Hostname: page-component-cd9895bd7-8ctnn Total loading time: 0 Render date: 2024-12-26T01:14:00.042Z Has data issue: false hasContentIssue false
  • English
  • Français

Demencia y depresión: co-distribución y factores de riesgo en una muestra de pacientes geriátricos internos y externos

Published online by Cambridge University Press:  12 May 2020

C. Morawetz ,
A. Stevens  and
H. Wormstall
C. Morawetz
Affiliation:
Departamento de Psiquiatría, Universidad de Tubinga, Tubinga, Alemania
A. Stevens
Affiliation:
Departamento de Psiquiatría, Universidad de Tubinga, Tubinga, Alemania
H. Wormstall
Affiliation:
Departamento de Psiquiatría, Universidad de Tubinga, Tubinga, Alemania
Get access

Resumen

Se presentan los resultados de un estudio transversal sobre 212 pacientes ancianos internos y externos, incluyendo datos sociodemográficos, resultados físicos, exploración de TAC y EEG, así como tests psicológicos para el rendimiento cognitivo y síntomas afectivos. Cuarenta y uno por ciento de los pacientes mostraron déficit cognitivo leve y 13%, grave. Se diagnosticó depresión en el 23% de los pacientes con deterioro cognitivo grave y en el 16% de los pacientes con deterioro leve o sin deterioro. El análisis estadístico reveló que el aumento de la edad, el sexo femenino y el bajo nivel intelectual premórbido estaban significativamente asociados con la pérdida de función cognitiva. La demencia y la depresión no estaban asociadas significativamente entre sí. El único factor de riesgo para la depresión era una historia de enfermedad afectiva, pero no los déficit cognitivos o la situación social. La exploración de TAC y el EEG fueron anómalos en el 50% de los pacientes; sin embargo, esto no se correlacionaba con el deterioro cognitivo o la presencia de depresión. A partir de este estudio, se concluye que la depresión y la demencia coinciden con frecuencia en los pacientes ancianos, pero que están asociadas con factores de riesgo diferentes. Se propone que la demencia y la depresión se traten como dos entidades patológicas distintas.

Keywords

pacientes geriátricosdemenciadepresiónexamen psicológicoexploración de TACEEG
Type
Artículo Original
Information
European Psychiatry (Ed. Española) , Volume 4 , Issue 4 , May 1997 , pp. 251 - 259
Copyright
Copyright © European Psychiatric Association 1997

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Morawetz C, Stevens A, Wormstall H, Dementia and depression: co-distribution and risk factors in a geriatric in-and outpatient sample. Eur Psychiatry 1996; 11: 369-375

