Utility of the Neurobehavioral Cognitive Status Examination (COGNISTAT) in differentiating between depressive states in late-life depression and late-onset Alzheimer’s disease: a preliminary study

Annals of General Psychiatry

Yoshiaki Tsuruoka²  Michio Takahashi¹  Masatoshi Suzuki¹  Koichi Sato¹  Yukihiko Shirayama¹ 

[1] Department of Psychiatry, Teikyo University Chiba Medical Center, 3426-3 Anesaki, Ichihara 299-0111, Japan

[2] Shirayurikai Otaki Hospital, 786 Uehara, Otaki 298-0223, Japan

关键词: HAM-D;    MMSE;    Late-life depression;    Cognition;    COGNISTAT;    Alzheimer’s disease;   

Others  :  1235561
DOI  :  10.1186/s12991-016-0091-5

 received in 2015-09-09, accepted in 2016-01-07,  发布年份 2016

【 摘 要 】

Background

It is often difficult to differentiate between the depressive states seen in late-life depression and late-onset Alzheimer’ disease (AD) in the clinical setting.

Methods

Thirty-four outpatients were recruited, all fulfilling the criteria of aged 65 years or above, scores of 14 or more on the Hamilton depression rating scale (HAM-D), and 26 or less on the Mini-Mental State Examination (MMSE). At the initial visit, they were administered the Neurobehavioral Cognitive Status Examination (COGNISTAT). At 1 month, a diagnosis of either senile depression (n = 24) or Alzheimer’ disease (n = 10) was made.

Results

The COGNISTAT revealed that the late-life depression group showed significantly higher scores in orientation and comprehension subtests compared with the AD group. At the study endpoint (6 months after treatment), MMSE detected significant improvements in the late-life depression group (n = 15), but no changes in the late-onset AD group (n = 7). Scores for memory, similarities, and judgment on the second COGNISTAT were significantly improved in the depressed group, whereas calculation scores deteriorated significantly in the AD group.

Conclusion

The COGNISTAT could prove useful in differentiating late-life depression from late-onset AD, despite similar scores on MMSE.

