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Depressive symptomatology in severe dementia in a European sample: prevalence, associated factors and prescription rate of antidepressants

Published online by Cambridge University Press:  11 December 2014

Clarissa M. Giebel*
Affiliation:
Personal Social Services Research Unit, University of Manchester, Devonshire House, Oxford Road, M13 9PL Manchester, UK
Caroline Sutcliffe
Affiliation:
Personal Social Services Research Unit, University of Manchester, Devonshire House, Oxford Road, M13 9PL Manchester, UK
Anna Renom-Guiteras
Affiliation:
School of Nursing Science, Faculty of Health, University of Witten/Herdecke, Germany
Seija Arve
Affiliation:
Department of Nursing Science, University of Turku, Turku, Finland
Ingalill Rahm Hallberg
Affiliation:
Department of Health Sciences, Lund University, Lund, Sweden
Maria Soto
Affiliation:
Department of Geriatric Medicine, Gerontopole, INSERM 1027, University Hospital de Toulouse, Toulouse, France
Adelaida Zabalegui
Affiliation:
Hospital Clinic of Barcelona, Nursing, Barcelona, Spain
Jan Hamers
Affiliation:
Department of Health Services Research, Maastricht University, Maastricht, the Netherlands
Kai Saks
Affiliation:
Department of Internal Medicine, University of Tartu, Tartu, Estonia
David Challis
Affiliation:
Personal Social Services Research Unit, University of Manchester, Devonshire House, Oxford Road, M13 9PL Manchester, UK
*
Correspondence should be addressed to: Clarissa M. Giebel, Personal Social Services Research Unit, University of Manchester, Devonshire House, Oxford Road, M13 9PL Manchester, UK. Phone: +44-161-275-5652; Fax: +44-161-275-5790. Email: clarissa.giebel@manchester.ac.uk.

Abstract

Background:

Depression is a common comorbid disorder of dementia. This study explores the prevalence of and factors associated with depressive symptomatology, and antidepressant prescription rates in severe dementia across eight European countries.

Methods:

In total, 414 people with severe dementia completed measures of cognition and quality of life (QoL), whilst carers completed proxy measures of activities of daily living (ADLs), depression, neuropsychiatric symptoms, QoL and comorbidity.

Results:

Findings indicated that 30% of the sample had depression, whilst the highest and lowest prevalence of depression was reported in Germany and Finland, respectively. Lower QoL, the presence of pain and more frequent neuropsychiatric symptoms were associated with depressive symptomatology, whilst no significant relationship between impairment of ADLs, comorbidity, and depression emerged. Spain and Estonia had the highest and lowest rates of antidepressant prescribing, respectively, whilst Germany had the highest discrepancy between depressive symptomatology and prescription.

Conclusions:

The study highlights variations across countries in the prevalence of depressive symptomatology in severe dementia and prescription of antidepressants. Information about factors associated with depressive symptomatology may help to better identify and manage depression.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2014 

