Hostname: page-component-586b7cd67f-r5fsc Total loading time: 0 Render date: 2024-11-29T03:05:11.407Z Has data issue: false hasContentIssue false
  • English
  • Français

Alzheimer's Disease, Other Dementias, Depression and Pseudo-dementia: Prevalence, Incidence and Three-Year Outcome in Liverpool

Published online by Cambridge University Press:  02 January 2018

J. R. M. Copeland ,
I. A. Davidson ,
M. E. Dewey ,
C. Gilmore ,
B. A. Larkin ,
C. Mcwilliam ,
P. A. Saunders ,
A. Scott ,
V. Sharma  and
C. Sullivan
J. R. M. Copeland*
Affiliation:
University of Liverpool Department of Psychiatry and the Institute of Human Ageing
I. A. Davidson
Affiliation:
Royal Liverpool Hospital
B. A. Larkin
Affiliation:
Manchester Higher Training Scheme
C. Mcwilliam
Affiliation:
Psychiatry of Old Age, University of Keele
A. Scott
Affiliation:
University of Liverpool, Department of Psychiatry, Liverpool
V. Sharma
Affiliation:
Walton Hospital, Liverpool
C. Sullivan
Affiliation:
Liverpool General Psychiatric Rotation Scheme, Wirral Health Authority
*
∗PO Box 147, Liverpool L69 3BX
Get access Rights & Permissions [Opens in a new window]

Abstract

A group of 1070 community-living persons aged 65 and over was assessed using the GMS–agecat package and other interviews at years 0 and 3. Year 3 interviewers were ‘blind’ to the findings at year 0, and the prevalence of organic disorders and depression was very similar in both years. According to the results at year 3, minimum and maximum prevalence figures for dementia at year 0 were 2.4% and 3.8% for moderate to severe and 0.4% and 2.4% for mild or early cases, with a best estimate of 3.5% and 0.8%, or 4.3% overall, divided into: senile, Alzheimer's type 3.3%; vascular 0.7%; and alcohol-related 0.3%. The overall incidence of dementia, clinically confirmed by six-year follow-up, was 9.2/1000 per year (Alzheimer type 6.3, vascular 1.9, alcohol related 1.0). Three years later, 72.0% of those with depressive psychosis and 62.3% of those with depressive neurosis were either dead or had some kind of psychiatric illness. Nearly 60% of milder depressive cases (7.2% of the total sample) had either died or developed a chronic mental illness. The outcome of depressive pseudodementias is equivocal so far. Findings at year 3 provide validation of agecat computer diagnosis against outcome; organic and depression diagnoses are seen to have important implications for prognosis.

Type
Papers
Information
The British Journal of Psychiatry , Volume 161 , Issue 2 , August 1992 , pp. 230 - 239
Copyright
Copyright © 1992 The Royal College of Psychiatrists 

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.)