【 授权许可】

   
2016 Tsuruoka et al.

【 图 表 】

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【 参考文献 】

• [1]Conwell Y, Duberstein PR, Cox C, Herrmann JH, Forbes NT, Caine ED: Relationship of age and axis I diagnoses in victims of completed suicide: a psychological autopsy study. Am J Psychiatry 1996, 153:1001-1008.
• [2]Lebowitz BD, Pearson JL, Schneider LS, Reynolds CF 3rd, Alexopoulos GS, Bruce ML, et al.: Diagnosis and treatment of depression in late life: Consensus statement update. JAMA 1997, 278:1186-1190.
• [3]Steffens DS, Potter GG: Geriatric depression and cognitive impairment. Psychol Med 2008, 38:163-175.
• [4]Folstein MF, Folstein SE, McHugh PR: Mini-Mental State: a practical method for grading the cognitive state of patients for the clinician. J Psychiat Res 1975, 12:189-198.
• [5]Rosen WG, Mohs RC, Davis KL: A new rating scale for Alzheimer’s disease. Am J Psychiatry 1984, 141:1356-1364.
• [6]Katz N, Hartman-Maeir A, Weiss P, Armon N: Comparison of cognitive status profiles of healthy elderly persons with dementia and neurosurgical patients using the neurobehavioral cognitive status examination. NeuroRehabilitation 1997, 9:179-186.
• [7]van Gorp WG, Marcotte TD, Sultzer D, Hinkin C, Mahler M, Cummings JL: Screening for dementia: Comparison of three commonly used instruments. J Clin Expe Neuropsychol 1999, 21:29-38.
• [8]Ames H, Hendrickse WA, Bakashi RS, LePage JP, Keefe C: Utility of the Neurobehavioral Cognitive Status Examination (Cognistat) with geriatric mental health outpatients. Clin Gerontologist 2009, 32:198-210.
• [9]Lyketsos CG, Olin J: Depression in Alzheimer’s disease: overview and treatment. Biol Psychiatry 2002, 52:243-252.
• [10]Butters MA, Whyte EM, Nebes RD, Begley AE, Dew MA, Mulsant BH, et al.: The nature and determinants of neuropsychological functioning in late-life depression. Arch Gen Psychiatry 2004, 61:587-595.
• [11]Sheline YI, Barch DM, Garcia K, Gersing K, Pieper C, Welsh-Bohmer K, et al.: Cognitive function in late life depression: Relationships depression severity, cerebrovasucular risk factors and processing speed. Biol Psychiatry 2006, 60:58-65.
• [12]Shimada H, Park H, Makizako H, Doi T, Lee S, Suzuki T: Depressive symptoms and cognitive performance in older adults. J Psychiatr Res 2014, 57:149-156.
• [13]Alexopoulos GS, Meyers BS, Young RC, Mattis S, Kakuma T: The course of geriatric depression with ‘reversible dementia’: a controlled study. Am J Psychiatry 1993, 150:1693-1699.
• [14]da Silva J, Gonçalves-Pereira M, Xavier M, Mukaetova-Ladinska EB: Affective disorders and risk of developing dementia: systematic review. Br J Psychiatry 2013, 202:177-186.
• [15]Nebes RD, Pollock BG, Houck PR, Butters MA, Mulsant BH, Zmuda MD, et al.: Persistence of cognitive impairment in geriatric patients following antidepressant treatment: a randomized, double-blind clinical trail with nortriptyline and paroxetine. J Psychiatr Res 2003, 37:99-108.
• [16]Gallassi R, Di Sarro R, Morreale A, Amore M: Memory impairment in patients with late-onset major depression: the effect of antidepressant therapy. J Affect Disord 2006, 91:243-350.
• [17]Savaskan E, Müller SE, Böhringer A, Schulz A, Schächinger H: Antidepressive therapy with escitalopram improves mood, cognitivee symptoms, and identity memory for angry faces in elderly depressed patients. Int J Neuropsychopharmac 2008, 11:381-388.
• [18]Munro CA, Longmire CF, Drye LT, Martin BK, Frangakis CE, Meinert CL, et al.: Cognitive outcomes after sertaline treatment in patients with depression of Alzheimer disease. Am J Geriatr Psychiatry 2012, 20:1036-1044.
• [19]Lyketsos CG, DelCampo L, Steinberg M, Miles Q, Steele CD, Munro C, et al.: Treating depression in Alzheimer disease: efficacy and safety of sertraline therapy, and the benefits of depression reduction: the DIADS. Arch Gen Psychiatry 2003, 60:737-746.
• [20]Emery VO, Oxman TE: Update on the dementia spectrum of depression. Am J Psychiatry 1992, 149:305-317.
• [21]Kobayahshi T, Kato S: Depression-dementia medius: Between depression and the manifestation of dementia symptoms. Psychogeriatrics 2011, 11:177-182.
• [22]Wilson RS, Capuano AW, Boyle PA, Hoganson GM, Hizel LP, Shah RC, et al.: Clinical-pathologic study of depressive symptoms and cognitive decline in old age. Neurology 2014, 83:702-709.
