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The pattern of depressive symptoms and factor analysis of the Cornell Scale among patients in Norwegian nursing homes
- Authors:
- BARCA Maria Lage, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 23(10), October 2008, pp.1058-1065.
- Publisher:
- Wiley
Depression is more prevalent in subjects with dementia than in those without it. Due to both psychological and biological risk factors it is suggested that a bimodal distribution of depressive symptoms exists with higher prevalence rates being found among patients suffering both with mild and with severe dementia. To confirm or reject the hypothesis of a bimodal distribution of depressive symptoms. A sample of 1,159 randomly selected nursing home patients was assessed using the Cornell Scale, the Clinical Dementia Rating Scale (CDR) and Lawton's Scale of the activities of daily living. Additionally, information was collected from the patients' records. A factor analysis of the Cornell Scale was performed. The use of antidepressants and demographic characteristics, except for gender distribution, did not differ across CDR groups. Patients with dementia had more symptoms such as anxiety, irritability, agitation, retardation, loss of interest, lack of joy and delusion than those without dementia. No symptom was more frequent among non-demented subjects. The factor analysis resulted in a five factors solution: mood, cyclic, physical, retardation and behavioural factor. The score on the mood subscale did not differ across CDR groups, whereas the scores on the four other subscales increased with increasing CDR scores. The results did not find a bimodal distribution of depressive symptoms. The explanation for the occurrence of the typical core symptoms of depression, the mood symptoms, is probably complex. The non-mood symptoms are probably strongly influenced by biological factors.
Occurrence of depression and its correlates in early onset dementia patients
- Authors:
- ROSNESS Tor Atle, BARCA Maria Lage, ENGEDAL Knut
- Journal article citation:
- International Journal of Geriatric Psychiatry, 25(7), July 2010, pp.704-711.
- Publisher:
- Wiley
Co-morbid depressive symptoms are common in all forms of dementia. This study investigated the occurrence of depression in early onset dementia patients and which characteristics were associated with depressive symptoms. The participants were 221 patients from the memory clinic at Ullevaal university hospital in Oslo, Norway who were diagnosed with dementia before the age of 65. The mean age of the participants was 58.6 years and 50.6% were women. Depression in these patients was measured by the Montgomery Asberg depression scale (MADRS). History of depression, current psychiatric co-morbidity and usage of antidepressants were recorded. The results showed that 123 patients (55.6%) had a mild degree of depression, 21 patients (9.5%) had a moderate degree of depression and 1 patient had a severe degree of depression. A factor analysis produced 2 factors. The first factor described dysphoria: lack of concentration, pessimistic thoughts, inner tension, suicidal thoughts, lassitude and lack of sleep. The second factor denoted sadness: observed sadness, reported sadness, lack of appetite and inability to feel. In an adjusted linear regression analysis, history of depression was the only significant variable associated with the MADRS total score and both factors 1 and 2. The article concludes that a high occurrence of depressive symptoms in early onset dementia patients was found; 65.7% of all the patients had some degree of depression. A history of depression was the most important correlate of depression in these patients.
Factors associated with depression in Norwegian nursing homes
- Authors:
- LAGE BARCA Maria, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 24(4), April 2009, pp.417-425.
- Publisher:
- Wiley
This study aimed to confirm or reject the hypothesis that depression in nursing homes is associated with worse medical health, cognitive and functional impairment. A sample of 902 randomly selected nursing-home patients was assessed using the Cornell Scale, the Clinical Dementia Rating Scale (CDR) the Self-Maintenance Scale and a general measurement of medical health. Additionally, information was collected from the patients' records. A multiple linear regression was performed with the Cornell Scale total score, and mood and non-mood subscale scores as the dependent variables. In the adjusted analysis, depression according to the Cornell total score was associated with worse medical health (strongest) and worse cognitive impairment, but not with worse functional impairment. The mood subscale score was associated with worse medical health, being unmarried and female gender, but not with worse cognitive impairment. The non-mood subscale score was correlated with cognitive impairment, worse medical health, younger age, digestive diseases and not having suffered from stroke. The hypothesis was partially confirmed. Worse general medical health was the strongest factor associated with depression, followed by degree of cognitive impairment. Cognitive impairment was not associated with the mood subscale score, but was the strongest correlate for the non-mood symptoms of the Cornell Scale.