Treating Depression in Alzheimer Disease

Lyketsos, Constantine G.; DelCampo, Lourdes; Steinberg, Martin H.; Miles, Quincy Samus; Steele, Cynthia D.; Munro, Cynthia A.; Baker, Alva; Sheppard, Jeannie Marie E.; Frangakis, Constantine; Brandt, Jason; Rabins, Peter V.

doi:10.1001/archpsyc.60.7.737

Cited by 349 publications

(101 citation statements)

References 67 publications

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“…[32], [33]]. We used the NPI ratings of the combined 5 mood domains depression/dysphoria, anxiety, irritability/lability, sleep, and appetite (NPI-M) [34,35] and defined the presence of significant behavioural problems as having 2 or more clinically relevant or at least 1 severe mood symptom. Both the CSDD and the NPI are valid, reliable instruments that are widely used to measure ‘behavioural' disturbance in PwD.…”

Section: Methodsmentioning

confidence: 99%

Factors of Resilience in Informal Caregivers of People with Dementia from Integrative International Data Analysis

Joling

Windle

Dröes

et al. 2016

Dement Geriatr Cogn Disord

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Background/Aims: Although caring for a person with dementia can be stressful, some caregivers appear to experience few negative consequences to their well-being. This study aimed to examine what proportion of caregivers demonstrates resilience under different challenging circumstances and to identify factors related to their resilience. Methods: Baseline data from 4 studies from the Netherlands and UK among informal caregivers of people with dementia were harmonized and integrated. Caregiver resilience was defined as high levels of psychological well-being despite different types of high caregiving demands. Multivariate regression analyses identified factors significantly related to caregiver resilience. Results: The integrated data set included 15 harmonized variables with data from 1,048 caregivers facing a high care demand. The prevalence of resilience varied between 35 and 43%, depending on the demand for high care. Being a male caregiver, caring for a female, living apart from your relative, and low caregiver burden were positively related to caregiver resilience. Conclusion: Caregivers have the capacity to demonstrate resilience despite significant challenges. This study demonstrates how harmonization of data from multiple existing studies can be used to increase power and explore the consistency of findings. This contributes to a better understanding of which factors are likely to facilitate caregiver resilience and offers insights for developing services.

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Section: Methodsmentioning

confidence: 99%

Factors of Resilience in Informal Caregivers of People with Dementia from Integrative International Data Analysis

Joling

Windle

Dröes

et al. 2016

Dement Geriatr Cogn Disord

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“…The results of previous studies, however, were inconsistent. A clinical trial which targeted AD patients with major depression showed that antidepressant therapy is superior to placebo in treating depression [43]. On the contrary, other trials which targeted depressive AD patients using cutoff scores of depression scales showed that antidepressants are not effective in treating depression [44,45].…”

Section: Discussionmentioning

confidence: 99%

Frequency of Depressive Syndromes in Elderly Individuals with No Cognitive Impairment, Mild Cognitive Impairment, and Alzheimer's Disease Dementia in a Memory Clinic Setting

Lee

Byun

et al. 2016

Dement Geriatr Cogn Disord

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Aims: The aims of this study were to investigate the frequency of various depressive syndromes in elderly individuals with no cognitive impairment (NC), mild cognitive impairment (MCI), and Alzheimer's disease dementia (AD) in a memory clinic setting, and then to test whether severe and milder forms of depressive syndromes are differentially associated with the cognitive groups. Methods: For 216 NC, 478 MCI, and 316 AD subjects, we investigated the frequency of depressive syndromes, defined by three different categories: major and minor depressive disorder (MaDD and MiDD) according to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, as well as depression according to the National Institute of Mental Health provisional diagnostic criteria for depression in Alzheimer's disease (NIMH-dAD). Results: The frequency of MaDD did not show any significant difference among NC, MCI, and AD. In contrast, the frequencies of MiDD and NIMH-dAD were higher than those of MaDD and showed significant group differences with a gradual increase from NC to AD. Conclusion: The findings suggest that the degenerative process of Alzheimer's disease contributes to the occurrence of mild depressive conditions, but not to severe depression.

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“…There is no evidence to support the use of antidepressants for the treatment of apathy in AD (44) and, in fact, selective serotonin reuptake inhibitors (SSRIs) may increase apathy (45,46). Thus we chose not to consider antidepressants as treatment for apathy in the ADMET study.…”

Section: Issues In Designing a Trial To Test Treatments For Apathymentioning

confidence: 99%

Designing a Trial to Evaluate Potential Treatments for Apathy in Dementia: The Apathy in Dementia Methylphenidate Trial (ADMET)

Drye

Scherer

Lanctôt

et al. 2013

The American Journal of Geriatric Psychiatry

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Background Research on efficacious treatments for apathy in Alzheimer’s disease has been hindered by a lack of consensus diagnosis, difficulties in measurement, and studies with small sample sizes. Methods In designing the Apathy in Dementia Methylphenidate Trial (ADMET), a trial to evaluate the efficacy and safety of methylphenidate for the treatment of apathy in Alzheimer’s disease, we encountered the following issues: defining and measuring apathy, distinguishing apathy and depression, determining an appropriate test treatment, selecting relevant secondary outcomes, recruiting participants, and deciding on a suitable method for treatment unmasking. ADMET is a 6-week randomized, double-masked, placebo-controlled multicenter clinical trial with two parallel treatment groups assigned in a 1:1 ratio with randomization stratified by clinical center. The recruitment goal is 60 randomized participants over 2 years. The primary outcomes are change in apathy severity as measured by the Apathy Evaluation Scale and the Alzheimer Disease Cooperative Study-Clinical Global Impression of Change. Conclusion The design decisions made for ADMET are important elements to be considered in trials assessing the safety and efficacy of medications for clinically significant apathy in Alzheimer’s disease.

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Treating Depression in Alzheimer Disease

Abstract: Sertraline is superior to placebo for the treatment of major depression in Alzheimer disease. Depression reduction is accompanied by lessened behavior disturbance and improved activities of daily living, but not improved cognition.

Cited by 349 publications

References 67 publications

Factors of Resilience in Informal Caregivers of People with Dementia from Integrative International Data Analysis

Factors of Resilience in Informal Caregivers of People with Dementia from Integrative International Data Analysis

Frequency of Depressive Syndromes in Elderly Individuals with No Cognitive Impairment, Mild Cognitive Impairment, and Alzheimer's Disease Dementia in a Memory Clinic Setting

Designing a Trial to Evaluate Potential Treatments for Apathy in Dementia: The Apathy in Dementia Methylphenidate Trial (ADMET)

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