Severity and risk factors of depression in Alzheimer's disease

To determine the frequency, severity and risk factors of depression in Alzheimer's disease.

Descriptive study.

The Department of Psychiatry, Sir Ganga Ram Hospital, Lahore, from August 2007 to December 2008.

Consecutive patients of Alzheimer's disease reporting to the department during the study period were included and those with extreme cognitive impairment were excluded. The cognitive status was judged by using the Mini- Mental State Examination (MMSE). The Hamilton rating scale for depression (Ham-D) was used as a symptom checklist to diagnose major depression according to the DSM-IV criteria. Chi-square test was used to check the significance of association.

There were 76 patients comprising of 34 males and 42 females. The mean age was 67.74 + or - 6.71 years; 66% were married, 14% were single and 20% were widowed; 47% had family history of depression and medical co-morbidity was observed in 48%. Based on MMSE, 31.5% had mild Alzheimer, 55.3% had moderate and 13.1% had severe Alzheimer. Judging from Hamilton rating scale, 25% patients were free from depression, 19.7% had mild depression, 27.6% had moderate depression and 27.6% were suffering from severe depression. The frequency of depression was significantly higher (p=0.0013) among females (90%) as compared to males (55.9%).

There is a high frequency of depression among patients of Alzheimer's disease particularly among female patients. This finding is consistent with the reports from other countries.