Usefulness of Neuropsychiatric Measures to Discriminate Depression Associated With Cognitive Disorders in the Elderly

DIEGO CASTRO ; JAIME JOSE PAHISSA; SERGIO STARKSTEIN; CAROL DILLON

New York

Congreso; Building Well-being through innovation. American Psychiatric Association, 2018; 2018

American Psychiatric Association

Background: In clinical practice, the presence of depression among individuals older than 60 years is common, and the frequency increases when the reason for consultation is cognitive complaint. In this context, the differentiation of subtypes of depression, as well as separating depression from cognitive decline is of great clinical relevance.Objective: To examine the efficacy of neuropsychiatric tools to better characterize the different subtypes of depression associated with cognitive decline in the elderly. Materials and Method: We examined 117 patients with depressive symptoms and/or cognitive complaint recruited from a Neuropsychiatric clinic at CEMIC University Hospital, and 40 healthy controls from the community. All participants were assessed with the SCAN (a semi-structured neuropsychiatric interview), Beck Depression Inventory (BDI), Hamilton Anxiety Scale (HAS), Neuropsychiatric Inventory (NPI), and Mini Mental State Exam (MMSE). Participants were also assessed with a comprehensive neuropsychological battery and scales to assess functionality. Depression diagnoses were made using DSM IV criteria, whereas AD was diagnosed based on NIMCS-AADRA criteria. Results: There were 30 patients with major depressive disorder (MDD), 31 with dysthymia, 29 with depression associated with mild cognitive impairment (Dep-MCI), and 25 patients with depression and mild Alzheimer´s dementia (DdAD).On BDI, patients with MDD and Dyst had significantly higher scores than the healthy controls, and also had higher scores than the other depressive groups. On MMSE, patients with DdAD had significantly lower scores than healthy controls, and than depressive groups. On serial recall and learning, patients with any depression had significantly more deficits than controls; whereas patients with DdAD had significantly lower scores than individuals with any depression. On both a recognition and naming testspatients with DdAD had significantly lower scores than individuals with any depression and controls (p