Depression Among African American Nursing Home Patients With Dementia

Abstract

The authors compared 218 black and 68 white nursing home patients with dementia for differences in the prevalence, recognition, and treatment of depression. There were no racial differences in depressive symptoms, but whites were significantly more likely to receive a diagnosis of "possible depression" and there were few racial differences in clinical, social, or demographic factors associated with depression. Depression was often unrecognized and undertreated in both racial groups; several depression instruments developed for use in dementia had good reliability and validity among blacks; and there were no significant differences in depressive symptoms or diagnosis between U.S.-born and Caribbean-born black patients. The absence of any appreciable interracial or intraracial differences in depression symptoms or diagnoses may reflect uniformity in nursing home selection criteria or lessening of mood differences that may have existed before admission.

Behavioural and psychological signs and symptoms of dementia across cultures: current status and the future

“…CMAI has also been formally evaluated in black Americans in nursing homes (Cohen et al, 1998b) and geriatric psychiatry inpatients (Akpaffiong et al, 1999) with good psychometric properties.…”

“…The Cornell Scale for Depression in Dementia (Alexopoulos et al, 1988) has been developed in Japanese (Schreiner and Morimoto, 2002) and Korean , and for use in African American nursing homes (Cohen et al, 1998b) with good psychometric properties. The Geriatric Depression Scale (Yesavage et al, 1983) and the Gestault Depression Scale (Abrahams and Alexopoulos, 1994) have been developed for use with African Americans in nursing homes with good psychometric properties (Cohen et al, 1998b).…”

“…The Geriatric Depression Scale (Yesavage et al, 1983) and the Gestault Depression Scale (Abrahams and Alexopoulos, 1994) have been developed for use with African Americans in nursing homes with good psychometric properties (Cohen et al, 1998b).…”

Major depression as a risk factor for early institutionalization of dementia patients living in the community

“…Literature about depression in dementia has accumulated over the past decade and highlights possible associations with non-Alzheimer's dementias (vascular dementia, Huntington's disease, parkinsonism) (Burns, 1991;Ballard et al, 1996;Margallo-Lana et al, 2001) and milder cognitive impairment (Newman, 1999). Despite estimates that 20% of dementia sufferers are also depressed (a prevalence rate three to four times higher than that among the non-demented elderly), depression is nonetheless under-diagnosed and under-treated in this patient population (Cohen et al, 1998;Elmstahl et al, 1998).…”

Interracial and Intraracial Differences in Neuropsychiatric Symptoms, Sociodemography, and Treatment Among Nursing Home Patients With

“…We are currently studying an alternative approach to improving clinical recognition by mandating structured depression screening with the Cornell Scale for Depression at the time of admission and every three months thereafter. We believe that the Cornell Scale may be especially useful because of its fairly high levels of sensitivity and specificity at all stages of dementia among both Black and White nursing home patients (Cohen, Hyland, & Magai, 1998). However, Streim and colleagues (1996) caution that while structural instruments should be used for screening, they cannot replace an experienced clinician's ability to determine if symptoms are attributable to a medical disorder or depression.…”