Specific psychological and behavioral symptoms of depression in patients with dementia.
Behavioral and psychological symptoms in dementia (BPSD) are very common, with 90% of patients experiencing at least one during the course of the disease. One-third of persons with dementia have depressive symptoms, and concomitant BPSD are very likely.


OBJECTIVE
This study aimed to characterize the psychological and behavioral manifestations of depression in patients with dementia.


METHODS
We recruited patients with dementia from several nursing homes in the Limousin region of France. Depression was as diagnosed by the Cornell Scale for Depression in Dementia (CSDD) with a cut-off of 7, and BPSD were assessed using the Neuropsychiatric Inventory (NPI).


RESULTS
Of 319 patients with dementia, 42.9% (n =137) were depressed and 75.9% (n = 242) had BPSD. All BPSD were significantly (p < 0.0001) more prevalent among depressed patients, but no significant differences were observed according to sex and age. The NPI showed that the most common additional symptoms in depressed patients were agitation (43.2%), anxiety (42.3%) and irritability (40.1%). Four NPI-based factors were indentified (63.9% of the common variance): factor 1 (disinhibition, irritability, agitation, anxiety), factor 2 (sleep disturbance, aberrant motor behavior, apathy), factor 3 (elation, hallucination, delirium) and the last with eating disorders. Depression in dementia patients was significantly associated with disinhibition, irritability, agitation, and anxiety.


CONCLUSIONS
BPSD are common and a major problem. Before addressing them as isolated symptoms, it is important to consider comorbidity with depression in order to optimize the therapeutic approach.
Prado-Jean
Annie
A
CMRR-The Limousin Center for Memory Research, University of Limoges, France. aniejean@hotmail.com
Couratier
Philippe
P
Druet-Cabanac
Michel
M
Nubukpo
Philippe
P
Bernard-Bourzeix
Laurence
L
Thomas
Philippe
P
Dechamps
Nicole
N
Videaud
Helene
H
Dantoine
Thierry
T
Clément
Jean Pierre
JP
D000368:Aged; D000369:Aged, 80 and over; D001526:Behavioral Symptoms / Q000175:diagnosis / Q000453:epidemiology*; D003704:Dementia / Q000523:psychology*; D003866:Depressive Disorder / Q000523:psychology*; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology*; D009483:Neuropsychological Tests; D009735:Nursing Homes; D011569:Psychiatric Status Rating Scales