The utility of the Visual Analogue Scale for the assessment of depressive mood in cognitively impaired patients

Background Early detection of depression in elderly demented patients may assist in adequate treatment. The aim of this study was to evaluate the utility of Visual Analogue Scale for depression among demented and mild cognitively impaired elderly patients. Methods 157 Patients, aged from 65 to 92 years, in a memory clinic were divided into two groups according to scores on the Mini Mental State Examination (MMSE): Demented group (62 patients) with MMSE scores from 16 to 23, and Mild Cognitively Impaired group (MCI-95 patients) with MMSE scores from 24 to 29. Subjects were diagnosed for depression according to DSM-IV criteria, using Hamilton Depression Rating Scale (HDRS) and a comprehensive clinical evaluation. All were administered a Visual Analogue Scale (VAS) for depression. Results In the demented group, 25 subjects were diagnosed as depressive. In the MCI group, 46 subjects were diagnosed as depressive. Mean VAS scores for the demented and MCI groups were similar, both for depressive and non-depressive patients. Correlations between VAS scores with HDRS scores and with the clinical diagnosis were high, although somewhat lower for the demented group. Analyzing data with ROC curve technique yielded significantly different ROC curves. Optimal cutoff point for the demented group was VAS value of 60, and 50 for the MCI group. Conclusions VAS seems to be a useful tool for evaluation of depression among cognitively impaired patients. Severity of cognitive decline in the elderly may influence the cutoff points on VAS for detecting depression. Further large-scale studies are needed to substantiate our observation. Copyright (C) 2004 John Wiley Sons, Ltd.