ABSTRACT
The current longitudinal study analyzes the natural course of depressive symptoms in patients with Alzheimer disease (AD). The goals were to identify the clinical and sociodemographic variables related to depressive symptoms, to assess the effect of depressive symptoms on the course of cognitive and functional impairment and on associated neuropsychiatric disorders, and to identify which factors are associated with remission, persistence, and emergence of depressive symptoms at 12 months. A sample of 150 patients with mild or moderate severity was assessed at baseline and at 12 months using the neuropsychologic battery Cambridge Cognitive Examination. The Neuropsychiatric Inventory and Rapid Disability Rating Scale were administered to the caregiver. Prevalence, persistence, and emergence of depressive symptoms at baseline were 51%, 55%, and 20%, respectively. Remission of depressive symptoms at 12 months leads to a decreased frequency of other noncognitive disorders and to a slight improvement in the assessment of global function. The presence of depressive symptoms does not affect the course of cognitive impairment at 12 months, and a psychiatric history of the patient and the number of depressive symptoms at baseline are risk factors for the emergence and persistence of depressive symptoms at 12 months.
Subject(s)
Alzheimer Disease/complications , Alzheimer Disease/psychology , Depression/etiology , Depression/psychology , Aged , Aged, 80 and over , Disease Progression , Female , Follow-Up Studies , Humans , Male , Medical History Taking , Mental Health , Psychiatric Status Rating Scales , Risk FactorsABSTRACT
OBJECTIVE: The objective of this study is to determine the effect of depressive symptoms of patients in the burden perceived by the carer, evaluate the course of this burden in relation to the disappearance, persistence or appearance of depressive symptoms after twelve months and find which factors are associated with a rise or fall in the carer s load after twelve months. PATIENTS AND METHODS: A prospective observational study for 12 months of a sample of 150 patients with the clinical diagnosis of probable Alzheimer s disease on the criteria of NINDCS ADDRA: The sociodemographic data of their carers were collected and tested on the following scales: CAMDEX, CAMCOG, NPI, RDRS 2 and Burden Interview (BI) initially and twelve months later. RESULTS: The existence of depression initially was associated with an increased burden (score of BI of 22.76 compared with 15.79), increased non cognitive symptoms (NPI score of 16.23 compared with 5.94) and greater functional disability (RDRS 2 score of 27.89 compared with 25.53). The burden increased in the group of patients whose depressive symptoms persisted and in those in whom they appeared after twelve months. CONCLUSION: The data suggest that depressive symptoms increase functional disability and are associated with an increase in non cognitive symptoms. At the same time the functional disability and non cognitive symptoms increase the carer's burden.
Subject(s)
Alzheimer Disease/psychology , Caregivers , Cost of Illness , Depression/etiology , Aged , Aged, 80 and over , Attitude to Health , Depression/diagnosis , Depression/epidemiology , Disability Evaluation , Female , Humans , Male , Prospective Studies , Psychomotor Disorders/diagnosis , Psychomotor Disorders/epidemiology , Psychomotor Disorders/etiology , Regression Analysis , Severity of Illness Index , Time FactorsABSTRACT
Objetivo. Determinar el efecto de la sintomatología depresiva de los pacientes en la carga percibida por el cuidador, valorar la evolución de la carga según la desaparición, persistencia y emergencia de los síntomas depresivos a los 12 meses y conocer qué factores se asocian con el aumento o disminución de la carga del cuidador a los 12 meses. Pacientes y métodos. Estudio prospectivo observable a 12 meses de una muestra de 150 pacientes con diagnóstico clínico de enfermedad de Alzheimer probable, según criterios NINDCS-ADDRA. Se recogieron los datos sociodemográficos del cuidador y se administraron las escalas siguientes: CAMDEX, CAMCOG, NPI, RDRS-2 y Burden Interview (BI), en el momento basal y a los 12 meses. Resultados. La presencia de depresión en el momento basal se asociaba a mayor carga (puntuación de BI de 22,76 frente a 15,79), a mayor aparición de sintomatología no cognitiva (puntuación de NPI de 16,23 frente a 5,94) y a mayor discapacidad funcional (puntuación RDRS-2 de 27,89 frente a 25,53). La carga aumenta en el grupo de pacientes en los que persistió la sintomatología depresiva y en aquellos en que emergió a los 12 meses. Conclusión. Los datos sugieren que los síntomas depresivos aumentan la discapacidad funcional y que se asocian a una mayor presencia de síntomas no cognitivos; a su vez, la discapacidad funcional y los síntomas no cognitivos aumentan la carga del cuidador (AU)
