Accuracy of Recognition and Diagnosis of Comorbid Depression in the Nursing Home

A variety of research has documented high levels of depression among older adults in the health care setting. Additional research has shown that care providers in health care settings are not very effective at diagnosing comorbid depression.This is a troublesome finding since comorbid depression has been linked to a number of negative outcomes in older adults. Early results have indicated that comorbid depression may be associated with a number of unfavorable consequences ranging from impairments in physical functioning to increased mortality.The health care setting with arguably the highest rate of physical impairment is the nursing home and it is the nursing home where the effects of comorbid depression may be most costly. Therefore, the current analysis uses data from the Institutional Population Component of the NationalMedical Expenditure Survey (US Department of Health and Human Services, 1990) to explore rates of both recognized and unrecognized comorbid depression in the nursing home setting. Using a constructed proxy variable representative of the DSM-III-R diagnosis of depression, results indicate that approximately 8.1% of nursing home residents have an unrecognized potential comorbid depression.

Recognition of familiar and unfamiliar music in normal aging and Alzheimer's disease

We tested normal young and elderly adults and elderly Alzheimer’s disease (AD) patients on recognition memory for tunes. In Experiment 1, AD patients and age-matched controls received a study list and an old/new recognition test of highly familiar, traditional tunes, followed by a study list and test of novel tunes. The controls performed better than did the AD patients. The controls showed the “mirror effect” of increased hits and reduced false alarms for traditional versus novel tunes, whereas the patients false-alarmed as often to traditional tunes as to novel tunes. Experiment 2 compared young adults and healthy elderly persons using a similar design. Performance was lower in the elderly group, but both younger and older subjects showed the mirror effect. Experiment 3 produced confusion between preexperimental familiarity and intraexperimental familiarity by mixing traditional and novel tunes in the study lists and tests. Here, the subjects in both age groups resembled the patients of Experiment 1 in failing to show the mirror effect. Older subjects again performed more poorly, and they differed qualitatively from younger subjects in setting stricter criteria for more nameable tunes. Distinguishing different sources of global familiarity is a factor in tune recognition, and the data suggest that this type of source monitoring is impaired in AD and involves different strategies in younger and older adults.