Neurological correlates of depressive symptoms in Alzheimer's disease and vascular dementia

Background. Organic brain disease such as dementia or stroke is associated with depression. In dementia, depressive symptoms are common where there is evidence of vascular disease and in Alzheimer's disease they often coexist with extrapyramidal signs: Method. In a study of 60 patients with Alzheime r's disease and 39 patients with vascular dementia, depressive symptoms wer e rated using the Cornell Scale for Depression in Dementia. Neurological si gns were assessed and severity of cognitive impairment was measured with th e Mini-Mental State Examination. Results. Depressive symptoms were more sev ere in vascular dementia. Pyramidal tract signs had no relationship to depr ession in either type of dementia. In vascular dementia, extrapyramidal and grasp reflexes were strongly related to the severity of depression, and we re associated with neurovegetative features. In Alzheimer's disease, extrap yramidal signs were the strongest independent predictor of the severity of depression. Conclusion. Depressive symptoms are more severe in vascular dem entia compared to Alzheimer's disease and were related to neurological abno rmalities. (C) 1999 Elsevier Science B.V. All rights reserved.