Hostname: page-component-cd9895bd7-gbm5v Total loading time: 0 Render date: 2024-12-21T14:45:49.218Z Has data issue: false hasContentIssue false
  • English
  • Français

One-week prevalence of depressive symptoms and psychotropic drug treatments among old people with different levels of cognitive impairment living in institutional care: changes between 1982 and 2000

Published online by Cambridge University Press:  18 May 2010

Hugo Lövheim ,
Ellinor Bergdahl ,
Per-Olof Sandman ,
Stig Karlsson  and
Yngve Gustafson
Hugo Lövheim*
Affiliation:
Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden
Ellinor Bergdahl
Affiliation:
Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden
Per-Olof Sandman
Affiliation:
Department of Nursing, Umeå University, Umeå, Sweden
Stig Karlsson
Affiliation:
Department of Nursing, Umeå University, Umeå, Sweden
Yngve Gustafson
Affiliation:
Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden
*
Correspondence should be addressed to: H. Lövheim, Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, SE-901 85 Umeå, Sweden. Phone: +46 90 785 88 59; Fax: +46 90 13 06 23. Email: [email protected].
Get access

Abstract

Background: Dementia and depression are common in advanced age, and often co-exist. There are indications of a decreased prevalence of depressive symptoms among old people in recent years, supposedly because of the manifold increase in antidepressant treatment. Whether the prevalence of depressive symptoms has decreased among people in different stages of dementia disorders has not yet been investigated.

Methods: A comparison was undertaken of two cross-sectional studies, conducted in 1982 and 2000, comprising 6864 participants living in geriatric care units in the county of Västerbotten, Sweden. Depressive symptoms were measured using the Multi-Dimensional Dementia Assessment Scale (MDDAS), and the cognitive score was measured with Gottfries’ cognitive scale. Drug data were obtained from prescription records.

Results: There was a significant decrease in depressive symptom score between 1982 and 2000 in all cognitive function groups except for the group with moderate cognitive impairment. Antidepressant drug use increased in all cognitive function groups.

Conclusion: The prevalence of depressive symptoms decreased between 1982 and 2000, in all levels of cognitive impairment except moderate cognitive impairment. This might possibly be explained by the depressive symptoms having different etiologies in different stages of a dementia disorder, which in turn might not be equally susceptible to antidepressant treatment.

