Depression is a frequent condition in Alzheimer's disease (AD). The prevalence of depressive symptoms depends on the severity of dementia and the instruments used. Our aim was to assess the prevalence of depression dependent on the severity of dementia by four different scales: The 15-point Geriatric Depression Scale (GDS), the Montgomery and Asperg Depression Scale (MADRS), the Cornell Scale for Depression in Dementia (CSDD) and the Nurses Observation Scale for Geriatric Patients (NOSGER). The study population consisted of 316 patients with Alzheimer's disease from a psychiatric out-patients memory-clinic, which was divided into two groups: mild AD (Mini-Mental Status Examination (MMSE) > or = 18) and moderate to severe AD (MMSE <18). Additionally, internal consistency and correlation of these scales were calculated. Prevalence of depression ranged between 27.5 and 53.4% in mild AD and between 36.3 and 68.4% in moderate to severe AD. Internal consistency was good in all scales (Cronbach's alpha .63-.85). For MADRS and CSDD it was independent of the stage of AD, while in GDS and NOSGER internal consistency decreased with severity of dementia. Correlation between the scales was better in mild AD than moderate to severe AD; the best results were obtained for the correlation between CSDD and MADRS in both groups. We conclude that in our study population CSDD and MADRS were the most consistent tools for detecting depression in AD independently of the severity of dementia.

The finding in AD that the atrophy rate in the entorhinal cortex is higher than in the hippocampus is consistent with the view that AD pathology begins in the entorhinal cortex.

The present study addresses the consequences of cognitive disturbances on symptomatic outcome. Fifty-three first-episode schizophrenics were reassessed (n = 32) 1 year after admission. Simple regression analyses revealed that several self-perceived cognitive deficits at baseline as measured with the Frankfurt Complaint Questionnaire significantly predicted increased Brief Psychiatric Rating Scale global scores at follow-up (p = 0.05 to p = 0.005). A stepwise regression analysis proved memory dysfunction to be the strongest predictor of symptomatic worsening (p = 0.005). It is suggested that the exploration and treatment of neuropsychological deficits in schizophrenia is of great clinical importance with regard to its impact on both functional and symptomatic outcome in schizophrenia.

The association between depression and apolipoprotein E (apoE) was investigated in 137 out-patients with Alzheimer’s disease. An ICD-10 diagnosis of depression was found in 21.1% of all patients. There was a good correlation between clinicians’ diagnoses and blinded rating by the Montgomery-Åsberg Depression Rating Scale (r = 0.70). In male patients, apoE 3/3 was detected in 34.1%, 3/4 in 38.6%, 4/4 in 13.6%, 2/4 in 6.8% and 2/3 in 6.8% of cases. In female patients, apoE 3/3 was detected in 35.5%, 3/4 in 45.2%, 4/4 in 12.8%, 2/4 in 3.2% and 2/3 in 3.2% of cases. When analyzing the variance of gene dosage effect, the frequency of the apoE Ε4 allele was significantly increased in depressed women but not in men. This effect remained stable in stepwise regression analysis when depression as the dependent variable was tested against the independent variables age, age of onset, duration of disease, cognitive status and years of school education.

This study evaluated the sensitivity and specificity of the cerebrospinal fluid (CSF) levels of tau-protein, amyloid-beta-peptide 1-42 (Abeta1-42), ApoE-genotype and the degree of cognitive decline as diagnostic markers for Alzheimer's disease (AD). Data was obtained from 105 AD patients and 68 controls. Median CSF-tau levels were increased (512 pg/ml vs. 145 pg/ml, p<0.001) and Abeta1-42-levels were decreased (238.5 pg/ml vs. 310 pg/ml, p<0.001) in AD patients compared to controls. A weak correlation was found between CSF-Abeta1-42 and MMSE score (r=.245). Within all subjects, a correlation of CSF-Abeta1-42 (r=-.337) and CSF-tau (r=.384) with age was found. The combination of CSF-tau levels and MMSE revealed the highest sensitivity (92%) and specificity (87%). In summary, CSF-tau was a useful biological marker to discriminate AD from normal aging, neurological and psychiatric disorders. CSF-Abeta1-42 showed no additional benefit in discriminating patients from controls but might be useful for tracking the severity of the disease.