Detecting Depression in Persons Living with Mild Cognitive Impairment: A Systematic Review

Britney Wong, Zahinoor Ismail, Zahra Goodarzi
International Psychogeriatrics. 2022;34(5):453-465. doi:10.1017/S1041610222000175

Mild cognitive impairment (MCI) consists of memory or cognitive deficits that do not affect daily function. Experiencing depression with MCI is common, affecting 32% of patients with MCI. Ultimately, comorbid depression with MCI is distressing for persons with MCI, leading to a poorer quality of life than their counterparts without depression. Given the burden that patients with MCI face when experiencing cooccurring depressive symptoms, effective assessment tools are needed to ensure accurate diagnosis and subsequent management. Depressive symptoms are currently assessed clinically via several tools, but their validity is unclear. The objective of this systematic review was to determine what tools for detecting depressive symptoms are most accurate and feasible among outpatients with MCI, compared with a DSM diagnosis of depression as a gold standard. MEDLINE, EMBASE, PsycINFO and Cochrane databases were searched from inception to April 25, 2021. After removing duplicates, 8748 abstracts were screened, with 6 included for data extraction. Nine tools were identified in the literature, including the GDS-15, BASDEC, BDI-II, CSDD, SDS, CES-D, and NPI, PHQ-2, and PHQ-9. Out of these tools, the CSDD demonstrated a high sensitivity (100%) and specificity (94%). Other tools also reported high sensitivities with varying specificities (i.e. BASDEC, BDI-II, SDS, depressive domain of the NPI). Despite these findings, there was only single study evidence for which depressive tools are most valid among persons with MCI. Therefore, more research is needed to characterize the diagnostic accuracy of commonly used depressive tools among persons with MCI, to better detect and manage these symptoms.