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The relationship between severity of Alzheimer's disease and prevalence of comorbid depressive symptoms and depression: a systematic review
- Authors:
- VERKAIK Renate, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 22(11), November 2007, pp.1063-1086.
- Publisher:
- Wiley
A systematic literature review based on the Cochrane methodology was performed. PubMed, PsychINFO and EMBASE databases were searched for existing studies that fulfilled predefined inclusion criteria. The studies were divided into: (1) those that analysed the association between severity of AD and prevalence of depressive symptoms (continuous approach) and (2) those that investigated the association between severity of AD and diagnosed depression (categorical approach). The quality of existing studies was rated and the results were synthesized with a best evidence synthesis. Twenty-four studies fulfilled the inclusion criteria. Nineteen reported results for a continuous approach and seven for a categorical approach. Three of the four high quality studies within the continuous approach did not find a significant association between severity of AD and prevalence of depressive symptoms. None of the three high quality studies using the categorical approach found a significant association between the severity of AD and the prevalence of diagnosed depression. There is evidence for a lack of association between the severity of AD and the prevalence of comorbid depressive symptoms or diagnosed depression. Until new studies contradict this conclusion, prevention and intervention strategies for comorbid depression in AD should be aimed at all patients irrespective their disease severity.
The effects of a nursing guideline on depression in psychogeriatric nursing home residents with dementia
- Authors:
- VERKAIK Renate, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 26(7), July 2011, pp.723-732.
- Publisher:
- Wiley
The prevalence of depression in Dutch psychogeriatric nursing home residents with dementia has been estimated at 19%. This study examined the effects of introducing a nursing guideline on depression in this group of patients. The multi-centre trial, with randomisation at ward level, involved 97 residents diagnosed with dementia and comorbid depression, from 18 psychogeriatric nursing home wards, in 9 Dutch nursing homes. Nursing teams were trained in applying the guideline to their own residents. Key elements of the nursing guideline are increasing individualised pleasant activities and decreasing unpleasant events. The primary outcome was severity of depression measured with the MDS/RAI-Depression Rating Scale (DRS) and the Cornell Scale for Depression in Dementia. The secondary outcome was mood as measured by the FACE-observation scale. Measurements took place at pre-test, post-test and follow-up. Compliance with the nursing guideline varied greatly between the wards and overall was only moderate. Despite this, residents on the experimental wards showed a significant reduction in depression on the DRS. There was a non-significant reduction on the Cornell scale. No effects on observed mood were found. The authors conclude that reductions in depression severity can be achieved by introducing a nursing guideline in this setting. Limitations to the study are discussed and ways of improving compliance with the guideline suggested.