title: Depressive symptoms in Chinese-American subjects with cognitive impairment.
abstract: OBJECTIVE
  To compare the prevalence of depressive symptoms and frequency of antidepressant use between a group of elderly Chinese-American subjects with and without cognitive impairment and a group of matched white subjects. A secondary aim was to examine the clinical and demographic predictors of depressive symptoms across these groups.
  
  
  METHODS
  The study was conducted at an academic neurology subspecialty clinic. This was a case-control study with 140 Chinese-American subjects and 140 demographically and cognitively matched white subjects. In each group, there were 48 cognitively normal and 92 cognitively impaired participants (49 with mild cognitive impairment, 43 with Alzheimer disease). The proportion of individuals with significant depressive symptoms, as indicated by a Geriatric Depression Scale score ≥6 of 15, and frequency of antidepressant use were compared across groups by using χ(2) analysis. Factors predicting depressive symptoms, including racial and diagnostic group, age, gender, Mini-Mental State Examination score, level of functional impairment, education level, and medical comorbidities, were assessed by using linear regression analysis.
  
  
  RESULTS
  Significant depressive symptoms were more common in cognitively impaired Chinese-American (35%) than cognitively impaired white (15%; χ(2)[1] = 9.4; p = 0.004) subjects. Chinese-American subjects with cognitive impairment were less likely to be receiving treatment for depression (12%) than white subjects with cognitive impairment (37%; χ(2)[1] = 15.6; p = 0.002). Racial and diagnostic group, age, level of functional impairment, Mini-Mental State Examination score, and education level were all statistically significant independent predictors of Geriatric Depression Scale score.
  
  
  CONCLUSIONS
  Elderly Chinese-American subjects with cognitive impairment are at increased risk for unrecognized and untreated depressive symptoms compared with elderly white subjects with cognitive impairment. Education level may contribute to this risk or it may be a surrogate marker for other factors contributing to depressive symptoms in this group.
authors.affiliation: Department of Neurology, VA Palo Alto Health Care System, Palo Alto, CA; Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA.
authors.forename: Steven Z
authors.initials: SZ
authors.lastname: Chao
authors.affiliation: Department of Neurology, Indiana University School of Medicine, Indiana Alzheimer Disease Center, Indianapolis, IN.
authors.forename: Brandy R
authors.initials: BR
authors.lastname: Matthews
authors.affiliation: Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA.
authors.forename: Jennifer S
authors.initials: JS
authors.lastname: Yokoyama
authors.affiliation: Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA.
authors.forename: Ngan Betty
authors.initials: NB
authors.lastname: Lai
authors.affiliation: Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA.
authors.forename: Hilary
authors.initials: H
authors.lastname: Ong
authors.affiliation: Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA.
authors.forename: Marian
authors.initials: M
authors.lastname: Tse
authors.affiliation: Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA.
authors.forename: Runfen Frances
authors.initials: RF
authors.lastname: Yuan
authors.affiliation: Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA.
authors.forename: Amy
authors.initials: A
authors.lastname: Lin
authors.affiliation: Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA.
authors.forename: Joel
authors.initials: J
authors.lastname: Kramer
authors.affiliation: Departments of Psychiatry, Neurology, and Epidemiology and Biostatistics, University of California, San Francisco, and Memory Disorders Clinic, San Francisco VA Medical Center, San Francisco, CA.
authors.forename: Kristine
authors.initials: K
authors.lastname: Yaffe
authors.affiliation: Department of Epidemiology and Biostatistics, University of California, San Francisco, CA.
authors.forename: John
authors.initials: J
authors.lastname: Kornak
authors.affiliation: Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA.
authors.forename: Bruce L
authors.initials: BL
authors.lastname: Miller
authors.affiliation: Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA. Electronic address: hrosen@memory.ucsf.edu.
authors.forename: Howard J
authors.initials: HJ
authors.lastname: Rosen
mesh_terms: D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use; D001213:Asian / Q000523:psychology*; D016022:Case-Control Studies; D003072:Cognition Disorders / Q000150:complications* / Q000453:epidemiology* / Q000208:ethnology; D003863:Depression / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology* / Q000208:ethnology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D044465:White People / Q000523:psychology
chemical_list: D000928:Antidepressive Agents
keywords: Chinese American; dementia; geriatric depression
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