References

Bibliografia

American Psychiatric Association (APA). Diagnostic and Statistical Manual of Mental Disorders 3rd ed, rev DSM-III-R. Washington, DC: APA, 1987.Google Scholar
Alexopoulos, GSMeyers, BSYoung, RLMattis, SKakuma, T. The course of geriatric depression with reversible dementia. Am J Psychiatry 1993; 150: 1693–9.Google ScholarPubMed
Angst, J. Epidemiologie der Spätdepression. In: Kielholz, PAdams, C eds. Der alte Mensch ais Patient. Cologne: Deutscher Ärzteverlag, 1986: 83–95.Google Scholar
Annen, BBachmann, EGerhard, U. Die Differentialdiagnose von Depression und Demenz anhand der kognitiven Funktionstuchtigkeit. Z Gerontopsych Psychiatrie 1991; 4: 257–63.Google Scholar
Baldwin, RC. Late life depression and structural brain changes: a review of recent resource imaging research. lnt J Ger Psychiatry 1993; 8: 115–23.CrossRefGoogle Scholar
Ballard, CGCassidy, GBannister, CMorhan, RNC. Prevalence, symptom profile and aetiology of depression in dementia sufferers. J Affect Disord 1993; 29: 1–6.CrossRefGoogle ScholarPubMed
Bickel, H. Epidemiologie. In: Lungershausen, E ed. Demenz, Berlin: Springer, 1992.Google Scholar
Berrios, GE. “Depressive pseudodementia” or “melancholic dementia”: a ninettenth century view. J Neurol Neurosurg Psychiatry 1985; 48: 393–400.CrossRefGoogle Scholar
Brandt, JWelsh, KABreitner, JSFostein, MFHelms, MChristian, JC. Hereditary influences on cognitive functioning of older men: a study of 4000 twin pairs. Arch Neurol 1993; 50: 599–603.Google ScholarPubMed
Bulbena, ABerrios, GE. Pseudodementia: facts and figures. Br J Psychiatry 1986; 148: 87–94.CrossRefGoogle ScholarPubMed
Burns, AJacoby, RLevy, R. Progression of cognitive impairment in Alzheimer's disease. J Am Geriatr Soc 1991; 39: 39–45.CrossRefGoogle ScholarPubMed
Corey-Bloom, JCGalasko, DHofstetter, CRJackson, JEThal, LJ. Clinical features distinguishing large cohorts with possible AD, probable AD and mixed dementia. JAm Geriatr Soc 1993; 41: 31–7.CrossRefGoogle ScholarPubMed
Denzler, PKessler, JMarkowitsch, HJ. Möglichkeiten und Mängel der psychopathometrischen Demenzdiagnostik. Fortschr Neurol Psychiatr 1986; 54: 382–92.CrossRefGoogle Scholar
Earnest, MPHeaton, RKWilkinson, WEMunke, WF. Cortical atrophy, ventricular enlargementt and intellectual impairment in the aged. Neurology 1979; 29: 1138–43.CrossRefGoogle ScholarPubMed
Emery, VOOxman, TE. Update on the dementia spectrum of depression. Am J Psychiatry 1992; 149: 305-17.Google ScholarPubMed
Feighner, JPRobins, EGuze, SBWoodruff, RAWinokur, G. Diagnostic criteria for use in psychiatrie research. Arch Gen Psychiatry 1972; 26: 57–63.Google Scholar
Folstein, MFMcHugh, PR. Dementia syndrome of depression. In: Katman, RTerry, RDBick, KL eds. Alzheimer's Disease. New York: Raven Press, 1978: 87–93.Google Scholar
Folstein, MFFolstein, SEMcHugh, PR. Mini-Mental- Satate. A practical method for grading the cognitive State of patients for the clinician. J Psychiatr Res 1975; 12: 189–98.CrossRefGoogle Scholar
Forsell, YJorm, AFFratiglioni, LGrut, MWinblad, B. Application of DSM-III R criteria for major depressive episode to elderly subjeets with and without dementia. Am J Psychiatry 1993; 150: 1199–202.Google ScholarPubMed
Geiger-Kabisch, CWeyerer, S. Zur Reliabilität und Validität von Screening-Instrumenten zur Erfassung von Depression bei älteren Menschen: Ein Überblick. Z Gerontopsych Psychiatrie 1991; 4: 75–89.Google Scholar
Grossberg, GTManepalli, JSolomon, K. Diagnosis of depression in demented patients. In: Morley, JE ed. Memory Function and Aging-Related Disorders. New York: Springer, 1992; 237-47.Google Scholar
Gurland, BJ. The borderlands of dementia: the influence of sociocultural characteristics on rates of dementia occuring in the senium. In: Miller, NECohen, CD eds. Clinical Aspects of Alzheimer's Disease and Senile Dementia. New York: Raven Press, 1981.Google Scholar
Hamilton, M. Development of a rating scale for primary depressive illness. Br J Soc Psychol 1967; 6: 278–96.CrossRefGoogle ScholarPubMed
