Prevalence of depression, anxiety, and apathy symptoms across dementia stages: A systematic review and meta‐analysis
Objective The present study aimed to resolve inconsistency in reported prevalence of affective symptoms by dementia stage. Methods/Design We conducted a meta‐analysis of studies with data on dementia stage and prevalence of depression, anxiety, or apathy assessed using validated tools. We performed...
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| Veröffentlicht in: | International journal of geriatric psychiatry 2021-09, Vol.36 (9), p.1330-1344 |
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| container_title | International journal of geriatric psychiatry |
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| creator | Leung, Dara K.Y. Chan, Wai Chi Spector, Aimee Wong, Gloria H.Y. |
| description | Objective
The present study aimed to resolve inconsistency in reported prevalence of affective symptoms by dementia stage.
Methods/Design
We conducted a meta‐analysis of studies with data on dementia stage and prevalence of depression, anxiety, or apathy assessed using validated tools. We performed random‐effects meta‐analysis and subgroup analysis on symptom prevalence by dementia stage, according to CDR.
Results
The meta‐analysis included 5897 people with dementia from 20 studies. Prevalence rates of depression in mild, moderate, and severe dementia were 38% (95% CI 32%–45%), 41% (95% CI 33%–49%), and 37% (95% CI 17%–56%) respectively. The corresponding prevalence for anxiety was 38% (95% CI 31%–45%), 41% (95% CI 31%–52%), and 37% (95% CI −8%–82%); and 54% (95% CI 45%–62%), 59% (95% CI 44%–73%), and 43% (95% CI 10%–75%) for apathy. The prevalence of depression, anxiety, and apathy did not differ with regard to dementia stage and type. The prevalence of depression in Alzheimer's disease (AD) was significantly lower when it was assessed using diagnostic criteria compared to screening tools. The prevalence of depression in AD was lowest in America, while anxiety in vascular dementia was higher in Europe than Asia.
Conclusions
Depression, anxiety, and apathy symptoms are highly prevalent across dementia stages. There is no evidence of any changes in prevalence of affective symptom as the illness progresses. Evaluation methods and cultural difference may explain some of the variance, suggesting further investigation of factors that may influence the report of symptoms, such as carer psychosocial characteristics, and more cross‐cultural studies are needed.
Key points
Random‐effects meta‐analysis showed no evidence of any changes in prevalence of depression, anxiety, and apathy as dementia progresses in general dementia, AD and VaD population
The variance of prevalence in depression and anxiety may be attributable to symptom evaluation method and region of study conducted
Future studies could examine the pattern and management of affective symptoms in relation to carer psychosocial characteristics and across culture |
| doi_str_mv | 10.1002/gps.5556 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2518970982</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2557901658</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4496-be9657570c659750e32a04bde783a8795a9c7ef1df761bd4a3a4816acdd24e093</originalsourceid><addsrcrecordid>eNp1kdtKHEEQhpuQENcD-AShITe5cNbumemTdyJGBUFBvR5qZ2q0ZU6Z6tXMnY-QZ8yTpHfXJCB41QX91UdV_YztSzGXQqSH9wPNlVL6A5tJ4VwipdYf2UxYqxKdZmKLbRM9ChH_pP3MtrLMCSUzO2NP1yM-QYNdibyveYXDiES-7w44dD89hmlVVBwGCA8Tp6kdQt8Sh3LsiSLfYhc8cApwj3TEjyNCAVsIvuRR7fF53d9igN8vv6CDZiJPu-xTDQ3h3uu7w-6-n96enCeXV2cXJ8eXSZnnTicLdFoZZUSplTNKYJaCyBcVGpuBNU6BKw3WsqqNlosqhwxyKzWUVZXmKFy2w75tvMPY_1gihaL1VGLTQIf9kopUSeuMcDaN6Nc36GO_HOO8K0oZJ6RW9r9wvf-IdTGMvoVxKqQoVlkUMYtilUVEv7wKl4sWq3_g3-NHINkAz77B6V1RcXZ9sxb-AQYVlKY</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2557901658</pqid></control><display><type>article</type><title>Prevalence of depression, anxiety, and apathy symptoms across dementia stages: A systematic review and meta‐analysis</title><source>Access via Wiley Online Library</source><creator>Leung, Dara K.Y. ; Chan, Wai Chi ; Spector, Aimee ; Wong, Gloria H.Y.</creator><creatorcontrib>Leung, Dara K.Y. ; Chan, Wai Chi ; Spector, Aimee ; Wong, Gloria H.Y.</creatorcontrib><description>Objective
The present study aimed to resolve inconsistency in reported prevalence of affective symptoms by dementia stage.
