Rigaud Anne-Sophie
Hôpital Broca, Paris.
Presse Med. 2003 Jul 12;32(24 Suppl):S5-8.
Signs of depression in patients with Alzheimer's disease are difficult to detect because they change over time and vary in intensity and duration. Estimated frequency depends greatly on the evaluation scale (Cornell scale, Geriatric Depression Scale, Behave-Alzheimer disease scale, Cohen-Mansfield scale, Neuropsychiatric Inventory (NPI)). Several risk factors have been identified including early age of disease onset, female gender, etc). The anatomic basis of depression is essentially related to the noradrenergic and serotoninergic systems. DEPRESSION IN THE CAREGIVER: Caregivers bear a heavy burden, psychologically (30-50% of all cases of depression), physically, and financially. Depression in the caregiver favors depression in the patient, and vice versa. Episodes may develop at any time during the disease course. Decompensation depends on both patient-related and caregiver-related factors. IMPORTANCE OF DETECTING DEPRESSION: Depression is frequent, both in the patient and in the caregiver and must be detected and treated early. It has been demonstrated that 50% of the caregivers may be affected, but only 10-20% are treated.
阿尔茨海默病患者的抑郁症状难以察觉，因为它们会随时间变化，强度和持续时间也各不相同。估计的发生率在很大程度上取决于评估量表（康奈尔量表、老年抑郁量表、阿尔茨海默病行为量表、科恩 - 曼斯菲尔德量表、神经精神科问卷（NPI））。已确定了几个风险因素，包括疾病发病年龄早、女性性别等。抑郁的解剖学基础本质上与去甲肾上腺素能和血清素能系统有关。照顾者的抑郁：照顾者承受着沉重的负担，包括心理负担（所有抑郁病例的30 - 50%）、身体负担和经济负担。照顾者的抑郁会加重患者的抑郁，反之亦然。在疾病过程中的任何时候都可能出现发作。失代偿取决于与患者相关和与照顾者相关的因素。检测抑郁的重要性：抑郁在患者和照顾者中都很常见，必须尽早检测和治疗。已经证明，50%的照顾者可能会受到影响，但只有10 - 20%得到治疗。
