Differential associations of Head and Body Symptoms with depression and physical comorbidity in patients with cognitive impairment

Roberta Riello, Christina Geroldi, Orazio Zanetti, Carlo Vergani, Giovanni B. Frisoni

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objective. To test the hypothesis that physical symptoms referred to the head might be specifically associated with depression in patients with cognitive impairment. Methods. Subjects were taken from those enrolled in 'The Mild Project' a prospective study on the natural history of mild dementia (Mini Mental State Examination ≥18) and with a diagnosis of Alzheimer's disease, vascular dementia, and mild cognitive impairment. A total of 129 subjects were included in the study. Physical symptoms were assessed with a checklist investigating nine different body organs or apparati. Physical symptoms were grouped into those referred to the head (Head Symptoms: ear and hearing; eyes and sight; and head and face) and all the others (Body Symptoms). Depressive symptoms were assessed with the Geriatric Depression Scale (GDS) and physical comorbidity with Greenfield's Index of Disease Severity (IDS). Results. The number of patients reporting one or more Head Symptoms linearly increased with increasing depression severity (Mantel-Haenszel test=6.497, df=1, p=0.011), while the number of patients reporting one or more Body Symptoms linearly increased with increasing physical comorbidity (Mantel-Haenszel test=4.726, df=1, p=0.030). These associations were confirmed in multivariate logistic regression models with adjustment for potential confounders (age, gender, education, cognitive performance, daily function, and diagnosis). Conclusions. Head Symptoms are specifically associated with depression while Body Symptoms with physical comorbidity, in patients with cognitive impairment. Recognizing these associations in individual patients may help clinicians decide whether to initiate or continue antidepressant therapy or whether to carry out physical instrumental investigations.

Original languageEnglish
Pages (from-to)209-215
Number of pages7
JournalInternational Journal of Geriatric Psychiatry
Volume19
Issue number3
DOIs
Publication statusPublished - Mar 2004

Fingerprint

Comorbidity
Head
Depression
Logistic Models
Metachromatic Leukodystrophy
Vascular Dementia
Checklist
Geriatrics
Antidepressive Agents
Hearing
Ear
Dementia
Cognitive Dysfunction
Alzheimer Disease
Prospective Studies
Education
Therapeutics

Keywords

  • Cognitive impairment
  • Depression
  • Somatic complaints

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Psychiatry and Mental health

Cite this

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title = "Differential associations of Head and Body Symptoms with depression and physical comorbidity in patients with cognitive impairment",
abstract = "Objective. To test the hypothesis that physical symptoms referred to the head might be specifically associated with depression in patients with cognitive impairment. Methods. Subjects were taken from those enrolled in 'The Mild Project' a prospective study on the natural history of mild dementia (Mini Mental State Examination ≥18) and with a diagnosis of Alzheimer's disease, vascular dementia, and mild cognitive impairment. A total of 129 subjects were included in the study. Physical symptoms were assessed with a checklist investigating nine different body organs or apparati. Physical symptoms were grouped into those referred to the head (Head Symptoms: ear and hearing; eyes and sight; and head and face) and all the others (Body Symptoms). Depressive symptoms were assessed with the Geriatric Depression Scale (GDS) and physical comorbidity with Greenfield's Index of Disease Severity (IDS). Results. The number of patients reporting one or more Head Symptoms linearly increased with increasing depression severity (Mantel-Haenszel test=6.497, df=1, p=0.011), while the number of patients reporting one or more Body Symptoms linearly increased with increasing physical comorbidity (Mantel-Haenszel test=4.726, df=1, p=0.030). These associations were confirmed in multivariate logistic regression models with adjustment for potential confounders (age, gender, education, cognitive performance, daily function, and diagnosis). Conclusions. Head Symptoms are specifically associated with depression while Body Symptoms with physical comorbidity, in patients with cognitive impairment. Recognizing these associations in individual patients may help clinicians decide whether to initiate or continue antidepressant therapy or whether to carry out physical instrumental investigations.",
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AU - Zanetti, Orazio

AU - Vergani, Carlo

AU - Frisoni, Giovanni B.

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N2 - Objective. To test the hypothesis that physical symptoms referred to the head might be specifically associated with depression in patients with cognitive impairment. Methods. Subjects were taken from those enrolled in 'The Mild Project' a prospective study on the natural history of mild dementia (Mini Mental State Examination ≥18) and with a diagnosis of Alzheimer's disease, vascular dementia, and mild cognitive impairment. A total of 129 subjects were included in the study. Physical symptoms were assessed with a checklist investigating nine different body organs or apparati. Physical symptoms were grouped into those referred to the head (Head Symptoms: ear and hearing; eyes and sight; and head and face) and all the others (Body Symptoms). Depressive symptoms were assessed with the Geriatric Depression Scale (GDS) and physical comorbidity with Greenfield's Index of Disease Severity (IDS). Results. The number of patients reporting one or more Head Symptoms linearly increased with increasing depression severity (Mantel-Haenszel test=6.497, df=1, p=0.011), while the number of patients reporting one or more Body Symptoms linearly increased with increasing physical comorbidity (Mantel-Haenszel test=4.726, df=1, p=0.030). These associations were confirmed in multivariate logistic regression models with adjustment for potential confounders (age, gender, education, cognitive performance, daily function, and diagnosis). Conclusions. Head Symptoms are specifically associated with depression while Body Symptoms with physical comorbidity, in patients with cognitive impairment. Recognizing these associations in individual patients may help clinicians decide whether to initiate or continue antidepressant therapy or whether to carry out physical instrumental investigations.

AB - Objective. To test the hypothesis that physical symptoms referred to the head might be specifically associated with depression in patients with cognitive impairment. Methods. Subjects were taken from those enrolled in 'The Mild Project' a prospective study on the natural history of mild dementia (Mini Mental State Examination ≥18) and with a diagnosis of Alzheimer's disease, vascular dementia, and mild cognitive impairment. A total of 129 subjects were included in the study. Physical symptoms were assessed with a checklist investigating nine different body organs or apparati. Physical symptoms were grouped into those referred to the head (Head Symptoms: ear and hearing; eyes and sight; and head and face) and all the others (Body Symptoms). Depressive symptoms were assessed with the Geriatric Depression Scale (GDS) and physical comorbidity with Greenfield's Index of Disease Severity (IDS). Results. The number of patients reporting one or more Head Symptoms linearly increased with increasing depression severity (Mantel-Haenszel test=6.497, df=1, p=0.011), while the number of patients reporting one or more Body Symptoms linearly increased with increasing physical comorbidity (Mantel-Haenszel test=4.726, df=1, p=0.030). These associations were confirmed in multivariate logistic regression models with adjustment for potential confounders (age, gender, education, cognitive performance, daily function, and diagnosis). Conclusions. Head Symptoms are specifically associated with depression while Body Symptoms with physical comorbidity, in patients with cognitive impairment. Recognizing these associations in individual patients may help clinicians decide whether to initiate or continue antidepressant therapy or whether to carry out physical instrumental investigations.

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