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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
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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

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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