Am J Psychiatry 1994; 151:1006-1009
Copyright © 1994 by American Psychiatric Association
Prevalence and incidence of major depression in Alzheimer's disease
MF Weiner, SD Edland and H Luszczynska
Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas 75235-9070.
OBJECTIVE: This study examined the prevalence and incidence of major
depressive disorder in Alzheimer's disease. METHOD: The authors
retrospectively reviewed two large Alzheimer's disease databases, one at
the University of Texas Southwestern Medical Center in Dallas and the other
at the Consortium to Establish a Registry for Alzheimer's Disease (CERAD).
The Dallas series contained 264 cases of Alzheimer's disease, of which 153
patients were followed up for an average of 3 years from initial
evaluation. The CERAD database contained 1,095 cases and excluded patients
with histories of depression at initial evaluation; 325 of these patients
were followed up for at least 2 years. Alzheimer's disease was diagnosed
according to the criteria of the National Institute of Neurological and
Communicative Disorders and Stroke and the Alzheimer's Disease and Related
Disorders Association; major depression was diagnosed according to the
DSM-III-R criteria. Most of the patients in these series were dwelling in
the community and had had Alzheimer's disease symptoms for approximately 4
years at the time of evaluation. RESULTS: In the Dallas series there was a
1.5% prevalence and a 0% incidence of major depression. In the CERAD series
there was a 1.3% 2-year incidence of major depression. CONCLUSIONS: The low
prevalence and incidence of DSM-III-R major depression in these patients
suggest that for the period of time the patients were followed up,
Alzheimer's disease did not predispose to major depression. However, major
depression may herald the subsequent onset of dementia. Depression in
dementia should perhaps be diagnosed by different criteria.
