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To the Editor:
We read the article by Palmer et al.,1 who show that anxiety and depressive symptoms are associated with an increased risk of late-life dementia of Alzheimer type.
We analyzed 93 patients with mild cognitive impairment (MCI) who were consecutively recruited (January 2004–January 2006) from the Center of Neurodegenerative and Aging-related Disease of the Neurological Department, University of Brescia. All subjects fulfilled the criteria proposed by Petersen et al.2 At 1- and 2-year evaluations, a complete neuropsychological battery was administered. The aim of the study was to analyze the relation between depressive symptoms, loneliness, and the conversion to dementia in MCI outpatients.
All subjects had a caregiver and nobody lived alone. Emotional loneliness was assessed utilizing two items—Do you feel that your life is empty? and Do you often feel helpless?—that are included in the Geriatric Depression Scale (GDS, short version).3 Patients were defined as emotionally isolated (loneliness) if they answered positively to at least one of the two items. Depressive symptoms were assessed with the remaining 13 GDS items.
At 2 years from baseline, 42 patients with MCI (45.2%) converted to dementia; 28 to Alzheimer disease (AD); 4 to AD with cerebrovascular disease; 5 to Lewy body dementia; and 5 to frontotemporal dementia. In a logistic regression analysis, ADAS-Cog basal score and loneliness, but not depressive symptoms, were independently associated …
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