Long-term outcome of depressive pseudodementia in the elderly

Fonseca, Jose Andres Saez; Lee, L.; Walker, Zuzana

doi:10.1016/j.eurpsy.2007.01.099

Cited by 11 publications

(21 citation statements)

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“…Although late-life depression may cause some cognitive impairment (i.e. “pseudodementia”), up to 70% of patients with pseudodementia will eventually develop ND leading to doubts regarding the diagnostic utility of pseudodementia26. Personality changes are typical in early AD, particularly loss of extraversion and social assertiveness27, which may be mistaken for MDD-related social withdrawal.…”

Section: Discussionmentioning

confidence: 99%

The Diagnostic Challenge of Psychiatric Symptoms in Neurodegenerative Disease

Woolley¹,

Khan²,

Murthy³

et al. 2011

J. Clin. Psychiatry

414

203

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Objective To identify rates of and risk factors for psychiatric diagnosis preceding the diagnosis of neurodegenerative disease (ND). Method Systematic, retrospective, blinded chart review of patients with a ND diagnosis [behavioral variant frontotemporal dementia (bvFTD n=69); Alzheimer’s disease (AD n=65); semantic dementia (SemD n=41); progressive non-fluent aphasia (PNFA n=17); corticobasal degeneration (n=25); progressive supranuclear palsy (n=15); and amyotrophic lateral sclerosis (ALS n=20)]. Results 28.2% of patients with a ND received a prior psychiatric diagnosis. Depression was the most common psychiatric diagnosis in all groups. BvFTD patients received a prior psychiatric diagnosis significantly more often (52.2%) than patients with AD (23.1%), SemD (24.4%), or PNFA (11.8%), and were more likely to receive diagnoses of bipolar affective disorder or schizophrenia than patients with other NDs (p<0.001). Younger age, higher education and a family history of psychiatric illness increased the rate of prior psychiatric diagnosis in patients with bvFTD (p<0.05). Cognitive, behavioral and emotional characteristics did not distinguish patients who did and did not receive a prior psychiatric diagnosis. Conclusion ND is often mistaken for psychiatric disease with bvFTD patients at highest risk for misdiagnosis. Because psychiatric misdiagnosis can lead to delayed and inappropriate treatment, and family and patient distress, physicians should consider referring mid- to late-life patients with new onset neuropsychiatric symptoms for ND evaluation.

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Section: Discussionmentioning

confidence: 99%

The Diagnostic Challenge of Psychiatric Symptoms in Neurodegenerative Disease

Woolley¹,

Khan²,

Murthy³

et al. 2011

J. Clin. Psychiatry

414

203

View full text Add to dashboard Cite

show abstract

“…Moreover, minor depression was found to constitute a clinically relevant syndrome of depression in Alzheimer’s disease (3). Depression can also be one of the earliest symptoms of AD (4–8). In addition, in a number of studies, it was found that a history of depression is a risk factor for the future development of dementia (9–14), and that the severity of psychopathological and neurological impairments in AD increases with the increasing severity of depression (3).…”

mentioning

confidence: 99%

Hypothalamic Vasopressin and Oxytocin mRNA Expression in Relation to Depressive State in Alzheimer’s Disease: A Difference With Major Depressive Disorder

Meynen

Unmehopa

Hofman

et al. 2009

J Neuroendocrinology

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Arginine vasopressin (AVP) and oxytocin (OXT), produced in the hypothalamic paraventricular (PVN) and supraoptic nucleus (SON), are considered to be involved in the pathophysiology of major depressive disorder (MDD). The objective of this study was to determine, for the first time, the relationship between AVP and OXT gene expression and depressive state in Alzheimer's disease (AD). Post-mortem brain tissue was obtained from six control subjects, and from a prospectively studied cohort of 23 AD patients, using the DSM-IIIR and the Cornell Scale for Depression in Dementia to determine depression diagnosis and severity. The amount of AVP and OXT mRNA was determined by in situ hybridisation. AD patients did not differ from controls with respect to the amount of AVP or OXT mRNA in the PVN or SON. Also, no differences were found between depressed and nondepressed AD patients and no relationship was found between the depression severity and AVP or OXT mRNA expression. The results indicate that AVP and OXT gene expression in the PVN and SON is unchanged in depressed AD patients compared to nondepressed AD patients. This is in contrast with the enhanced AVP gene expression in MDD, suggesting a difference in pathophysiology between MDD and depression in AD.

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“…On the other hand, it is well-known that reversible depression-related cognitive decline (also known as depressive pseudo-dementia) is often considered as true dementia and these patients do not receive adequate treatment for their mood disorder [22]. However, the depressive pseudo-dementia in old age seems to be a long-term predictor of true dementia [5,23].…”

Section: Discussionmentioning

confidence: 99%

Untreated Depressive Symptoms Significantly Worsen Quality of Life of the Elderly and may Lead to the Misdiagnosis of Dementia: A Cross-Sectional Study

Vörös

Fekete

Tényi

et al. 2020

Preprint

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Background: Several studies demonstrated the role of depressive mood and cognitive impairment in the background of elevated mortality and decreased Quality of Life (QoL) of the elderly.Methods: In the framework of the ICT4Life project self-administered questionnaires and clinical screening tools were used to assess QoL, depressive symptoms and cognitive functions of 60 elderly over the age of 65.Results: Males found to be depressed and cognitively declined more frequently; and had higher scores on the depression and lower on the QoL scales. Depressed elderly had lower cognitive levels and their QoL was significantly poorer than that of the non-depressed subjects. Depressive disorders were detected in a quarter of the elderly, and the majority of them did not receive adequate antidepressant medication.Conclusions: Close correlation between depression and cognitive impairment was confirmed, as well as the key role of depression in the background of QoL decline. Results also highlighted the problems of recognition and adequate treatment of depression and cognitive decline in elderly, which can be further complicated by the common symptoms of depressive pseudo-dementia. Early recognition of depressive symptoms is important not only to treat the underlying mood disorder, but also to improve QoL of the elderly.

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Long-term outcome of depressive pseudodementia in the elderly

Cited by 11 publications

References 0 publications

The Diagnostic Challenge of Psychiatric Symptoms in Neurodegenerative Disease

The Diagnostic Challenge of Psychiatric Symptoms in Neurodegenerative Disease

Hypothalamic Vasopressin and Oxytocin mRNA Expression in Relation to Depressive State in Alzheimer’s Disease: A Difference With Major Depressive Disorder

Untreated Depressive Symptoms Significantly Worsen Quality of Life of the Elderly and may Lead to the Misdiagnosis of Dementia: A Cross-Sectional Study

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