References

American Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorders (3rd edn) (DSM–III). Washington, DC: APA.Google Scholar
American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM–III–R). Washington, DC: APA.Google Scholar
Baldwin, R. C. & Jolley, D. J. (1986) The prognosis of depression in old age. British Journal of Psychiatry, 149, 574–583.Google Scholar
Bergmann, K., Kay, D. W. K., Foster, E. M., et al (1971) A follow-up study of randomly selected community residents to assess the effects of chronic brain syndrome and cerebrovascular disease. Proceedings of Fifth Congress of Psychiatry, Part II, 856–865.Google Scholar
Brayne, C. & Galloway, P. (1989) An epidemiological study of dementia in a rural population of elderly women. British Journal of Psychiatry, 155, 147–152.Google Scholar
Broe, G. A., Akhatar, A. J., Andrews, G. R., et al (1976) Neurological disorders in the elderly at home. Neurology, Neurosurgery and Psychiatry, 39, 362–366.Google Scholar
Clarke, M., Lowry, R. & Clarke, S. (1986) Cognitive impairment in the elderly – a community survey. Age and Ageing, 15, 2782–2784.CrossRefGoogle ScholarPubMed
Copeland, J. R. M. (1987) Prevalence of depressive illness in the elderly community. In The Presentation of Depression: Current Approaches (eds Freeling, P., Downey, L. J. & Malkin, J. C.). Occasional Paper 36. London: Royal College of General Practitioners.Google Scholar
Copeland, J. R. M., Kelleher, M. J., Kellett, J. M., et al (1976) “A semi-structured clinical interview for the assessment of diagnosis and mental state in the elderly. The Geriatric Mental State 1. Development and reliability”. Psychological Medicine, 6, 439–449.Google Scholar
Copeland, J. R. M., Dewey, M. E. & Griffiths-Jones, H. M. (1986) Computerised psychiatric diagnostic system and case nomenclature for elderly subjects: GMS and agecat. Psychological Medicine, 16, 89–99.CrossRefGoogle ScholarPubMed
Copeland, J. R. M., Dewey, M. E., Wood, N., et al (1987a) The range of mental illness amongst the elderly in the community: prevalence in Liverpool. British Journal of Psychiatry, 150, 815–823.Google Scholar
Copeland, J. R. M., Gurland, B. J., Dewey, M. E., et al (1987b) Is there more dementia, depression and neurosis in New York? A comparative study of the elderly in New York and London using the computer diagnosis agecat. British Journal of Psychiatry, 151, 466–473.CrossRefGoogle ScholarPubMed
Copeland, J. R. M., Dewey, M. E., Henderson, A. S., et al (1988) The Geriatric Mental State (GMS) used in the community. Replication studies of the computerised diagnosis agecat. Psychological Medicine, 18, 219–223.Google Scholar
Copeland, J. R. M., Dewey, M. E. & Griffiths-Jones, H. M. (1990) Dementia and depression in elderly persons: agecat compared with DSM III and pervasive illness. International Journal of Geriatric Psychiatry, 5, 47–51.Google Scholar
Copeland, J. R. M., Dewey, M. E. & Saunders, (1991) The epidemiology of dementia: GMS-AGECAT studies of prevalence and incidence, including studies in progress. European Archives of Psychiatry and Clinical Neuroscience, 240, 212–217.CrossRefGoogle ScholarPubMed
Copeland, J. R. M., Dewey, M. E. (1991) Neuropsychological diagnosis (GMS–HAS–AGECAT package). International Psychogeriatrics, 3 (suppl.), 43–49.Google Scholar
Davidson, I. A., Dewey, M. E. & Copeland, J. R. M. (1988) The relationship between mortality and mental disorder: evidence from the Liverpool Longitudinal Study. International Journal of Geriatric Psychiatry, 3, 95–98.CrossRefGoogle Scholar
Dewey, M. E. & Copeland, J. R. M. (1986) Computerised diagnosis in the elderly: agecat. Journal of Microcomputer Applications, 9, 135–140.Google Scholar
Dewey, M. E., Davidson, I. A. & Copeland, J. R. M. (1988) Risk factors for dementia: evidence from the Liverpool Study of Continuing Health in the Community. International Journal of Geriatric Psychiatry, 3, 289–292.Google Scholar
Folstein, M. F., Folstein, S. E. & McHugh, K. K. (1975) Mini-mental state: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.Google Scholar
Gurland, B. J., Fleiss, J. L., Goldberg, K., et al (1976) A semi-structured clinical interview for the assessment of diagnosis and mental state in the elderly. The Geriatric Mental State Schedule 2. A factor analysis. Psychological Medicine, 6, 451–459.Google Scholar
Hachinski, V. C., Illiff, L. D., Zihka, E., et al (1975) Cerebral flow in dementia. Archives of Neurology, 32, 632–637.CrossRefGoogle ScholarPubMed
Hagnell, O., Lanke, J., Rorsman, B., et al (1981) Does the incidence of age psychosis decrease? A prospective longitudinal study of a complete population investigated during the 25 year period 1947–1972. The Lundby Study. Neuropsychobiology, 74, 201–211.Google Scholar
Hagnell, O., Lanke, J., Rorsman, B., et al (1983) Current trends in the incidence of senile and multi-infarct dementia. A prospective study of a total population followed up over 25 years: The Lundby Study. Archives of Psychiatry and Neurological Science, 233, 423–438.Google Scholar
Henderson, A. S. (1986) The epidemiology of Alzheimer's disease. British Medical Bulletin, 42, 3–10.Google Scholar
Kay, D. W. K., Beamish, R. & Roth, M. (1964) Old age mental disorders in Newcastle upon Tyne. Part I. A study of prevalence. British Journal of Psychiatry, 110, 146–158.Google Scholar
Kay, D. W. K., Henderson, A. S., Scott, R., (1985) Dementia and depression among the elderly living in the Hobart community: the effect of the diagnostic criteria on the prevalence rates. Psychological Medicine, 15, 771–788.Google Scholar
Lobo, A., Saz, P., Dia, J.-L., et al (1990) The Liverpool–Zaragoza Study: background and preliminary data of case-finding method for a population study on dementias. In Case Finding for Dementia in Epidemiological Studies (eds Dewey, M. E., Copeland, J. R. M. & Hofman, A.). Liverpool: Institute of Human Ageing.Google Scholar
Morgan, K., Dalloso, H. M., Arie, T., et al (1987) Mental health and psychological well-being among the old and very old living at home. British Journal of Psychiatry, 150, 808–814.CrossRefGoogle ScholarPubMed
Mortimer, J. A., Schuman, L. M. & French, L. R. (1981) Epidemiology of dementing illness. In The Epidemiology of Dementia (eds Mortimer, J. A. & Schuman, L. M.). New York: Oxford University Press.Google Scholar
Murphy, E. (1983) The prognosis of depression in old age. British Journal of Psychiatry, 142, 111–119.Google Scholar
Parsons, P. L. (1965) Mental health of Swansea's old folk. British Journal of Preventive and Social Medicine, 19, 43–47.Google Scholar
Robins, L. N., Helzer, J. E., Croughan, J., et al (1981) National Institute of Mental Health and Diagnostic Interview Schedule: its listing, characteristics and validity. Archives of General Psychiatry, 38, 381–389.Google Scholar
Saunders, P., Copeland, J. R. M., Davidson, I. A., et al (1989) Alcohol use and abuse in the elderly: findings from the Liverpool longitudinal study of continuing health in the community. International Journal of Geriatric Psychiatry, 4, 103–108.Google Scholar
Sullivan, C., Copeland, J. R. M., Davidson, I. A., et al (1988) Benzodiazepine usage amongst the elderly: findings of the Liverpool community survey. International Journal of Geriatric Psychiatry, 3, 289–292.Google Scholar
Wing, J. K., Cooper, J. E. & Sartorius, N. (1974) The Description and Classification of Psychiatric Symptoms: An Instruction Manual for the PSE and Catego System. London: Cambridge University Press.Google Scholar
World Health Organization (1986) ICD–10. Draft of Chapter V. Geneva: WHO.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.