Brief neuropsychologic differentiation of demented versus depressed elderly inpatients

Recent investigations have suggested the utility of brief, psychometric screening batteries in the early detection of abnormal mental decline. This study extended the investigation of one of these batteries, comprised of three tests (Controlled Oral Word Association, Visual Retention, Temporal Orientation), to the difficult issue of differentiating dementia from depression in a hospitalized sample composed of a group of depressed only patients (N = 50) vs an age-matched demented group (N = 50), some of whom presented mixed dementia/depression syndromes. Demented patients consistently performed more poorly as a group than depressed patients on each of the three measures. This was the case even when three-group (demented only, mixed demented/depressed, depressed only) comparisons were conducted. Impairment was more common on one or more tests with demented vs depressed patients. However, limitations for screening purposes and for the definitive detection of dementia were noted in view of only moderate predictive power of the tests with discriminant function analysis. Nevertheless, the potential clinical utility of the three tests in the general hospital and other primary care settings was apparent.