IFSCEN. A glossary of terms commonly used by clinical electroencephalographers. Electroencephalogr Clin Neurophysiol 1974; 37: 538–48.CrossRefGoogle Scholar
Kessler, JDenzler, PMarkowitsch, HJ. Demenz-Test. Wein-heim: Beltz, 1988.Google Scholar
Kielholz, PAdams, CBech P et al. Depression and cognitive impairment in the elderly. A multicenter study. Eur Psychiatry 1995; 10: 61–74.CrossRefGoogle Scholar
Kiloh, LG. Pseudo-dementia. Acta Psychiatr Scand 1991; 365: 336–51.Google Scholar
Kral, VA. The relationship between senile dementia (Alzheimer’s type) and depression. Can J Psychiatry 1983; 28: 304–6.CrossRefGoogle ScholarPubMed
Kuhl, KP. Gründzuge der psychometrischen Demenzdiagnostik. In: Gutzmann, H ed. Der dementielle Patient. Beme: Huber, 1992: 87–103.Google Scholar
Lauter, HDame, S. Depressive disorders and dementia: the clinical view. Acta Psychiatr Scand 1992; 366: 40–6.Google Scholar
Mahendra, B. Depression and dementia: the multi-faceted relationship. Psychol Med 1985; 15: 227–36.CrossRefGoogle ScholarPubMed
Mattis, S. Mental status examination for organic mental syndrome in the elderly patient. In: Bellak, LKarasu, TB eds. Geriatric Psychiatry. New York: Grune and Stratton, 1976: 77–122.Google Scholar
Palmer, AMDeKosky, ST. Monoamine neurons and aging in Alzheimer's disease. J Neural Transm Gen Sect 1993; 91: 135–59.CrossRefGoogle ScholarPubMed
Paulsen, JSWeisstein, CCHeaton, RK. The neuropsychology of aging. Curr Opin Psychiatry 1994; 7: 347–53.CrossRefGoogle Scholar
Rabins, PVPearlson, GDStauss, ME. Cognitive impairment in psychiatrie syndroms. In: Whitehouse, PJ ed. Dementia. Philadelphia: FA Davis Co, 1993: 359-71.Google Scholar
Rapp, PRHeindel, WC. Memory Systems in normal and pathological aging. Curr Opin Neurol 1994; 7: 294–8.CrossRefGoogle ScholarPubMed
Sandor, TAlbert, MStafford, JHarpley, S. Use of computerized CT analysis to discriminate between Alzheimer patients and control subjeets. Am J Neurol 1988; 9: 1181–7.Google Scholar
Schaie, KW. The optimization of cognitive functioning in oid age: predictions on cohort-sequential and longitudinal data. In: Baltes, PBBaltes, MM eds. Successful Aging. Cambridge Univ Press, 1990; 94–117.CrossRefGoogle Scholar
Sheikh, JAYesavage, JA (1986) Geriatric Depression Scale (GDS): Recent findings and development of a shorter version. In: Brink, TL ed. Clinical Gerontology: A Guide to Assessment and Intervention. New York: Haworth Press.Google Scholar
Skoog, I. The prevalence of psychotic, depressive and anxiety syndromes in demented and non-demented 85-years-olds. Int J Geriatr Psychiatry 1993; 8: 247–54.CrossRefGoogle Scholar
Smith, CDGallenstein, LGLayton, WJKryscio, RJMarkesbery, WR. Magnetic resonance spectroscopy in Alzheimer's and Pick's disease. Neurobiol Aging 1993; 14: 85–92.CrossRefGoogle ScholarPubMed
Stoppe, GStaedt, J. Die fruhe diagnostische Differenzierung primär dementer von primär depressiven Syndromen im Alter-ein Beitrag zur Pseudodemenzkiskussiori. Fortschr Neurol Psychiatr 1993; 61: 172–82.CrossRefGoogle Scholar
Teri, LWagner, A. Alzheimer's disease and depression. J Consult Clin Psychol 1992; 60: 379–89.CrossRefGoogle ScholarPubMed
Turrina, CCaruso, REste, Ret al. Affective disorders among elderly general practice patients. A two-phase survey in Brescia, Italy. Br J Psychiatry 1994; 164: 533–7.CrossRefGoogle Scholar
Verhey, FRJRozendaal, NPonds, RWHMJolles, J. Dementia, awareness and depression. Int J Geriatr Psychiatry 1993; 8: 851–6.CrossRefGoogle Scholar
Wiederhold, WCCahn, DButters, NMSalmon, DPKritz-Silverstein, DBarrett-Connor, E. Effects of age, gender and education on selected neuropsychological tests in an elderly community cohort. J Am Geriatr Soc 1993; 41: 639–47.CrossRefGoogle Scholar
Wilson, RSRosenbaum, GBrown, G. The problem of premorbid intelligence in neuropsychological assessment. J Clin Neuropsychol 1979; 1: 49–93.CrossRefGoogle Scholar
Zaudig, MMittelhammer, JHiller, W. SIDAM - Strukturiertes Interview für die Diagnose einer Demenz vom Alzheimer-Typ, der Multi-Infarkt-Demenz und Demenzen anderer Ätiologie nach DSM-IIIR und 1CD-10. Munich: Logomed, Höpker, 1990.Google Scholar