• [23]Wiederman MW, Morgan CD: The Neurobehavioral Cognitive Status Exam (NCSE) with geriatric inpatients. Clin Gerontologist 1995, 15:35-47.
• [24]Crowe SF, Hoogenraad K: Differentiation of dementia of the Alzheimer’s type from depression with cognitive impairment on the basis of a cortical versus subcortical pattern of cognitive deficit. Arch Clin Neuropsychol 2000, 15:9-19.
• [25]Hofman M, Seifritz E, Kräuchi K, Hock C, Hampel H, Neugebauer A, et al.: Alzheimer’s disease, depression and normal ageing: merit of simple psychomotor and visuospatial tasks. Int J Geriatr Psychiatry 2000, 15:31-39.
• [26]Kaschel R, Logie RH, Kazén M, Della Sala S: Alzheimer’s disease, but not ageing or depression, affects dual-tasking. J Neurol 2009, 256:1860-1868.
• [27]Petersen RC, Smith GE, Waring SC, Ivnik RJ, Tangalos EG, Kokmen E: Mild cognitive impairment: clinical characterization and outcome. Arch Neurol 1999, 56:303-308.
• [28]Kiernan RJ, Mueller J, Langston JW, Van Dyke C: The Neurobehavioral Cognitive Status Examination: A brief but differentiated approach to cognitive assessment. Ann Int Med 1987, 107:481-485.
• [29]Logue PE, Tupler LA, D’Amico C, Schmitt FA: The Neurobehavioral Cognitive Status Examination: Psychiatric properties in use with psychiatric inpatients. J Clin Psychol 1993, 49:80-89.
• [30]Drane DL, Osato SS: Using the Neurobehavioral Status Examination as a screening measure for older adults. Arch Clin Neuropsychol 1997, 12:139-143.
• [31]Macaulay C, Battista M, Lebby PC, Mueller J: Geriatric performance on the Neurobehavioral Cognitive Status Examination (Cognistat). What is normal? Arch Clin Neuropsychol 2003, 18:463-471.
• [32]Haynes RB: How to read clinical journals: II. To learn about a diagnostic test. Can Med Asso J 1981, 124:703-710.
• [33]Doraiswamy PM, Krishnan RR, Oxman T, Jenkyn LR, Coffey DJ, Burt T, et al.: Does antidepressant therapy improve cognition in elderly depressed patients? J Gerontol A Biol Sci Med Sci 2003, 58A:1137-1144.
• [34]Schwamm LH, Van Dyke C, Kiernan RJ, Merrin EL, Mueller J: The Neurobehavioral Cognitive Status Examination: Comparison with the Cognitive Capacity Screening Examination and the Mini-Metal State Examination in a neurosurgical population. Ann Int Med 1987, 107:486-491.
• [35]Fields SD, Fulop G, Sachs CJ, Strain J, Fillit H: Usefulness of the Neurobehavioural Cognitive Status Examination in the hospitalized elderly. Int Psychoger 1992, 4:93-102.
• [36]Lee JS, Potter GG, Wagner HR, Welsh-Bohmer KA, Steffens DC: Persistent mild cognitive impairment in geriatric depression. Int Psychoger 2007, 19:25-135.
• [37]Dierckx E, Engelborghs S, De Raedt R, De Deyn PP, Ponjaert-Kristoffersen L: Differentiation between mild cognitive impairment, Alzheimer’s disease and depression by means of cued recall. Psychol Med 2007, 37:747-755.
• [38]Grober E, Hall CB, Lipton RB, Zonderman AB, Resnick SM, Kawas C: Memory impairment, executive dysfunction, and intellectual decline in preclinical Altzheimer’s disease. J Int Neuropsychol Soc 2008, 14:266-278.
• [39]Royall DR, Lauterbach EC, Cummings JL, Reeve A, Rummans TA, Kaufer DI, et al.: Executive control function: A review of its promise and challenges for clinical research. J Neuropsychiat Clin Neurosci 2002, 14:377-405.
• [40]Gilbert SJ, Burgess PW: Executive function. Curr Biol 2008, 18:R110-R114.
• [41]Martyr A, Clare L: Executive function and activities of daily living in Alzheimer’s disease: A correlational meta-analysis. Dementia Geriatr Cogn Disord 2012, 33:189-203.
• [42]Song J, Ahn IS, Kang HS, Myung W, Lee Y, Woo SY, et al.: Cognitive subdomain responses to galantamine in Alzheimer’s disease. J Nerv Ment Dis. 2014, 202:253-259.
• [43]Raskin J, Wiltse CG, Siegal A, Sheikh J, Xu J, Dinkel JJ, et al.: Efficacy of duloxetine on cognition, depression, and pain in elderly patients with major depressive disorder: an 8-week, double-blind, placebo-controlled trial. Am J Psychiatry 2007, 164:900-909.
• [44]Chemerinski E, Petracca G, Sabe L, Kremer J, Starkstein SE: The specificity of depressive symptoms in patients with Alzheimer’s disease. Am J Psychiatry 2001, 158:68-72.
• [45]Garbryelewicz T, Styczynska M, Pfeffer A, Wasiak B, Barczak A, Luczwek E, Androsiuk W, Barcikowska M: Prevalence of major and minor depression in elderly persons with mild cognitive impairment– MADRS factor analysis. Int J Geriatr Psychiatry 2004, 19:1168-1172.