Depressive Symptoms In Alzheimer's Disease Research Articles

Premorbid personality and behavioral symptoms in Alzheimer disease. Some cautions.

To evaluate the extent to which the previously reported relationship between premorbid personality and psychopathological symptoms after the onset of Alzheimer disease (AD) is due to the use of a single informant for both personality and symptom information. Premorbid personality descriptions of patients with AD were obtained from 2 sources, primary caregivers and secondary informants, using the Personality Assessment Schedule and NEO-PI-R Neuroticism Scale, respectively. All information regarding depression and anxiety since the onset of AD was obtained from primary caregivers using clinical interviews and the Cornell Scale for Depression in Dementia. When data were obtained from the same informant, significant relationships were found between premorbid personality and both presence of depression and the severity of anxiety symptoms. When data were obtained from 2 different informants, the only significant relationship was between premorbid neuroticism and anxiety severity. As in a previous report, there was a relationship between premorbid personality and depressive symptoms in AD, but only when personality and symptom information was obtained from the same informant. On the other hand, there was a relationship between premorbid personality and severity of anxiety symptoms both when personality and symptom information came from different informants as well as from the same informant. These data suggest that retrospective bias contributes to the apparent consistency between premorbid personality and some aspects of psychiatric symptoms in AD, specifically depression.

Depressive Symptoms in Alzheimer Disease

Depression is difficult to assess in Alzheimer disease (AD) and controversy surrounds the prevalence, etiology, and characteristics of mood alterations in patients with this disorder. We used a variety of standardized instruments to assess mood changes in 33 patients with AD. The frequency of depression ranged from 6 to 30%, depending on the diagnostic criteria employed. No relationship was found between patient depression and dementia severity, self-awareness of cognitive deficits (as measured by a memory self-rating scale), or mood of the caregiver. Delusional patients had higher scores on mood rating scales than nondelusional patients. The results suggest that depression in AD is not severe and is unrelated to patient self-awareness of illness. We hypothesize that the cholinergic deficit of AD may ameliorate depressive symptoms.