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Depressive Syndromes in Dementia

Published online by Cambridge University Press:  02 December 2014

Lilian Thorpe  and
Bernard Groulx
Lilian Thorpe
Affiliation:
University of Saskatchewan, Saskatoon, SK, Canada
Bernard Groulx
Affiliation:
McGill University, Centre for Studies in Aging, Montreal QC, Canada
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Abstract

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Background:

Depressive syndromes in dementia are common, treatment is challenging and controlled intervention studies are small in number. The goal of this paper is to review known information about the etiology, epidemiology and treatment of these syndromes, as summarized at the recent Canadian Consensus Conference on Dementia.

Methods:

A number of Medline searches were performed (most recently updated in October 2000) using the subject categories dementia and depression, or apathy or emotional lability and other relevant articles were also reviewed. The background article was edited and amended at the Consensus Conference on Dementia. Final recommendations appearing in the summary article by Patterson et al were accepted by the group consensus process. Clinical discussion and informational updates were added for the current text by the authors.

Results:

Depressive syndromes, ranging in severity from isolated symptoms to full depressive disorders, increase in dementia. While clear-cut depressive disorder is increased in this population, sub-syndromal disorders are even more common and cause considerable distress. Antidepressant treatment may improve the quality of life in depressed, demented people, although it is less successful than in those without cognitive impairment and carries more risk of iatrogenic effects.

Conclusion:

Physicians should be alert to the presence of depressive syndromes in dementia. Depressive illness should be treated and, when necessary, referral should be made to an appropriate specialist. Treatment must minimize iatrogenic effects. Although there is some support for treatment of syndromes that do not meet criteria for depressive disorder or dysthymia, the first line of intervention in these situations should involve nonpharmacological approaches.

Type
Research Article
Information
Canadian Journal of Neurological Sciences , Volume 28 , Supplement S1: Canadian Consensus Conference on Dementia , May 2001 , pp. S83 - S95
Copyright
Copyright © The Canadian Journal of Neurological 2001

References

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