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References

Alexopoulos, G. S. (1988). The Cornell Scale for Depression in Dementia: Administration & Scoring Guidelines. NY: Cornell Institute of Geriatric Psychiatry.Google Scholar
Alexopoulus, G. S., Abrams, R. S., Young, R. C. and Shamoian, C. A. (1988). Cornell scale for depression in dementia. Biological Psychiatry, 23, 271284.Google Scholar
Alzheimer's Disease International (2012). National Alzheimer and Dementia Plans Planned Policies and Activities.Google Scholar
Ballard, C. G., Bannister, C., Solis, M., Oyebode, F. and Wilcock, G. (1996). The prevalence, associations and symptoms of depression amongst dementia sufferers. Journal of Affective Disorders, 36, 135144.Google Scholar
Beerens, H. et al. (2014). Quality of life and quality of care for people with dementia receiving long term institutional care or professional home care: the European RightTimePlaceCare study. Journal of the American Medical Directors Association, 15, 5461.Google Scholar
Bielinski, K. and Lawlor, B. (2006). Depression in Severe Dementia in A. Burns and B. Winblad (eds) Severe Dementia. Chichester: Wiley.Google Scholar
Charlson, M. E., Pompei, P., Ales, K. and MacKenzie, C. R. (1987). A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. Journal of Chronic Diseases, 40, 373383.CrossRefGoogle ScholarPubMed
Chou, K. L. (2007). Reciprocal relationship between pain and depression in older adults: evidence from the English longitudinal study of ageing. Journal of Affective Disorders, 102, 115123.CrossRefGoogle ScholarPubMed
Cohen-Mansfield, J. and Libin, A. (2005). Verbal and physical non-aggressive agitated behaviors in elderly persons with dementia: robustness of syndromes. Journal of Psychiatric Research, 39, 325332.Google Scholar
Conde-Sala, J. L. et al. (2014). Severity of dementia, anosognosia, and depression in relation to the quality of life of patients with Alzheimer disease: discrepancies between patients and caregivers. American Journal of Geriatric Psychiatry, 22, 138147.Google Scholar
Davydow, D. S., Zivin, K. and Langa, K. M. (2014). Hospitalization, depression and dementia in community-dwelling older Americans: findings from the national health and aging trends study. General Hospital Psychiatry, 36, 135141.Google Scholar
deMedeiros, K. et al. (2010). The Neuropsychiatric Inventory-Clinician rating scale (NPI-C): reliability and validity of a revised assessment of neuropsychiatric symptoms in dementia. International Psychogeriatrics, 22, 984994.CrossRefGoogle Scholar
Department of Health (2009). Living Well with Dementia. A National Dementia Strategy. London: Department of Health.Google Scholar
Donaldson, C., Tarrier, N. and Burns, A. (1998). Determinants of carer stress in Alzheimer's disease. International Journal of Geriatric Psychiatry, 13, 248256.Google Scholar
Earnst, K. S. et al. (2001). Loss of financial capacity in Alzheimer's disease: the role of working memory. Aging Neuropsychology and Cognition, 8, 109119.Google Scholar
Folstein, M., Folstein, S. and McHugh, P. (1975). “Mini-mental state.” A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189198.Google Scholar
G8 UK (2013). G8 Dementia Summit Declaration. London: Department of Health.Google Scholar
Gaugler, J. E., Hovater, M., Roth, D. L., Johnston, J. A., Kane, R. L. and Sarsour, K. (2014). Depressive, functional status, and neuropsychiatric symptom trajectories before an Alzheimer's disease diagnosis. Aging & Mental Health, 18, 110116.Google Scholar
Giebel, C. M. et al. (2014). Deterioration of basic activities of daily living and their impact on quality of life across different cognitive stages of dementia: a European study. International Psychogeriatrics, 26, 12831293.Google Scholar
Giebel, C. M., Sutcliffe, C. and Challis, D. (2015). Activities of daily living and quality of life across different stages of dementia: a UK study. Aging & Mental Health, 19(1), 6371.Google Scholar
Graeske, J., Fischer, T., Kuhlmey, A. and Wolf-Ostermann, K. (2012). Quality of life in dementia care – differences in quality of life measurements performed by residents with dementia and by nursing staff. Aging & Mental Health, 16, 819827.CrossRefGoogle Scholar
Hawes, C., Morris, J. N., Phillips, C. D., Fries, B. E., Murphy, K. and Mor, V. (1997). Development of the nursing home resident assessment instrument in the USA. Age & Ageing, 26 (Suppl. 2), 1925.Google Scholar
Hoe, J., Katona, C., Roch, B. and Livingston, G. (2005). Use of the QoL-AD for measuring quality of life in people with severe dementia – the LASER-AD study. Age & Ageing, 34, 130135.Google Scholar
Iden, K. R., Engedal, K., Hjorleifsson, S. and Ruths, S. (2014). Prevalence of depression among recently admitted long-term care patients in norwegian nursing homes: associations with diagnostic workup and use of antidepressants. Dementia and Geriatric Cognitive Disorders, 37, 154162.Google Scholar
Katz, S., Ford, A. B., Moskowitz, R. W., Jackson, B. A. and Jaffe, M. W. (1963). Studies of illness in the aged: the index of ADL: a standardized measure of biological and psychosocial function. Journal of the American Medical Association, 85, 914919.CrossRefGoogle Scholar
Kaufer, D. I. et al. (2000). Validation of the NPI-Q, a brief clinical form of the neuropsychiatric inventory. Journal of Neuropsychiatry and Clinical Neuroscience, 12, 233239.Google Scholar
Knapskog, A.-B., Barca, M. L. and Engedal, K. (2011). The cornell study group: a comparison of the validity of the cornell scale and the MADRS in detecting depression among memory clinic patients. Dementia and Geriatric Cognitive Disorders, 32, 287294.Google Scholar
