Hostname: page-component-8448b6f56d-42gr6 Total loading time: 0 Render date: 2024-04-20T03:53:06.222Z Has data issue: false hasContentIssue false
  • English
  • Français

Dementia and depression among the elderly living in the Hobart community: the effect of the diagnostic criteria on the prevalence rates

Published online by Cambridge University Press:  09 July 2009

D. W. K. Kay ,
A. S. Henderson ,
R. Scott ,
J. Wilson ,
D. Rickwood  and
D. A. Grayson
D. W. K. Kay*
Affiliation:
Department of Psychiatry, University of Tasmania, Australia, NH and MRC Social Psychiatry Research Unit, Australian National University, Australia
A. S. Henderson
Affiliation:
Department of Psychiatry, University of Tasmania, Australia, NH and MRC Social Psychiatry Research Unit, Australian National University, Australia
R. Scott
Affiliation:
Department of Psychiatry, University of Tasmania, Australia, NH and MRC Social Psychiatry Research Unit, Australian National University, Australia
J. Wilson
Affiliation:
Department of Psychiatry, University of Tasmania, Australia, NH and MRC Social Psychiatry Research Unit, Australian National University, Australia
D. Rickwood
Affiliation:
Department of Psychiatry, University of Tasmania, Australia, NH and MRC Social Psychiatry Research Unit, Australian National University, Australia
D. A. Grayson
Affiliation:
Department of Psychiatry, University of Tasmania, Australia, NH and MRC Social Psychiatry Research Unit, Australian National University, Australia
*
1Address for correspondence: Professor D. W. K. Kay, 8 Grosvenor Place, Newcastle upon Tyne NE2 2RB.
Get access Rights & Permissions [Opens in a new window]

Synopsis

A survey was made of 274 non-institutionalized persons aged 70 and over living in Hobart. The prevalence of dementia and of depression was measured by interviewing subjects using a modified version of the Geriatric Mental State Schedule (GMS) (Copeland et al. 1976) and the Mini Mental State Examination (MMSE) (Folstein et al. 1975). Rates of morbidity were derived from different diagnostic procedures. These were: (1) diagnoses made by a psychiatrist (A.S.H.) directly from the interview schedules and audiotapes, and rated as mild, moderate or severe; (2) the criteria laid down in DSM-III, converted into algorithms describing 3 degrees of severity; and (3) the algorithms for pervasive dementia and depression proposed by Gurland et al. (1983), and from these authors' rational scales. In addition, the relation between scales for dementia and for depression and the diagnosed categories was examined. Some problems in applying these methods to aged persons in the community are discussed. It is concluded that more detailed specification of criteria is desirable if the comparative epidemiology of dementia and depression in old age is to advance.

Type
Research Article
Information
Psychological Medicine , Volume 15 , Issue 4 , November 1985 , pp. 771 - 788
Copyright
Copyright © Cambridge University Press 1985

