Alzheimer's disease and depression: neuropsychological impairment and progression of the illness

Article Abstract:

Alzheimer's disease is a progressive degenerative brain disorder leading to cognitive impairment and eventually total loss of cognition and ability to function. The disease may exist with or without the presence of other psychiatric symptoms, and in particular, many Alzheimer's patients have also been diagnosed with depression. The effect of depression on cognitive function in these patients has not been clearly defined. To determine the extent and the nature of the differences between patients with Alzheimer's disease and depression and patients with Alzheimer's disease only, 174 individuals who were diagnosed with probable Alzheimer's disease were evaluated in a longitudinal study. Ten of the patients met the criteria for major depression; these 10 patients were matched with 10 nondepressed patients from within the group. Extensive clinical evaluation was performed using medical, neurological, psychiatric, and social tests, and these patients were followed for one year. The results indicated no significant differences between the two groups in neuropsychological deficits. At initial and follow-up testing, both groups scored similarly in areas of attention, language, memory, learning, and visuospatial functions. Although the results of this study should be considered preliminary, it appears that depression does not have an impact on the natural course of Alzheimer's disease and no neuropsychological deficits were found that differentiate depressed from nondepressed patients with Alzheimer's disease. (Consumer Summary produced by Reliance Medical Information, Inc.)

Psychological aspects, Research, Depression, Mental, Depression (Mood disorder), Alzheimer's disease, Neuropsychology

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Hypersomnia in bipolar depression: a comparison with narcolepsy using the multiple sleep latency test

Article Abstract:

Hypersomnia (excessive sleeping) is not characteristic of affective disorders such as depression, except in younger depressed patients, particularly those in the depressed phase of bipolar depression. There is little information available about this phenomenon, but one speculation is that hypersomnia is related to narcolepsy, a sleep disorder characterized by attacks of drowsiness and sleep. In narcolepsy, it has been found that patients spend an unusually large amount of time in the REM stage of sleep. In at least one study of patients with bipolar depression, who were not in an active disease phase, a high percentage of the time sleeping was spent in the REM stage as well. In the present study, 25 patients with bipolar depression, who were currently in a depressed phase, reported symptoms of hypersomnia. The patients were studied for two nights in a sleep laboratory. On each night, sleep characteristics were recorded and data were collected on daytime naps. When data were compared to that collected for 23 patients with narcolepsy who were not depressed, no similarities were found in the sleep characteristics of the two groups. It is concluded that hypersomnia in depressed patients is likely to be due to lack of interest, withdrawal, decreased energy, and other symptoms characteristic of depression, rather than to an increase in the patients' need to sleep or to an increase in REM-stage sleep. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Causes of, Physiological aspects, Bipolar disorder, Narcolepsy, Hypersomnia

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Sleep impairment and daytime sleepiness in later life

Article Abstract:

A 75-year-old white married man who has complained of restless sleep for the past 10 years is diagnosed to have sleeping disorders. Initial assessment of the case suggested that the subject may be suffering from sleep apnea syndrome, which is characterized by daytime sleepiness. Analysis of the subject's clinical history also suggested periodic limb movements disorder. Sleep laboratory studies attributed the disorders to repetitive apneas and of the associated oxyhemoglobin desaturation, and the periodic limb movements to restless legs syndrome.

Case studies, Insomnia, Sleep disorders, Restless legs syndrome

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