Patient predictors of response to treatment of depression in Alzheimer's disease: The DIADS study

Objective: To investigate patient predictors of response to treatment of Major Depressive Episode (MDE) in Alzheimer's disease (AD). Methods: Forty-four outpatients with AD and MDE were randomized to receive either sertraline or placebo in a 12-week placebo-controlled, flexible-dose clinical trial after a one week single-blind placebo phase. All participants were evaluated for depression at entry using the 21-item Hamilton Depression Rating Scale (HDRS) and the Cornell Scale for Depression in Dementia (CSDD). All subjects completed baseline neuropsychological testing. Caregiver burden and depression were also measured. The forty-two subjects who completed at least one post-enrollment follow-up visit were included in the analysis. Results: No baseline demographic, mood, neuropsychiatric, neuropsychological, or caregiver variable was a statistically significant predictor of response to treatment. There were trends for African-American patients (p = 0.07) and those with milder baseline agitation/aggression (p = 0.08) to respond better. Conclusion: No baseline characteristic assessed clearly predicts response to treatment of MDE in AD. A diverse population of depressed AD patients may thus respond similarly to the same treatment.