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'Don't know' responses in elderly demented and depressed patients
1Department of Psychiatry and Behavioral Sciences, University of Texas Medical Branch, Galveston 77550.
Journal of Geriatric Psychiatry and Neurology
|April 1, 1989
Summary
Patients with dementia made more errors on orientation questions than those with reversible dementia. Contrary to suggestions, both groups did not differ in "don
Area of Science:
- Gerontology
- Neurology
- Psychiatry
Background:
- Differentiating between dementia and depression with reversible dementia is crucial for accurate diagnosis and treatment.
- Previous suggestions indicated that patients with depression and reversible dementia might exhibit more "don't know" responses on cognitive tests compared to demented patients.
Purpose of the Study:
- To investigate whether patients with depression and reversible dementia (DRD) exhibit a higher frequency of "don't know" responses on cognitive assessments than patients with dementia.
- To compare cognitive performance, specifically errors and "don't know" responses, between demented patients and DRD patients using the Mini-Mental Status Examination (MMSE).
Main Methods:
- Inpatients diagnosed with dementia (n=20) or major depression with reversible dementia (DRD, n=11) were administered the MMSE.
- MMSE scores, errors, and "don't know" responses were recorded at admission and before discharge.
- Group comparisons were performed on MMSE performance, focusing on overall scores, errors, and specific MMSE sections.
Main Results:
- Demented patients scored significantly lower and made more errors on the MMSE compared to the DRD group.
- No significant difference was found in the number of "don't know" responses between the demented and DRD groups.
- Demented patients exhibited significantly more errors and lower scores specifically on the orientation section of the MMSE.
Conclusions:
- The study refutes the hypothesis that DRD patients provide more "don't know" responses than demented patients.
- Demented patients demonstrate a higher propensity for errors, particularly in orientation-related cognitive tasks, compared to DRD patients.
- These findings highlight distinct cognitive error patterns that may aid in differentiating between dementia and reversible dementia in depressed patients.