title: Clinical characteristics according to depression screening tools in patients with Alzheimer's disease: view from self, caregiver-reported and drug-intervention pattern.
abstract: OBJECTIVE
  Depression in Alzheimer's disease (AD) has different clinical manifestations from primary depression of non-demented patients. We designed the present study to explore the following: (i) to determine the clinical characteristics of patients with and without depression according to observational and subjective depression screening scale; and (ii) to examine the depression prevalence rate in patients with AD according to these criteria.
  
  
  METHODS
  The Geriatric Depression Scale (GDS, observational scale) and Neuropsychiatry Inventory Depression subscale (NPI-D; subjective scale) were administered to 257 patients with drug-naïve probable AD. The study groups were classified into the three subgroups of "no-depression", GDS depression and NPI-DS (NPI-D significant) depression group, and the clinical characteristics of these subgroups were examined.
  
  
  RESULTS
  The NPI-DS depression group showed lower scores on the Korean version of the Mini-Mental State Examination compared with the no-depression group, and higher NPI subdomain scores compared with other groups. The GDS depression group showed higher NPI motor subdomain scores compared with the no-depression group. Depression defined by NPI-DS was the least frequent (10.5%), and NPI-DA (NPI-D any) was the most frequent (56.4%). The prevalence of depression defined by GDS and anti-depressant usage was 30.0% and 16.0% each. The level of agreement between the screening tools determined through the kappa index was from low to moderate.
  
  
  CONCLUSIONS
  The present study showed that different depression screening tools revealed a different prevalence and poor concordance rate among depression screening tools. Considering lower cognitive functions and higher BPSD symptoms in the NPI-DS depression group, NPI-DS could be associated with disease severity in AD patients. However, the clinical significance of GDS remains uncertain.
authors.affiliation: Department of Neurology, Hyoja Geriatric Hospital, Yongin shi, Korea.
authors.forename: Yong Tae
authors.initials: YT
authors.lastname: Kwak
authors.forename: YoungSoon
authors.initials: Y
authors.lastname: Yang
authors.forename: Seon Jong
authors.initials: SJ
authors.lastname: Pyo
authors.forename: Min-Seong
authors.initials: MS
authors.lastname: Koo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000523:psychology*; D000928:Antidepressive Agents / Q000627:therapeutic use; D017028:Caregivers / Q000523:psychology; D003866:Depressive Disorder / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D015995:Prevalence; D012189:Retrospective Studies; D012647:Self-Assessment
chemical_list: D000928:Antidepressive Agents
keywords: Alzheimer's disease; Geriatric Depression Scale; Neuropsychiatry Inventory; depression