Clinically significant depressive symptoms and very mild to mild dementia of the Alzheimer type

Objective To compare depressive symptoms reported by persons with very mild or mild dementia of the Alzheimer type (DAT) with those reported for the p erson by a collateral source. Design Cross-sectional evaluation. Setting Washington University Alzheimer's Disease Research Center. Participants Consecutive series of elderly volunteers (n = 156) enrolled in longitudinal studies with a Clinical Dementia Rating (CDR) of 0.5 (very mi ld) or 1 (mild). Twenty-one per cent (n = 33) exhibited clinically signific ant depressive symptoms for which treatment was recommended. Main outcome measures Presence and frequency of DSM-IV depressive symptoms within the last year and last month reported by the participant or collater al source as ascertained by clinical examination and structured interviews. Results Collateral source information is essential in diagnosing clinically significant depressive symptoms. The Geriatric Depression Scale scores cor relate with participant information only and therefore may substantially un derestimate depression. Depressive symptoms fluctuate in individuals with D AT. The most consistent depressive symptoms are depressed mood, fatigue and indecision. Conclusions Clinically significant depressive symptoms may be common in ind ividuals with very mild or mild DAT, although they may fluctuate. Informati on from both a knowledgeable collateral source and the participant is impor tant for detection of depressive symptoms. Copyright (C) 2001 John Wiley & Sons, Ltd.