Clinical psychological tests useful for differentiating depressive state with Alzheimer's disease from major depression of the elderly

Abstract

Background: A depressive state with Alzheimer's disease (AD) is difficult to differentiate from major depression (MD) in many cases. The purpose of this study was to identify differences between the two disorders using a battery of clinically available psychological tests. Methods: We evaluated depression and apathy using the Geriatric Depression Scale consisting of 30 items (GDS30) and Apathy Scale in 38 patients with AD and 31 with MD who were diagnosed based on clinical symptoms and radiological findings. In addition, the Cornel Medical Index (CMI) was employed to compare the psychological features of the two disorders. Results: In AD patients, the Apathy Scale score was greater than the GDS30 score, suggesting a strong tendency toward apathy. There was a significant difference in the GDS30/Apathy Scale score ratio between the two groups (P < 0.05, OR: 3.11). When examining the downstream mental items of the CMI, the values of tension-category parameters were significantly greater in AD patients, whereas those of depression-category parameters were significantly higher in MD patients. In individual patients, we compared the scores for the two categories, and there was a marked difference (P < 0.001, OR: 10.6). Conclusion: These results suggest that the GDS30, Apathy Scale, and CMI are useful for differentiating MD from AD and evaluating their psychological features.

Elderly depression and diffusion tensor imaging

“…In the clinical setting, depression in the elderly needs to be differentially diagnosis from neurodegenerative diseases causing dementia, 3 including Alzheimer's disease, 4 diffuse Lewy body disease, 5 frontotemporal dementia, 6 and Parkinson's disease 7 , but this is sometimes difficult, even with neuropsychological, 8,9 biochemical, 10–12 electrophysiological, 13,14 or brain imaging examinations 15–18 . For dementia patients with depression, effective pharmacological 4 and non‐pharmacological 19–22 interventions are sometimes required to control agitation, irritation, negativism, and violent and suicidal behaviors 11 …”

Differential Diagnosis of Depression and Dementia

“…This af fi rms that mood symptoms in the early stages of dementia are better characterized by an apathetic syndrome rather than dysphoric mood. Therefore, apathy, particularly in the context of cognitive changes, may be an early marker of preclinical AD, whereas dysphoric mood may be more indicative of a primary depressive disorder [ 50,51 ] .…”

Treating comorbidities in dementia: Depression.

“…■ ■ Primary mood symptoms. Dysphoric mood symptoms may be indicative of a primary depressive disorder, whereas apathy in the context of cognitive changes may be a marker of preclinical AD (Hattori, Yoshiyama, Miura, & Fujie, 2010;Landes, Sperry, Strauss, & Geldmacher, 2001).…”