Dementia and depression symptomatology as assessed through screening tests of older patients in an outpatient clinic.

Objective: This study examined the prevalence of dementia and depression symptoms as assessed through screening instruments in older patients visiting a family practice clinic, compared screening results with indications of either a dementia or depression-related diagnosis as reported on patients' medical records and billing statements, and examined the relationship between screening instrument results and patients' demographics.

Methods: A total of 214 patients were interviewed and completed a written survey relating to dementia (Mini-Mental State Exam), depression (Beck Depression Inventory), medical conditions, and demographics. Patients were 60 years of age and older visiting a family practice clinic serving an outpatient population in northwest Illinois and southern Wisconsin. The clinic is an undergraduate teaching site of the University of Illinois College of Medicine at Rockford. Patients were interviewed at the time of their visits for routine medical care as they appeared on study recruitment days.

Results: The response rate was greater than 90%. About 20% of the patients scored in the range of possible cognitive impairment and over 22% scored in the range of possible mild to moderate depression. Overall, about 38% of the patients showed symptoms of either dementia or depression, or both. Based on chart review, there was significant under-reporting of dementia or cognitive difficulties and low correlation between screening results and chart and billing information related to depression.

Conclusions: The results reaffirm a significant rate of mental health problems in older patients in outpatient settings. This situation warrants examination of the reasons for under-reporting of mental health problems and the potential relationship between mental health problems and the general health status of elderly patients.