Keywords

depressiondementianursing homeold ageAlzheimer's diseaseSSRI
Type
Research Article
Information
International Psychogeriatrics , Volume 22 , Special Issue 7: Focus on mental health issues in long-term-care homes , November 2010 , pp. 1154 - 1160
Copyright
Copyright © International Psychogeriatric Association 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Aalten, P., van Valen, E., de Vugt, M. E., Lousberg, R., Jolles, J. and Verhey, F. R. (2006). Awareness and behavioral problems in dementia patients: a prospective study. International Psychogeriatrics, 18, 3–17. doi: 10.1017/S1041610205002772.CrossRefGoogle ScholarPubMed
Adolfsson, R., Gottfries, C. G., Nyström, L. and Winblad, B. (1981). Prevalence of dementia disorders in institutionalized Swedish old people: the work load imposed by caring for these patients. Acta Psychiatrica Scandinavica, 63, 225–244.CrossRefGoogle ScholarPubMed
Amore, M., Tagariello, P., Laterza, C. and Savoia, E. M. (2007). Subtypes of depression in dementia. Archives of Gerontology and Geriatrics, 44 (Suppl.), 23–33. doi: 10.1016/j.archger.2007.01.004.CrossRefGoogle ScholarPubMed
Ballard, C., Neill, D., O'Brien, J., McKeith, I. G., Ince, P. and Perry, R. (2000). Anxiety, depression and psychosis in vascular dementia: prevalence and associations. Journal of Affective Disorders, 59, 97–106. doi: 10.1016/S0165-0327(99)00057-9.CrossRefGoogle ScholarPubMed
Bergdahl, E., Allard, P., Lundman, B. and Gustafson, Y. (2007). Depression in the oldest old in urban and rural municipalities. Aging and Mental Health, 11, 570–578. doi: 10.1080/13607860601086595.Google Scholar
Blazer, D. G. (2003). Depression in late life: review and commentary. Journals of Gerontology. Series A: Biological Sciences and Medical Sciences, 58, 249–265.CrossRefGoogle Scholar
Blazer, D. G. and Hybels, C. F. (2005). Origins of depression in later life. Psychological Medicine, 35, 1241–1252. doi: 10.1017/S0033291705004411.Google Scholar
Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975). “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.CrossRefGoogle Scholar
Forsell, Y. and Winblad, B. (1998). Major depression in a population of demented and nondemented older people: prevalence and correlates. Journal of the American Geriatrics Society, 46, 27–30.CrossRefGoogle Scholar
Fuhrer, R., Dufouil, C. and Dartigues, J. F. (2003). Exploring sex differences in the relationship between depressive symptoms and dementia incidence: prospective results from the PAQUID Study. Journal of the American Geriatrics Society, 51, 1055–1063. doi: 10.1046/j.1532-5415.2003.51352.x.Google Scholar
Ganguli, M., Du, Y., Dodge, H. H., Ratcliff, G. G. and Chang, C. C. (2006). Depressive symptoms and cognitive decline in late life: a prospective epidemiological study. Archives of General Psychiatry, 63, 153–160.Google Scholar
Garre-Olmo, J. et al. (2003). Evolution of depressive symptoms in Alzheimer disease: one-year follow-up. Alzheimer Disease and Associated Disorders, 17, 77–85.Google Scholar
Kallin, K., Gustafson, Y., Sandman, P. O. and Karlsson, S. (2004). Drugs and falls in older people in geriatric care settings. Aging: Clinical and Experimental Research, 16, 270–276.Google Scholar
Leonard, R., Tinetti, M. E., Allore, H. G. and Drickamer, M. A. (2006). Potentially modifiable resident characteristics that are associated with physical or verbal aggression among nursing home residents with dementia. Archives of Internal Medicine, 166, 1295–1300.Google Scholar
Lövheim, H., Sandman, P. O., Kallin, K., Karlsson, S. and Gustafson, Y. (2006). Relationship between antipsychotic drug use and behavioral and psychological symptoms of dementia in old people with cognitive impairment living in geriatric care. International Psychogeriatrics, 18, 713–726. doi: 10.1017/S1041610206003930.CrossRefGoogle ScholarPubMed
Lövheim, H., Sandman, P., Kallin, K., Karlsson, S. and Gustafson, Y. (2008a). Symptoms of mental health and psychotropic drug use among old people living in geriatric care: changes between 1982 and 2000. International Journal of Geriatric Psychiatry, 23, 289–294. doi: 10.1002/gps.1876.Google Scholar
Lövheim, H., Sandman, P. O., Karlsson, S. and Gustafson, Y. (2008b). Behavioral and psychological symptoms of dementia in relation to level of cognitive impairment. International Psychogeriatrics, 20, 777–789. doi: 10.1017/S1041610208006777.Google Scholar
Lyketsos, C. G. and Olin, J. (2002). Depression in Alzheimer's disease: overview and treatment. Biological Psychiatry, 52, 243–252. doi 10.1016/S0006-3223(02)01348-3.CrossRefGoogle ScholarPubMed
Menon, A. S. et al. (2001). Relationship between aggressive behaviors and depression among nursing home residents with dementia. International Journal of Geriatric Psychiatry, 16, 139–146. doi: 10.1002/1099-1166(200102)16:2<139::AID-GPS284>3.0.CO;2-5.3.0.CO;2-5>CrossRefGoogle ScholarPubMed
Mitchell, A. J. (2005). Depression as a risk factor for later dementia: a robust relationship? Age and Ageing, 34, 207–209. doi: 10.1093/ageing/afi078.CrossRefGoogle ScholarPubMed
Modrego, P. J. and Ferrandez, J. (2004). Depression in patients with mild cognitive impairment increases the risk of developing dementia of Alzheimer type: a prospective cohort study. Archives of Neurology, 61, 1290–1293.Google Scholar
Montagnier, D. et al. (2006). Evolution of prevalence of depressive symptoms and antidepressant use between 1988 and 1999 in a large sample of older French people: results from the Personnes Agées Quid study. Journal of the American Geriatrics Society, 54, 1839–1845. doi: 10.1046/j.1532-5415.2003.51352.x.Google Scholar
O'Connor, D. W., Ames, D., Gardner, B. and King, M. (2008). Psychosocial treatments of behavior symptoms in dementia: a systematic review of reports meeting quality standards. International Psychogeriatrics, 21, 241–251. doi: 10.1017/S1041610208008223.CrossRefGoogle ScholarPubMed
Olin, J. T., Katz, I. R., Meyers, B. S., Schneider, L. S. and Lebowitz, B. D. (2002). Provisional diagnostic criteria for depression of Alzheimer disease: rationale and background. American Journal of Geriatric Psychiatry, 10, 129–141.Google Scholar
Sandman, P. O., Adolfsson, R., Norberg, A., Nystrom, L. and Winblad, B. (1988). Long-term care of the elderly: a descriptive study of 3600 institutionalized patients in the county of Vasterbotten, Sweden. Comprehensive Gerontology A, 2, 120–132.Google Scholar
Vinkers, D. J., Gussekloo, J., Stek, M. L., Westendorp, R. G. and Van Der Mast, R. C. (2004). Temporal relation between depression and cognitive impairment in old age: prospective population based study. BMJ, 329, 881. doi: 10.1136/bmj.38216.604664.DE.Google Scholar
World Health Organization (2007). Anatomical Therapeutical Chemical (ATC) Classification Index Including Defined Daily Doses (DDD) for Plain Substances. Oslo: World Health Organization Collaborating Centre for Drug Statistics Methodology.Google Scholar