Methods/Design
We conducted a meta‐analysis of studies with data on dementia stage and prevalence of depression, anxiety, or apathy assessed using validated tools. We performed random‐effects meta‐analysis and subgroup analysis on symptom prevalence by dementia stage, according to CDR.
Results
The meta‐analysis included 5897 people with dementia from 20 studies. Prevalence rates of depression in mild, moderate, and severe dementia were 38% (95% CI 32%–45%), 41% (95% CI 33%–49%), and 37% (95% CI 17%–56%) respectively. The corresponding prevalence for anxiety was 38% (95% CI 31%–45%), 41% (95% CI 31%–52%), and 37% (95% CI −8%–82%); and 54% (95% CI 45%–62%), 59% (95% CI 44%–73%), and 43% (95% CI 10%–75%) for apathy. The prevalence of depression, anxiety, and apathy did not differ with regard to dementia stage and type. The prevalence of depression in Alzheimer's disease (AD) was significantly lower when it was assessed using diagnostic criteria compared to screening tools. The prevalence of depression in AD was lowest in America, while anxiety in vascular dementia was higher in Europe than Asia.
Conclusions
Depression, anxiety, and apathy symptoms are highly prevalent across dementia stages. There is no evidence of any changes in prevalence of affective symptom as the illness progresses. Evaluation methods and cultural difference may explain some of the variance, suggesting further investigation of factors that may influence the report of symptoms, such as carer psychosocial characteristics, and more cross‐cultural studies are needed.
Key points
Random‐effects meta‐analysis showed no evidence of any changes in prevalence of depression, anxiety, and apathy as dementia progresses in general dementia, AD and VaD population
The variance of prevalence in depression and anxiety may be attributable to symptom evaluation method and region of study conducted
Future studies could examine the pattern and management of affective symptoms in relation to carer psychosocial characteristics and across culture</description><identifier>ISSN: 0885-6230</identifier><identifier>EISSN: 1099-1166</identifier><identifier>DOI: 10.1002/gps.5556</identifier><identifier>PMID: 33905138</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Alzheimer's disease ; Anxiety ; Apathy ; Dementia ; Dementia disorders ; depression ; Emotional behavior ; Geriatric psychiatry ; Mental depression ; Meta-analysis ; Neurodegenerative diseases ; neuropsychiatric symptoms ; prevalence ; Systematic review ; Vascular dementia</subject><ispartof>International journal of geriatric psychiatry, 2021-09, Vol.36 (9), p.1330-1344</ispartof><rights>2021 John Wiley & Sons Ltd.</rights><rights>2021 John Wiley & Sons Ltd.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4496-be9657570c659750e32a04bde783a8795a9c7ef1df761bd4a3a4816acdd24e093</citedby><cites>FETCH-LOGICAL-c4496-be9657570c659750e32a04bde783a8795a9c7ef1df761bd4a3a4816acdd24e093</cites><orcidid>0000-0002-1331-942X ; 0000-0002-7255-2790</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fgps.5556$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fgps.5556$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33905138$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Leung, Dara K.Y.</creatorcontrib><creatorcontrib>Chan, Wai Chi</creatorcontrib><creatorcontrib>Spector, Aimee</creatorcontrib><creatorcontrib>Wong, Gloria H.Y.</creatorcontrib><title>Prevalence of depression, anxiety, and apathy symptoms across dementia stages: A systematic review and meta‐analysis</title><title>International journal of geriatric psychiatry</title><addtitle>Int J Geriatr Psychiatry</addtitle><description>Objective
The present study aimed to resolve inconsistency in reported prevalence of affective symptoms by dementia stage.
