Assessment of Mood States in Neurodegenerative Disease: Methodological Issues and Diagnostic Recommendations

Mood disorders are common in patients with neurodegenerative disease. Accurate diagnosis and assessment of mood changes are a crucial requirement for establishing reliable correlations with functional neuroanatomical changes, investigating their causes, and establishing effective treatment strategies. However, differential diagnosis of mood disorders is difficult in elderly patients with aphasia, impaired emotional expression, and other cognitive and neurobehavioral impairments. Although specific assessment of internal mood state would improve diagnostic accuracy, most standardized measures of mood are not appropriate for this population. The Visual Analog Mood Scales (VAMS) are valid, standardized measures, developed specifically for neurologically impaired patients, which assess eight moods: sad, happy, tense, afraid, tired, energetic, confused, and angry. The utility of these very brief scales is presented, as are specific recommendations and guidelines for the diagnosis of depression and other mood disorders in patients with neurodegenerative disease, such as dementia, Parkinson's disease, and stroke.