Depression and dementia have been linked through a variety of research paths. Some exploration has identified similarities in symptoms, especially those related to memory and cognition. This has led to theories suggesting that depression may be predictive of dementia, or even a prodrome, early symptom of dementia or Alzheimer’s (AD). Evidence pertaining to depression has shown that age of onset is a significant indicator of condition course, symptom trajectory and overall outcome.
Therefore, Kathrin Heser of the Department of Psychiatry at the University of Bonn in Germany used age of onset to look at the influence of depression, depression symptoms, and severity of symptoms on AD in a sample of 2,663 elderly individuals. Heser evaluated subjective memory and objective cognition in the participants, as well as course and manifestation of depression, every 18 months for almost five years.
She found that depression was uniquely linked to dementia and AD. Specifically, Heser discovered that the participants with very late-onset of depression, over the age of 70, who had present symptoms of depression were the most likely to develop dementia. This was exacerbated by high levels of memory impairment and worry.
However, the participants with only mid-life depression onset only had increased risk of AD dementia. The young-onset participants had no significant increased risk for AD or all-course dementia. It was only the very late-onset participants with symptoms that demonstrated clear prodromal symptoms of dementia. Heser believes that these participants could have had longer courses of depression without any periods of remission, thus increasing their subjective memory and objective cognition problems and making them more vulnerable to dementia.
In sum, these findings show that depression may be a prodromal symptom of AD and dementia rather than merely a risk factor. If this finding can be validated in future work, the clinical implications could be significant. Professionals working with the elderly, and especially those with any evident symptoms of depression, might consider putting more focus on memory and cognition issues as these could indicate early signs of dementia in this segment of the population. “Thus,” added Heser, “Very late-onset depression with persistent symptomatology that is based on worrisome subjective memory impairment in the elderly might deserve close neuropsychological monitoring.”
Heser, K., et al. (2013). Age of major depression onset, depressive symptoms, and risk for subsequent dementia: Results of the German study on ageing, cognition, and dementia in primary care patients (AgeCoDe). Psychological Medicine 43.8 (2013): 1597-610. ProQuest. Web.
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