Methods/Design
We conducted a meta‐analysis of studies with data on dementia stage and prevalence of depression, anxiety, or apathy assessed using validated tools. We performed random‐effects meta‐analysis and subgroup analysis on symptom prevalence by dementia stage, according to CDR.
Results
The meta‐analysis included 5897 people with dementia from 20 studies. Prevalence rates of depression in mild, moderate, and severe dementia were 38% (95% CI 32%–45%), 41% (95% CI 33%–49%), and 37% (95% CI 17%–56%) respectively. The corresponding prevalence for anxiety was 38% (95% CI 31%–45%), 41% (95% CI 31%–52%), and 37% (95% CI −8%–82%); and 54% (95% CI 45%–62%), 59% (95% CI 44%–73%), and 43% (95% CI 10%–75%) for apathy. The prevalence of depression, anxiety, and apathy did not differ with regard to dementia stage and type. The prevalence of depression in Alzheimer's disease (AD) was significantly lower when it was assessed using diagnostic criteria compared to screening tools. The prevalence of depression in AD was lowest in America, while anxiety in vascular dementia was higher in Europe than Asia.
Conclusions
Depression, anxiety, and apathy symptoms are highly prevalent across dementia stages. There is no evidence of any changes in prevalence of affective symptom as the illness progresses. Evaluation methods and cultural difference may explain some of the variance, suggesting further investigation of factors that may influence the report of symptoms, such as carer psychosocial characteristics, and more cross‐cultural studies are needed.
Key points
Random‐effects meta‐analysis showed no evidence of any changes in prevalence of depression, anxiety, and apathy as dementia progresses in general dementia, AD and VaD population
The variance of prevalence in depression and anxiety may be attributable to symptom evaluation method and region of study conducted
Future studies could examine the pattern and management of affective symptoms in relation to carer psychosocial characteristics and across culture</description><subject>Alzheimer's disease</subject><subject>Anxiety</subject><subject>Apathy</subject><subject>Dementia</subject><subject>Dementia disorders</subject><subject>depression</subject><subject>Emotional behavior</subject><subject>Geriatric psychiatry</subject><subject>Mental depression</subject><subject>Meta-analysis</subject><subject>Neurodegenerative diseases</subject><subject>neuropsychiatric symptoms</subject><subject>prevalence</subject><subject>Systematic review</subject><subject>Vascular dementia</subject><issn>0885-6230</issn><issn>1099-1166</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp1kdtKHEEQhpuQENcD-AShITe5cNbumemTdyJGBUFBvR5qZ2q0ZU6Z6tXMnY-QZ8yTpHfXJCB41QX91UdV_YztSzGXQqSH9wPNlVL6A5tJ4VwipdYf2UxYqxKdZmKLbRM9ChH_pP3MtrLMCSUzO2NP1yM-QYNdibyveYXDiES-7w44dD89hmlVVBwGCA8Tp6kdQt8Sh3LsiSLfYhc8cApwj3TEjyNCAVsIvuRR7fF53d9igN8vv6CDZiJPu-xTDQ3h3uu7w-6-n96enCeXV2cXJ8eXSZnnTicLdFoZZUSplTNKYJaCyBcVGpuBNU6BKw3WsqqNlosqhwxyKzWUVZXmKFy2w75tvMPY_1gihaL1VGLTQIf9kopUSeuMcDaN6Nc36GO_HOO8K0oZJ6RW9r9wvf-IdTGMvoVxKqQoVlkUMYtilUVEv7wKl4sWq3_g3-NHINkAz77B6V1RcXZ9sxb-AQYVlKY</recordid><startdate>202109</startdate><enddate>202109</enddate><creator>Leung, Dara K.Y.</creator><creator>Chan, Wai Chi</creator><creator>Spector, Aimee</creator><creator>Wong, Gloria H.Y.</creator><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-1331-942X</orcidid><orcidid>https://orcid.org/0000-0002-7255-2790</orcidid></search><sort><creationdate>202109</creationdate><title>Prevalence of depression, anxiety, and apathy symptoms across dementia stages: A systematic review and meta‐analysis</title><author>Leung, Dara K.Y. ; Chan, Wai Chi ; Spector, Aimee ; Wong, Gloria H.Y.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4496-be9657570c659750e32a04bde783a8795a9c7ef1df761bd4a3a4816acdd24e093</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Alzheimer's disease</topic><topic>Anxiety</topic><topic>Apathy</topic><topic>Dementia</topic><topic>Dementia disorders</topic><topic>depression</topic><topic>Emotional behavior</topic><topic>Geriatric psychiatry</topic><topic>Mental depression</topic><topic>Meta-analysis</topic><topic>Neurodegenerative diseases</topic><topic>neuropsychiatric symptoms</topic><topic>prevalence</topic><topic>Systematic review</topic><topic>Vascular dementia</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Leung, Dara K.Y.