Late-life depressive disorder in the community. I. The relationship between MMSE score and depression in subjects with and without psychiatric history.

BACKGROUND

In previous studies cognitive impairment in depressed elderly in-patients tends to be associated with a late onset of depression. This study tests the hypothesis that cognitive impairment is associated with depression only in elderly individuals with no history of psychiatric illness.

METHOD

We investigated an age-stratified sample of 4051 elderly people living in the community, aged between 65 and 84 (AMSTEL). The relationship between depression (GMS-AGECAT diagnosis) and scores on the Mini Mental State Examination was studied in subjects with and without a reported psychiatric history (CAMDEX questionnaire).

RESULTS

Low MMSE scores (MMSE < or = 25) were only associated with depression in subjects with no psychiatric history (young/old: OR = 2.75, 95% CI = 1.83, 4.19; old/old: OR = 2.21, 95% CI = 1.61, 3.03).

CONCLUSIONS

We concluded that the combination of cognitive impairment and first-episode depression in elderly individuals may indicate cerebral deterioration. Depression as such may not be associated with cognitive impairment.