Assessment of alexithymia and cognition in elderly patients with depression

Abstract

Objectives: Depression is the most common psychiatric illness in the elderly. Alexithymia and cognitive impairment can be independently associated with depression and old age. This study aims to assess the alexithymia and cognitive dysfunction in geriatric patients with depression. Materials and Methods: A cross-sectional study was conducted on 100 participants of >60 years with depression. Participants were assessed using semi-structured pro forma, Geriatric Depression Scale (GDS), Hamilton Depression Rating Scale (HDRS), Toronto Alexithymia Scale-20 (TAS-20) having 3 subscales – “difficulty describing feeling” (DDF), “difficulty identifying feeling” (DIF), and “externally oriented thinking,” and Montreal Cognitive Assessment (MoCA). Statistical analysis was done using Chi-square/Fisher's exact test, Pearson's correlation, and t-test. Results: The mean age of the participants was 67.35 years with equal gender distribution. Thirty-four percent were >70 years of age and 53% from rural area. The median duration of depression was 30 months with a median duration of untreated illness, 6 months. Anxiety was the most common psychiatric comorbidity (43%). Seventy-one percent had alexithymia whereas 77% had cognitive impairment (MoCA score <26). Scores on GDS, HDRS, TAS-20, DIF, DDF, and MoCA (<26) were significantly higher in elder participants (P < 0.05) and those from rural area (P < 0.05). Higher TAS-20 score correlated with lower MoCA score (P < 0.01). Furthermore, severe depression correlated with higher TAS-20 and lower MoCA score. Conclusion: More than two-third of participants had alexithymia and cognitive dysfunction. Higher alexithymia was associated with poor cognition. Severe depression correlated with higher alexithymia and cognitive impairment. Alexithymia and cognitive dysfunction were higher in the elderly from rural region.