Self-, collateral- and clinician assessment of depression in persons with cognitive impairment.
OBJECTIVE
This investigation examined the associations between self-reports, collateral-source reports and a clinician's diagnosis of depression in persons with cognitive impairment.


METHODS
Responses on the Geriatric Depression Scale - 15 (GDS-15) from 162 participants with a diagnosis of Mild Cognitive Impairment (n = 78) or Alzheimer's Dementia and a Mini-Mental State score >or=15 (n = 84) were compared with both their collateral sources' report on either the Neuropsychiatric Inventory Questionnaire (n = 93) and/or the collateral-source GDS-15 (n = 67), or a clinician's diagnosis of Major Depression (MD).


RESULTS
Significant differences were seen between self- versus collateral-source reports of depression in these participants. Participants' reports of loss of interest (anhedonia) significantly increased the odds of disagreement with their collateral sources (OR = 3.78, 95% CI: 1.3-11.2) while reports of negative cognitions significantly decreased the odds of such a disagreement (OR = 0.31, 95% CI: 0.1-0.9). The symptom of anhedonia also showed the strongest association with the clinician's diagnosis of MD.


CONCLUSIONS
A motivational symptom like loss of interest was seen to play an important role in depression experienced by those with cognitive impairment.
Chopra
Mohit P
MP
Harvard Medical School and Boston University School of Medicine, Boston, MA, USA. Mohit.Chopra@va.gov
Sullivan
Jan R
JR
Feldman
Zachary
Z
Landes
Reid D
RD
Beck
Cornelia
C
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D001131:Arkansas; D003072:Cognition Disorders / Q000150:complications / Q000523:psychology*; D003704:Dementia / Q000150:complications / Q000523:psychology*; D003866:Depressive Disorder / Q000150:complications / Q000175:diagnosis* / Q000523:psychology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data*; D011594:Psychometrics; D012649:Self Concept; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires