Differences in Depressive Patterns According to Disease Severityin Early-Onset Alzheimer’s Disease

Article type: Research Article

Authors: Yoon, Bora^a | Yang, Dong Won^b | Hong, Yun Jeong^c | Choi, Seong Hye^d | Park, Sun Ah^e | Park, Hee Kyung^f | Kim, Yong Duk^a | Shim, Yong S.^{g; *}

Affiliations: [a] Department of Neurology, Konyang University Hospital, College of Medicine, Konyang University, Daejeon, Republic of Korea | [b] Department of Neurology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea | [c] Department of Neurology, Dong-A University College of Medicine, Busan, Republic of Korea | [d] Department of Neurology, Inha University School of Medicine, Incheon, Republic of Korea | [e] Department of Neurology, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea | [f] Department of Neurology, Inje University Ilsan Paik Hospital, Goyang, Republic of Korea | [g] Department of Neurology, Bucheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Republic of Korea

Correspondence: [*] Correspondence to: Yong S. Shim, MD, PhD, Department of Neurology, Bucheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 327 Sosa-ro, Wonmi-gu, Bucheon, Gyeonggi-do 420717, Republic of Korea. Tel.: +82 3234 2020; Fax: +82 3234 2669; E-mail: ysshim@catholic.ac.kr.

Abstract: Background & Objective: Depression frequently combines with dementia, including early-onset Alzheimer’s disease (EOAD). We investigated differences in prevalence and characteristics of depressive symptoms according to dementia severity in EOAD patients. Methods: The 15-item Korean version of the Geriatric Depression Scale (GDS-15) was administered to 412 EOAD patients. Factor analysis was used to assess GDS-15 factor structure. We subdivided participants into three groups by disease severity, then compared the frequencies and scores of individual GDS-15 items and performed logistic regression analysis to assess associations between depressive symptoms and EOAD stage. Results: Factor analysis yielded three factor categories: 1) “hopelessness and ominousness” (symptoms no. 6, 8, 12, 14, 15); 2) “unhappiness and dissatisfaction” (no. 1, 3, 5, 7, 11); and 3) “monotony and lack of energy” (no. 2, 4, 9, 10, 13). Factor 2 depressive symptoms (no. 1, 5, 11) were less common in moderate EOAD. The risk of Factor 1 symptoms: no. 12 (OR, 2.04; 95% CI, 1.19–3.50; p = 0.010) and 14 (OR, 1.84; 95% CI, 1.07–3.16; p = 0.028) was higher in mild than very mild EOAD. The risk of Factor 2 symptoms: no. 9 (OR, 2.69; 95% CI, 1.08–6.71; p = 0.033) and 13 (OR, 2.12; 95% CI, 1.02–4.40; p = 0.043) was higher in moderate than mild EOAD. Conclusion: We confirmed that depressive symptoms differ according to EOAD severity. When assessing depressive symptoms related to dementia progression, we recommend focusing on “hopelessness and ominousness” in very mild EOAD and “unhappiness and dissatisfaction” in mild EOAD.

Keywords: Alzheimer’s disease, depression, disease progression, early-onset, geriatric depression scale, prediction

DOI: 10.3233/JAD-150703

Journal: Journal of Alzheimer's Disease, vol. 52, no. 1, pp. 91-99, 2016