Comorbid depression in dementia on psychogeriatric nursing home wards: which symptoms are prominent?
OBJECTIVE
To provide insight into the prevalence and clinically relevant symptoms of comorbid depression among dementia patients in psychogeriatric nursing home wards, to enhance depression recognition.


METHODS
Cross-sectional analyses of multicenter diagnostic data.


METHODS
Psychogeriatric wards of Dutch nursing homes.


METHODS
Five hundred and eighteen residents with dementia.


METHODS
1) Diagnosis of depression in dementia (Provisional Diagnostic Criteria for Depression of Alzheimer disease [PDC-dAD]), 2) dementia (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition-PC), and 3) stage of dementia (Geriatric Depression Scale).


RESULTS
The point prevalence of comorbid depression in dementia (Stages 2-6) on psychogeriatric nursing home wards was 19%. "Depressed mood," "irritability," and "fatigue" were the most prevalent depressive symptoms. Residents taking antidepressants at the time of the PDC-dAD depression diagnosis showed more depressive symptoms than residents who were not. The mean number of depressive symptoms was 5.6 (SD 1.84), which did not differ between the dementia stages. Also, no differences were found in the point prevalence of the shown symptoms between dementia stages.


CONCLUSIONS
Irritability was put forward by the developers of the PDC-dAD, as one of the specific symptoms of depression in Alzheimer disease. This study shows that irritability is one of the most prevalent depressive symptoms in psychogeriatric nursing home residents diagnosed with comorbid depression. Irritability should therefore alert caregivers to the presence of depression and could help early recognition. The high-prevalence rate of comorbid depression in dementia in this setting justifies attention to early recognition and intervention.
Verkaik
Renate
R
NIVEL, Netherlands Institute for Health Services Research, Utrecht, Utrecht, The Netherlands. r.verkaik@nivel.nl
Francke
Anneke L
AL
van Meijel
Berno
B
Ribbe
Miel W
MW
Bensing
Jozien M
JM
D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D003937:Diagnosis, Differential; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006707:Homes for the Aged / Q000706:statistics & numerical data*; D006801:Humans; D007508:Irritable Mood; D008297:Male; D008403:Mass Screening; D008609:Mental Status Schedule / Q000706:statistics & numerical data; D009426:Netherlands; D009735:Nursing Homes / Q000706:statistics & numerical data*; D010552:Personality Assessment / Q000706:statistics & numerical data; D011594:Psychometrics; D015203:Reproducibility of Results