Depression in Alzheimer's disease: Phenomenological features and association with severity and progression of cognitive and functional impairment

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Abstract
Seventy‐eight outpatients with a clinical diagnosis of dementia in Alzheimer's disease according to the ICD‐10 draft research criteria were investigated with annual evaluations over a period of 2 years to study the phenomenology and association with severity and progression of cognitive and functional impairment of depression in Alzheimer's disease. As measured by the Dementia Mood Assesment Scale (DMAS), depressive symptoms occurred frequently, such as decrease in motor activity, lack of responsiveness, agitation and depressed appearance. Multiple stepwise regression demonstrated that decrease in motor activity and lack of responsiveness were the strongest contributors to an association of depressive symptoms with severity of cognitive and functional impairment. The global score of the DMAS mood subscale was not related to dementia severity. There was no relation between depressive symptoms in Alzheimer's disease and the rate of cognitive and functional decline within a 12‐month and 24‐month observational period. Our results suggest that depressive symptoms are frequent concomitants of dementia in Alzheimer's disease. Depressive symptoms are in part associated with a greater severity of cognitive and functional impairment in Alzheimer's disease. However, depressive symptoms, unlike other non‐cognitive psychopathological symptoms, for example psychotic phenomena, are not prognostically relevant with respect to a lower or higher rate of symptom progression.