Differential diagnosis of depression and Alzheimer's disease with the Addenbrooke's Cognitive Examination-Revised (ACE-R).

BACKGROUND: One of the usual problems psychologists and clinicians face in clinical practice is differential diagnostics of Alzheimer's disease and depression. It has been reported that the ACE and ACE-R could discriminate the cognitive dysfunctions due to depression from that due to dementia, although this is not uniform in all studies. The current study aimed to evaluate the utility of the ACE-R to differentiate late-life onset depression (with severe episode) from mild-moderate Alzheimer's Disease (AD). METHODS: This study received approval from the Lithuanian Bioethics Committee. All participants were older than 50 years (mean age = 66.52 (±8.76) years). The study sample consisted of 295 individuals: 117 with severe depression, 85 with mild-moderate Alzheimer's disease (AD), and 94 age, gender and education matched participants of control group. RESULTS: The ACE-R had high sensitivity (100%) and specificity (81%) at detecting cognitive impairments related to AD. Patients with late-life onset depression (ACE-R mean 76.82, SD = 7.36) performed worse than controls (ACE-R mean 85.08, SD = 7.2), but better than the AD group (ACE-R mean 54.74, SD = 12.19). Participants with late-life onset depression were differentiated by mild impairment in the ACE-R total score with mild memory (13.79, SD = 6.29) and greater deficits in letter fluency (3.65, SD = 1.21) than in semantic fluency (4.68, SD = 1.23). Participants with AD were differentiated by severely impaired performance on attention and orientation (11.80, SD = 2.93), memory (8.25, SD = 3.47) and language subtests (17.21, SD = 4.04), and moderately impaired performance on verbal fluency (6.07, SD = 2.74). CONCLUSIONS: ACE-R has diagnostic accuracy in detecting people with AD and can be used in differential diagnostics of late-life onset depression (severe episode) and AD. Diagnostic accuracy may be improved by analyzing the neuropsychological profiles and using lower cutoffs for different age groups.

Digit ratio (2D:4D) in Lithuania once and now: testing for sex differences, relations with eye and hair color, and a possible secular change.

The second-to-fourth digit ratio (2D:4D) is a sexually dimorphic somatic trait and has been proposed as a biomarker for the organizational, i.e., permanent, effects of prenatal testosterone on the human brain. Accordingly, recent research has related 2D:4D to a variety of sex-dependent, hormonally influenced traits and phenotypes. The geographical variation in typical 2D:4D is marked and presently poorly understood. This study presents the first investigation into the 2D:4D ratio in a Baltic country. A contemporary sample of 109 Lithuanian men and women was compared with data from a historical sample of 100 Lithuanian men and women, collected and published in the 1880s and rediscovered only now. The findings included the following lines of evidence: (i) seen in an international perspective, the average 2D:4D in Lithuania is low; (ii) there was a sex difference in 2D:4D in the expected direction in both samples; (iii) a previously adduced hypothesis of an association of lighter eye and hair color with higher, i.e., more feminized, 2D:4D received no support in both samples; and (iv) the average 2D:4D in the contemporary sample was higher than in the historical sample. In view of a hypothesized increase in 2D:4D in modern populations, owing to increased environmental levels of endocrine disruptors such as xenoestrogens, this latter finding appears to be of particular notice. However, because finger-length measurement methods differed across the samples, it cannot be safely ruled out that the apparent time trend in Lithuanian 2D:4D in truth is an artifact. The puzzling geographical pattern seen in the 2D:4D ratio and the question of possible time trends therein deserve further investigations.