Knapskog, A.-B., Barca, M. L. and Engedal, K. (2013). Prevalence of depression among memory clinic patients as measured by the cornell scale of depression in Dementia. Aging & Mental Health, 18, 579587.Google Scholar
Kruger, T. M., Abner, E. L., Mendiondo, M., Schmitt, F. A., Smith, C. D. and Jicha, G.A. (2012). Differential reports of pain and depression differentiate mild cognitive impairment from cognitively intact elderly participants. Journal of Geriatric Psychiatry and Neurology, 25, 107112.Google Scholar
Logsdon, R. G., Gibbons, L. E., McCurry, S. M. and Terri, L. (1999). Quality of life in Alzheimer's disease: patient and caregiver reports. Journal of Mental Health & Aging, 5, 2132.Google Scholar
Maas, C. J. M. and Hox, J. J. (2005). Sufficient sample sizes for multilevel modeling. Methodology: European Journal of Research Methods for the Behavioral and Social Sciences, 1, 8692.Google Scholar
Miller, L. A., Mioshi, E., Savage, S., Lah, S., Hodges, J. R. and Piguet, O. (2013). Identifying cognitive and demographic variables that contribute to carer burden in dementia. Dementia and Geriatric Cognitive Disorders, 36, 4349.Google Scholar
Molloy, D. W., Alemayehu, E. and Roberts, R. (1991). Reliability of a standardized Mini-Mental State Examination compared with the traditional Mini-Mental State Examination. American Journal of Psychiatry, 148, 102105.Google Scholar
Molloy, D. W. and Standish, T. I. M. (1997). A guide to the standardized mini-mental state examination. International Psychogeriatrics, 9 (Suppl. 1), 8794.Google Scholar
National Institute for Health and Clinical Excellence (NICE) (2006). Final Appraisal Determination: Donepezil, Galantamine, Rivastagmine (Review) and Memantine for the Treatment of Alzheimer's Disease. London: Department of Health.Google Scholar
Nikmat, A. W., Hawthorne, G. and Al-Mashoor, S. H. (2013). The comparison of quality of life among people with mild dementia in nursing home and home care—a preliminary report. Dementia, doi: 10.1177/1471301213494509.Google Scholar
Onder, G., Liperoti, R., Soldato, M., Cipriani, M. C., Bernabei, R. and Landi, F. (2007). Depression and risk of nursing home admission among older adults in home care in europe: results from the aged in home care (AdHOC) study. Journal of Clinical Psychiatry, 68, 13921398.CrossRefGoogle ScholarPubMed
Payne, J. L. et al. (1998). Relationship of cognitive and functional impairment to depressive features in Alzheimer's disease and other dementias. Journal of Neuropsychiatry and Clinical Neuroscience, 10, 440447.Google Scholar
Prina, A. M. et al. (2013). Association between depression and hospital outcomes among older men. Canadian Medical Association Journal, 185, 117123.Google Scholar
Reppermund, S. et al. (2011). The relationship of current depressive symptoms and past depression with cognitive impairment and instrumental activities of daily living in an elderly population: the Sydney memory and ageing study. Journal of Psychiatric Research, 45, 16001607.Google Scholar
Rosness, T. A., Barca, M. L. and Engedal, K. (2010). Occurrence of depression and its correlates in early onset dementia patients. International Journal of Geriatric Psychiatry, 25, 704711.Google Scholar
Soto-Martin, M. et al. (2014). Associated factors with antipsychotic use in long-term institutional care in eight European countries: results from the RightTimePlaceCare study. Journal of the American Medical Directors Association, in press.Google Scholar
Thorgrimsen, L. et al. (2003). Whose quality of life is it anyway?: the validity and reliability of the quality of life-Alzheimer's disease (QoL-AD) scale. Alzheimer Disease and Associated Disorders, 17, 201208.Google Scholar
Tombaugh, T. N. and Mclntyre, N. J. (1992). The mini-mental state examination: a comprehensive review. Journal of the American Geriatric Society, 40, 922935.Google Scholar
van Asch, I. F. M., Nuyen, J., Verbeek, M. A., Frijters, D. H. M., Achterberg, W. P. and Pot, A. M. (2013). The diagnosis of depression and use of antidepressants in nursing home residents with and without dementia. International Journal of Geriatric Psychiatry, 28, 312318.Google Scholar
van der Linde, R. M., Dening, T., Matthews, F. E. and Brayne, C. (2014). Grouping of behavioural and psychological symptoms of dementia. International Journal of Geriatric Psychiatry, 29, 562568.Google Scholar
Van der Museele, S. et al. (2013). Prevalence and associated behavioural symptoms of depression in mild cognitive impairment and dementia due to Alzheimer's disease. International Journal of Geriatric Psychiatry, 28, 947958.Google Scholar
Verbeek, H. et al. (2012). A European study investigating patterns of transition from home care towards institutional dementia care: the protocol of a RightTimePlaceCare study. BMC Public Health, 12, 68.Google Scholar
Vilalta-Franch, J. et al. (2010). Syndromic association of behavioral and psychological symptoms of dementia in Alzheimer disease and patient classification. American Journal of Geriatric Psychiatry, 18, 421432.Google Scholar
Wetzels, R. B., Zuidema, S. U., De Jonghe, J. F. M., Verhey, F. R. J. and Koopmans, R. T. C. M. (2010). Determinants of quality of life in nursing home residents with dementia. Dementia and Geriatric Cognitive Disorders, 29, 189197.Google Scholar
WHO Collaborating Centre for Drug Statistics Methodology (2012). Guidelines for ATC classification and DDD assignment 2013. Oslo.Google Scholar
Woods, R. T. et al. (2014). What contributes to a good quality of life in early dementia? awareness and the QoL-AD: a cross-sectional study. Health Quality of Life Outcomes, 12, 94104.Google Scholar
Wright, S. L. and Persad, C. (2007). Distinguishing between depression and dementia in older persons: neuropsychological and neuropathological correlates. Journal of Geriatric Psychiatry and Neurology, 20, 189198.Google Scholar