Cognitive complaint and test performance in elderly patients suffering depression or dementia

✍ Scribed by Michael Feehan; Robert G. Knight; Fiona M. Partridge

• Publisher: John Wiley and Sons
• Year: 1991
• Tongue: English
• Weight: 587 KB
• Volume: 6
• Category: Article
• ISSN: 0885-6230
• DOI: 10.1002/gps.930060505

✦ Synopsis

Ten depressed elderly patients were compared with 20 age-matched normal controls on measures of memory, perceptual organization, and speed of letter cancellation. Only on the letter cancellation task were there significant differences between groups. In contrast, 10 elderly patients with primary degenerative dementia (Alzheimer's type) performed more poorly than 10 age-matched normal controls on all the cognitive tests employed. Depressed patients rated their level of dysfunction in performing everyday tasks as more severe than the controls; however, the demented patients rated their degree of deficit as significantly less severe than the normal controls. The relationship between patient's subjective ratings of their cognitive difficulties and their results on neuropsychological tests is discussed. The present data suggest that determining subjective complaint may be important when assessing geriatric patients.

KEY woms-Geriatrics, depression, dementia, neuropsychological tests.

The accurate discrimination of dementia and depression in the geriatric patient can be a problem in clinical practice (Kendrick and Moyes, 1979;Kiloh, 1961; Knight and Moroney, 1985). The reported high rate of misdiagnosis of dementia in elderly patients with purely affective disorders is generally attributed to the effect depression has on the efficiency of the patient's cognition (McAllister and Price, 1982; Pearce, 1982;Sweet, 1983). Experimental investigations of the effects of depression on the cognitive function of younger patients, however, have tended to produce inconsistent results (Glass et al., 1978;Miller, 1975;Miller and Lewis, 1977). Recently, Gass and Russell (1986) demonstrated that on two clinical measures of memory, performance was affected by organic brain damage but not by depression.

There have been few experimental studies of the effect of depression on the cognitive performance of the elderly, although case reports and clinical reviews suggesting that depression can mimic