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Original Articles

Self-, collateral- and clinician assessment of depression in persons with cognitive impairment

, , , &
Pages 675-683
Received 16 Dec 2006
Accepted 02 Jun 2007
Published online: 20 Nov 2008

Objectives: This investigation examined the associations between self-reports, collateral-source reports and a clinician's diagnosis of depression in persons with cognitive impairment.

Method: Responses on the Geriatric Depression Scale – 15 (GDS-15) from 162 participants with a diagnosis of Mild Cognitive Impairment (n = 78) or Alzheimer's Dementia and a Mini-Mental State score ≥15 (n = 84) were compared with both their collateral sources’ report on either the Neuropsychiatric Inventory Questionnaire (n = 93) and/or the collateral-source GDS-15 (n = 67), or a clinician's diagnosis of Major Depression (MD).

Results: Significant differences were seen between self- versus collateral-source reports of depression in these participants. Participants’ reports of loss of interest (anhedonia) significantly increased the odds of disagreement with their collateral sources (OR = 3.78, 95% CI: 1.3–11.2) while reports of negative cognitions significantly decreased the odds of such a disagreement (OR = 0.31, 95% CI: 0.1–0.9). The symptom of anhedonia also showed the strongest association with the clinician's diagnosis of MD.

Conclusion: A motivational symptom like loss of interest was seen to play an important role in depression experienced by those with cognitive impairment.

Acknowledgements

Data presented in this manuscript were collected as part of an Alzheimer's Disease Core Center grant from the National Institute of Aging, P30 AG19606. Some of the findings in this manuscript were presented at the 2007 Annual Meeting of the American Association of Geriatric Psychiatry (AAGP), March, New Orleans, LA, USA. We would like to thank Dr Thomas Oxman for his constructive criticism and Ms Christine Oots for her help in preparing this manuscript.

 

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