[Clinical investigation on depression on a randomized and stratified sample in an elderly population]. / Indagine clinica sulla depressione in un campione randomizzato e stratificato di popolazione anziana.

The prevalence of depression in the elderly was investigated in a random stratified sample of 100 subjects from the general population of Appignano (Macerata, Regione Marche, Italy). After sampling with the simple random method, each subject underwent a diagnostic work-up including: a) three psychodiagnostic tests (Short Scale for the Assessment of Mental Health--SSAMH, Geriatric Depression Scale--GDS, and Scale for the Self-evaluation of Depression from the Psychogeriatric Interview--PGI) and b) psychiatric evaluation (according to DSM-III-R diagnostic criteria). Results were as follows: a) all the 3 tests (SSAMH, GDS, PGI) were suitable for the goals of this research, with a sensibility of 95.4%, 90.9%, and 95.4%, and a specificity of 90.4%, 88.9%, and 90.5%, respectively; b) the prevalence of depression in the sample was 25.9% (26.1% in females and 25.6% in males); c) the most common disorder was dysthymia, with higher percentage in females than in males (75% and 50% of all the depressive syndromes, respectively); d) the prevalence of depression was higher in females 60-69 years old and in males 70-79 years old.

Prevalence of clinically diagnosed Alzheimer's disease and other dementing disorders: a door-to-door survey in Appignano, Macerata Province, Italy.

The purpose of this study was to investigate the prevalence of dementia in an Italian population using a door-to-door 2-phase design. As part of a social and health survey, we administered the Hodkinson abbreviated mental test to all persons over age 59 residing in the Commune of Appignano on January 1, 1987 (N = 778). We then investigated all subjects scoring 7 or less on the cognitive test following a standardized diagnostic protocol. We found 48 patients affected by dementia, yielding a crude prevalence ratio (cases per 100 population over age 59) of 6.2; prevalence ratios were 2.6 for Alzheimer's disease, 2.2 for multi-infarct dementia, 0.8 for mixed dementia, 0.4 for secondary dementia, and 0.3 for unspecified dementia. Age- and sex-specific prevalence ratios increased steeply with age and were consistently higher in women for Alzheimer's disease and in men for dementia of all types and multi-infarct dementia. Alzheimer's disease was slightly more frequent than multi-infarct dementia; however, the most common type of dementia varied across age groups. Most cases of Alzheimer's disease were sporadic and had a late age of onset. Comparison with other populations suggests that dementia of all types is as frequent in Appignano as elsewhere, and that Alzheimer's disease might be more frequent in rural than in urban populations.