</creatorcontrib><creatorcontrib>Chan, Wai Chi</creatorcontrib><creatorcontrib>Spector, Aimee</creatorcontrib><creatorcontrib>Wong, Gloria H.Y.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>International journal of geriatric psychiatry</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Leung, Dara K.Y.</au><au>Chan, Wai Chi</au><au>Spector, Aimee</au><au>Wong, Gloria H.Y.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prevalence of depression, anxiety, and apathy symptoms across dementia stages: A systematic review and meta‐analysis</atitle><jtitle>International journal of geriatric psychiatry</jtitle><addtitle>Int J Geriatr Psychiatry</addtitle><date>2021-09</date><risdate>2021</risdate><volume>36</volume><issue>9</issue><spage>1330</spage><epage>1344</epage><pages>1330-1344</pages><issn>0885-6230</issn><eissn>1099-1166</eissn><abstract>Objective
The present study aimed to resolve inconsistency in reported prevalence of affective symptoms by dementia stage.
Methods/Design
We conducted a meta‐analysis of studies with data on dementia stage and prevalence of depression, anxiety, or apathy assessed using validated tools. We performed random‐effects meta‐analysis and subgroup analysis on symptom prevalence by dementia stage, according to CDR.
Results
The meta‐analysis included 5897 people with dementia from 20 studies. Prevalence rates of depression in mild, moderate, and severe dementia were 38% (95% CI 32%–45%), 41% (95% CI 33%–49%), and 37% (95% CI 17%–56%) respectively. The corresponding prevalence for anxiety was 38% (95% CI 31%–45%), 41% (95% CI 31%–52%), and 37% (95% CI −8%–82%); and 54% (95% CI 45%–62%), 59% (95% CI 44%–73%), and 43% (95% CI 10%–75%) for apathy. The prevalence of depression, anxiety, and apathy did not differ with regard to dementia stage and type. The prevalence of depression in Alzheimer's disease (AD) was significantly lower when it was assessed using diagnostic criteria compared to screening tools. The prevalence of depression in AD was lowest in America, while anxiety in vascular dementia was higher in Europe than Asia.
Conclusions
Depression, anxiety, and apathy symptoms are highly prevalent across dementia stages. There is no evidence of any changes in prevalence of affective symptom as the illness progresses. Evaluation methods and cultural difference may explain some of the variance, suggesting further investigation of factors that may influence the report of symptoms, such as carer psychosocial characteristics, and more cross‐cultural studies are needed.
Key points
Random‐effects meta‐analysis showed no evidence of any changes in prevalence of depression, anxiety, and apathy as dementia progresses in general dementia, AD and VaD population
The variance of prevalence in depression and anxiety may be attributable to symptom evaluation method and region of study conducted
Future studies could examine the pattern and management of affective symptoms in relation to carer psychosocial characteristics and across culture</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>33905138</pmid><doi>10.1002/gps.5556</doi><tpages>15</tpages><orcidid>https://orcid.org/0000-0002-1331-942X</orcidid><orcidid>https://orcid.org/0000-0002-7255-2790</orcidid><oa>free_for_read</oa></addata></record> |
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| language | eng |
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| source | Access via Wiley Online Library |
| subjects | Alzheimer's disease Anxiety Apathy Dementia Dementia disorders depression Emotional behavior Geriatric psychiatry Mental depression Meta-analysis Neurodegenerative diseases neuropsychiatric symptoms prevalence Systematic review Vascular dementia |
| title | Prevalence of depression, anxiety, and apathy symptoms across dementia stages: A systematic review and meta‐analysis |
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