Self-reported depressive syndromes in mild cognitive impairment and mild Alzheimer's disease.
BACKGROUND
There is suggestion that self-reported depressive syndromes can independently manifest in the general population as cognitive/affective or somatic/vegetative. The Beck Depression Inventory, 2nd edition (BDI-II), a self-report measure of depressive symptoms, has been shown to support this two-factor structure. However, this finding has not been examined in an older adult sample with cognitive impairment. In order to determine whether older adults with cognitive impairments exhibit similarly independent cognitive/affective and somatic/vegetative depressive syndromes, we explored the factor structure of the BDI-II in this population.


METHODS
Participants were 228 older adults (mean age = 74, SD = 7.9) diagnosed with mild cognitive impairment (MCI; n = 137) or early Alzheimer's disease (n = 85), who completed the BDI-II as part of an outpatient neuropsychological evaluation. Exploratory principal component factor analysis with direct Oblimin rotation was conducted, and a two-factor solution was specified based on our theoretical conceptualization of the cognitive/affective and somatic/vegetative items from the scale.


RESULTS
The first factor represented cognitive/affective symptoms of depression (e.g. self-dislike, pessimism, worthlessness), and accounted for 36% of the variance. Adding the second factor, reflecting somatic/vegetative items (e.g. sleep and appetite changes, loss of energy), accounted for an additional 6.8% of the variance.


CONCLUSIONS
Results supported the presence of two distinct depressive syndromes, cognitive/affective and somatic/vegetative symptoms. Thus, cognitively impaired older adults report mood symptoms relatively similarly to younger and midlife adults. This supports the validity of self-reported mood in this group, and the results may have implications for psychiatric treatment in this population.
Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA.
Janessa O
JO
Carvalho
Jing Ee
JE
Tan
Beth A
BA
Springate
Jennifer D
JD
Davis
D000339:Affect; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000150:complications / Q000175:diagnosis / Q000523:psychology*; D060825:Cognitive Dysfunction / Q000150:complications / Q000175:diagnosis / Q000523:psychology*; D003863:Depression / Q000175:diagnosis* / Q000523:psychology; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D010555:Personality Inventory; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics; D015203:Reproducibility of Results; D057566:Self Report