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Am J Psychiatry 1993; 150:1693-1699
Copyright © 1993 by American Psychiatric Association
The course of geriatric depression with "reversible dementia": a controlled study
GS Alexopoulos, BS Meyers, RC Young, S Mattis and T Kakuma
Department of Psychiatry, Cornell University Medical College, White Plains, NY.
OBJECTIVE: The goals of this longitudinal investigation were 1) to study
the rate of development of irreversible dementia in elderly depressed
patients with a dementia syndrome that subsided after improvement of
depression and 2) to compare it with that of depressed, never-demented
patients. METHOD: The subjects were 57 elderly patients consecutively
hospitalized for major depression. At entry into the study, 23 subjects
also met criteria for "reversible dementia," while 34 were without
dementia. After a systematic clinical evaluation, the subjects were
followed up at approximately yearly intervals for an average of 33.8
months. RESULTS: Irreversible dementia developed significantly more
frequently in the depressed group with reversible dementia (43%) than in
the group with depression alone (12%). Survival analysis showed that the
group with reversible dementia had a 4.69- times higher chance of having
developed dementia at follow-up than the patients with depression alone. No
clinical characteristics at entry into the study were found to discriminate
the subjects who developed irreversible dementia during the follow-up
period from those who remained nondemented. CONCLUSIONS: These findings
suggest that geriatric depression with reversible dementia is a clinical
entity that includes a group of patients with early-stage dementing
disorders. Therefore, identification of a reversible dementia syndrome is
an indication for a thorough diagnostic workup and frequent follow-ups in
order to identify treatable neurological disorders.
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