Abstract
Objective
To compare depressive symptoms reported by persons with very mild or mild dementia of the Alzheimer type (DAT) with those reported for the person by a collateral source.
Design
Crossโsectional evaluation.
Setting
Washington University Alzheimer's Disease Research Center.
Participants
Consecutive series of elderly volunteers (nโ=โ156) enrolled in longitudinal studies with a Clinical Dementia Rating (CDR) of 0.5 (very mild) or 1 (mild). Twentyโone per cent (nโ=โ33) exhibited clinically significant depressive symptoms for which treatment was recommended.
Main outcome measures
Presence and frequency of DSMโIV depressive symptoms within the last year and last month reported by the participant or collateral source as ascertained by clinical examination and structured interviews.
Results
Collateral source information is essential in diagnosing clinically significant depressive symptoms. The Geriatric Depression Scale scores correlate with participant information only and therefore may substantially underestimate depression. Depressive symptoms fluctuate in individuals with DAT. The most consistent depressive symptoms are depressed mood, fatigue and indecision.
Conclusions
Clinically significant depressive symptoms may be common in individuals with very mild or mild DAT, although they may fluctuate. Information from both a knowledgeable collateral source and the participant is important for detection of depressive symptoms. Copyright ยฉ 2001 John Wiley & Sons, Ltd.