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Schlagwörter:
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Zusammenfassung:
Depressive symptoms are common in mild cognitive impairment (MCI),
dementia caused by Alzheimer's disease (AD dementia) and in cognitively
unimpaired older adults. However, it is unclear whether they could
contribute to the identification of cognitive impairment in ageing. To
assess the potential utility of depressive symptoms to distinguish
between healthy cognitive ageing and MCI and AD dementia. The diagnostic
workup of the cognitive function of 1737 older cognitively unimpaired
individuals, 334 people with MCI and 142 individuals with AD dementia
relied on a comprehensive neuropsychiatric assessment, including the
Mini Mental State Examination (MMSE). Depressive symptoms were tapped
with the 15-item Geriatric Depression Scale (GDS). Proportional odds
logistic regression (POLR) models and the machine learning technique
Adaptive Boosting algorithm (AdaBoost) were employed. Stratified
repeated random subsampling (stratified bootstrap resampling) was used
to recursive partitioning to training- and validation set (70/30 ratio).
The average accuracy of the POLR models for the GDS total score in
distinguishing between cognitive impairment and healthy cognitive ageing
exceeded 78% and was inferior to that of MMSE. Of note, the sensitivity
of GDS total score was very low. By employing the AdaBoost algorithm and
considering GDS items separately, the average accuracy was higher than
0.72 and comparable to that of the MMSE, while sensitivity- and
specificity values were more balanced. The findings of the study provide
initial evidence that depressive symptoms may contribute to
distinguishing between cognitive impairment and cognitively healthy
ageing.
