The course of geriatric depression with "reversible dementia": a controlled study

Am J Psychiatry. 1993 Nov;150(11):1693-9. doi: 10.1176/ajp.150.11.1693.


Objective: The goals of this longitudinal investigation were 1) to study the rate of development of irreversible dementia in elderly depressed patients with a dementia syndrome that subsided after improvement of depression and 2) to compare it with that of depressed, never-demented patients.

Method: The subjects were 57 elderly patients consecutively hospitalized for major depression. At entry into the study, 23 subjects also met criteria for "reversible dementia," while 34 were without dementia. After a systematic clinical evaluation, the subjects were followed up at approximately yearly intervals for an average of 33.8 months.

Results: Irreversible dementia developed significantly more frequently in the depressed group with reversible dementia (43%) than in the group with depression alone (12%). Survival analysis showed that the group with reversible dementia had a 4.69-times higher chance of having developed dementia at follow-up than the patients with depression alone. No clinical characteristics at entry into the study were found to discriminate the subjects who developed irreversible dementia during the follow-up period from those who remained nondemented.

Conclusions: These findings suggest that geriatric depression with reversible dementia is a clinical entity that includes a group of patients with early-stage dementing disorders. Therefore, identification of a reversible dementia syndrome is an indication for a thorough diagnostic workup and frequent follow-ups in order to identify treatable neurological disorders.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aged
  • Antidepressive Agents / therapeutic use
  • Antipsychotic Agents / therapeutic use
  • Comorbidity
  • Dementia / classification
  • Dementia / diagnosis*
  • Dementia / epidemiology
  • Depressive Disorder / diagnosis*
  • Depressive Disorder / drug therapy
  • Depressive Disorder / epidemiology
  • Diagnosis, Differential
  • Female
  • Follow-Up Studies
  • Hospitalization
  • Humans
  • Male
  • Psychiatric Status Rating Scales
  • Survival Analysis


  • Antidepressive Agents
  • Antipsychotic Agents