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

American Psychiatric Association (1980). Diagnostic and Statistical Manual of Mental Disorders (third edn) (DSM-III). APA: Washington, D.C.Google Scholar
Anthony, J. C., Niaz, U., LeResche, L. A., Von Korff, M. R. & Folstein, M. F. (1982). Limits of the ‘Mini-Mental State’ as a screening test for dementia and delirium among hospital patients. Psychological Medicine 12, 397–408.Google Scholar
Blazer, D. & Williams, C. (1980). Epidemiology of dysphoria and depression in an elderly population. American Journal of Psychiatry 137, 439–444.Google Scholar
Breitner, J. C. S. & Folstein, M. F. (1984). Familial Alzheimer Dementia: a prevalent disorder with specific clinical features. Psychological Medicine 14, 63–80.CrossRefGoogle ScholarPubMed
Copeland, J. R. M., Kelleher, M. J., Kellett, J. M., Gourlay, A. J., Gurland, B. J., Fleiss, J. L. & Sharpe, L. (1976). A semi-structured clinical interview for the assessment of diagnosis and mental state in the elderly: the Geriatric Mental State Schedule. I. Development and reliability. Psychological Medicine 6, 439–449.Google Scholar
Cronbach, L. J. (1931). Coefficient alpha and the internal structure of tests. Psychometrika 16 (3), 297–334.Google Scholar
Folstein, M. F. & Breitner, J. C. S. (1981). Language disorder predicts familial Alzheimer's disease. Johns Hopkins Medical Journal 149, 145–147.Google ScholarPubMed
Folstein, M. F., Folstein, S. E. & 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
Golden, R. R., Teresi, J. A. & Gurland, B. J. (1983). Detection of dementia and depression cases with the comprehensive assessment and referral evaluation interview schedule. International Journal on Aging and Human Development 16, 241–254.Google Scholar
Golden, R. R., Teresi, J. A. & Gurland, B. J. (1984). Development of indicator scales for the comprehensive assessment and referral evaluation (CARE) interview schedule. Journal of Gerontology 39, 138–146.CrossRefGoogle ScholarPubMed
Gurland, B. J. & Wilder, D. E. (1984), The CARE interview revisited: development of an efficient, systematic clinical assessment. Journal of Gerontology 39, 129–137.CrossRefGoogle ScholarPubMed
Gurland, B. J., Kuriansky, J., Sharpe, L., Simon, R., Stiller, P. & Birkett, P. (1977). The Comprehensive Assessment and Referral Evaluation (CARE) – rationale, development and reliability. International Journal of Aging and Human Development 8, 9–42.CrossRefGoogle ScholarPubMed
Gurland, B. J., Dean, L., Cross, P. & Golden, R. (1980). The epidemiology of depression and dementia in the elderly: the use of multiple indicators of these conditions. In Psychopathology in the Aged (ed. Cole, J. O. and Barrett, J. E.), pp. 37–60. Raven Press: New YorkGoogle Scholar
Gurland, B. J., Dean, L. L., Copeland, J., Gurland, R. & Golden, R. (1982). Criteria for the diagnosis of dementia in the community elderly. The Gerontologist 22, 180–186.Google Scholar
Gurland, B. J., Copeland, J., Kuriansky, J., Kelleher, M. J., Sharpe, L. & Dean, L. (1983). The Mind and Mood of Aging. Croom Helm: London.Google Scholar
Gurland, B. J., Golden, R. R., Teresi, J. A. & Challop, J. (1984). The short-CARE: an efficient instrument for the assessment of depression, dementia and disability. Journal of Gerontology 39, 166–169.Google Scholar
Henderson, A. S. & Huppert, F. A. (1984). The problem of mild dementia. Psychological Medicine 14, 5–11.CrossRefGoogle ScholarPubMed
Henderson, A. S. & Kay, D. W. K. (1984). The epidemiology of mental disorders in the aged. In Handbook of Studies in Psychiatry and Old Age (ed. Kay, D. W. K. and Burrows, G.), pp. 53–88. Elsevier/North-Holland: AmsterdamGoogle Scholar
Henderson, A. S., Duncan-Jones, P. & Finlay-Jones, R. A. (1983). The reliability of the Geriatric Mental State Examination. Acta Psychiatrica Scandinavica 67, 281–289.CrossRefGoogle ScholarPubMed
Henderson, A. S., Grayson, D. A., Scott, R., Wilson, J., Rickwood, D. & Kay, D. W. K. (1986). Social support, dementia and depression among the elderly living in the Hobart community. (Submitted for publication.)Google Scholar
Jorm, A. F. & Henderson, A. S. (1985). Possible improvement to the diagnostic criteria for dementia in DSM-III. British Journal of Psychiatry (in the press).Google Scholar
Kay, D. W. K. & Bergmann, K. (1980). Epidemiology of mental disorders among the aged in the community. In Handbook of Mental Health and Aging (ed. Birren, J. E. and Sloane, B.), pp. 34–56. Prentice-Hall: Englewood Cliffs, N.J.Google Scholar
Kendell, R. E. (1982). The choice of diagnostic criteria for biological research. Archives of General Psychiatry 39, 1334–1339.Google Scholar
Kiloh, L. G. (1961). Pseudo-dementia. Acta Psychiatrica Scandinavica 37, 336–351.Google Scholar
Mortimer, J. A., Schuman, L. M. & French, L. R. (1981). Epidemiology of dementing illness. In The Epidemiology of Dementia (ed. Mortimer, J. A. and Schuman, L. M.), pp. 3–23. Oxford University Press: New YorkGoogle Scholar
Myers, J. K., Weissman, M. M., Tischler, G. L., Holzer, C. E., Leaf, P. J., Orvaschel, H., Anthony, J. C., Boyd, J. H., Burke, J. D., Kramer, M. & Stoltsman, R. (1984). Six-month prevalence of psychiatric disorders in three communities. Archives of General Psychiatry 41, 959–967.Google Scholar
Pfeffer, R. I., Kurosaki, T. T., Harrah, C. H., Chance, J. M., Bates, D., Detels, R., Filos, S. & Butzke, C. (1981). A survey diagnostic tool for senile dementia. American Journal of Epidemiology 114, 515–527.CrossRefGoogle ScholarPubMed
Regier, D. A., Myers, J. K., Kramer, M., Robins, L. N., Blazer, D. G., Houg, R. L., Eaton, W. W. & Locke, B. Z. (1984). The NIMH epidemiologic catchment area (ECA) program: historical context, major objectives, and study population characteristics. Archives of General Psychiatry 41, 934–941.Google Scholar
Robins, L. N. (1978). Psychiatric epidemiology. Archives of General Psychiatry 35, 697–702.Google Scholar
Robins, L. N., Helzer, J. E., Croughan, J. & Ratcliff, K. S. (1981). National Institute of Mental Health Diagnostic Interview Schedule. Its history, characteristics, and validity. Archives of General Psychiatry 38, 381–388.Google Scholar
Weingartner, H., Cohen, R. M., Murphy, D. L., Martello, J. & Gerdt, C. (1981). Cognitive process in depression. Archives of General Psychiatry 38, 42–47.CrossRefGoogle ScholarPubMed
Weissman, M. M. & Klerman, G. L. (1978). Epidemiology of mental disorders. Archives of General Psychiatry 35, 705–712.CrossRefGoogle ScholarPubMed
Weissman, M. M., Myers, J. K., Tischler, G. L., Holzer, C. E., Leaf, P. J., Orvaschel, H. & Brody, J. A. (1985). Psychiatric disorders (DSM-III) and cognitive impairment in the elderly in a US urban community. Acta Psychiatrica Scandinavica 71, 366–379.CrossRefGoogle Scholar
Wing, J. K., Cooper, J. E. & Sartorius, N. (1974). The Measurement and Classification of Psychiatric Symptoms. Cambridge University Press: Cambridge.Google Scholar
Wing, J. K., Henderson, A. S. & Winckle, M. (1977). The rating of symptoms by a psychiatrist and a non-psychiatrist: a study of patients referred from general practice. Psychological Medicine 7, 713–715.Google Scholar
World Health Organization (1974). Glossary of Mental Disorders and Guide to their Classification. WHO: Geneva.Google Scholar