoogle Scholar
Gonfrier, S., Andrieu, S., Renaud, D., Vellas, B. and Robert, P. H. (2012). Course of neuropsychiatric symptoms during a 4-year follow up in the REAL-FR cohort. Journal of Nutrition Health and Aging, 16, 134–137.CrossRefGoogle ScholarPubMed
Hindmarch, I., Lehfeld, H., de Jongh, P. and Erzigkeit, H. (1998). The bayer activities of daily living scale (B-ADL). Dementia and Geriatric Cognitive Disorders, 9 (Suppl. 2), 20–26.CrossRefGoogle ScholarPubMed
Kessler, J., Markowitsch, H. J. and Denzler, P. (1990). Mini-Mental-Status-Test (MMST) [German Version]. Göttingen: Beltz Test GmbH.Google Scholar
Langa, K. M. and Levine, D. A. (2014). The diagnosis and management of mild cognitive impairment: a clinical review. JAMA, 312, 2551–2561.CrossRefGoogle ScholarPubMed
Logsdon, R. G., Gibbons, L. E., McCurry, S. M. and Teri, L. (1999). Quality of life in Alzheimer's disease: patient and caregiver reports. Journal of Mental health and Aging, 5, 21–32.Google Scholar
Luppa, M., Luck, T., Ritschel, F., Angermeyer, M. C., Villringer, A. and Riedel-Heller, S. G. (2013). Depression and incident dementia. An 8-year population-based prospective study. PLos One, 8, e59246.CrossRefGoogle ScholarPubMed
Luppa, M. et al. (2012). Prevalence and risk factors of depressive symptoms in latest life–results of the leipzig longitudinal study of the aged (LEILA 75+). International Journal of Geriatric Psychiatry, 27, 286–295.CrossRefGoogle ScholarPubMed
Lyketsos, C. G., Lopez, O., Jones, B., Fitzpatrick, A. L., Breitner, J. and DeKosky, S. (2002). Prevalence of neuropsychiatric symptoms in dementia and mild cognitive impairment: results from the cardiovascular health study. JAMA, 288, 1475–1483.CrossRefGoogle ScholarPubMed
Naylor, M. D. et al. (2012). Advancing Alzheimer's disease diagnosis, treatment, and care: recommendations from the ware Invitational Summit. Alzheimers & Dementia, 8, 445–452.CrossRefGoogle ScholarPubMed
StataCorp (2014). Stata Statistical Software: Release 13. In College Station, TX: StataCorp LP.Google Scholar
Teipel, S. J. et al. (2015). Neuropsychiatric symptoms in people screened positive for dementia in primary care. International Psychogeriatrics, 27, 39–48.CrossRefGoogle ScholarPubMed
Thyrian, J. R. and Hoffmann, W. (2012). Dementia care and general physicians-a survey on prevalence, means, attitudes and recommendations. Central European Journal of Public Health, 20, 270–275.CrossRefGoogle ScholarPubMed
Thyrian, J. R. et al. (2012). Life- and person-centred help in Mecklenburg-Western Pomerania, Germany (DelpHi): study protocol for a randomised controlled trial. Trials, 13, 56.CrossRefGoogle ScholarPubMed
Thyrian, J. R. et al. (2015). Burden of behavioral and psychiatric symptoms in people screened positive for dementia in primary care: results of the DelpHi-Study. Journal of Alzheimers Disease, 46, 451–459.CrossRefGoogle ScholarPubMed
WHO Collaborating Centre for Drug Statistics Methodology and Nordic Council on Medicines (1996). Guidelines for ATC classification. Oslo: World Health Organisation.Google Scholar
Wissenschaftliches Institut der AOK (WIDO) (2013). GKV-Arzneimittelindex. http://www.wido.de/gkv-arzneimittelind.html Google Scholar
World Health Organisation (WHO) (2008). The Global Burden of Disease: 2004 Update. Geneva: WHO.Google Scholar
Yesavage, J. A. et al. (1982). Development and validation of a geriatric depression screening scale: a preliminary report. Journal of Psychiatric Research, 17, 37–49.CrossRefGoogle Scholar