Preventing the onset of dementia and Alzheimer’s disease (AD), improving the diagnosis, and slowing the progression of these diseases remain a challenge. The aim of this study was to elucidate the association between depression and dementia/AD and to identify possible relationships between these diseases and different sociodemographic and clinical features. In this regard, a case-control study was conducted in Spain in 2018–2019. The definition of a case was: A person ≥ 65 years old with dementia and/or AD and a score of 5–7 on the Global Deterioration Scale (GDS). The sample consisted of 125 controls; among the cases, 96 had dementia and 74 had AD. The predictor variables were depression, dyslipidemia, type 2 diabetes mellitus, and hypertension. The results showed that depression, diabetes mellitus, and older age were associated with an increased likelihood of developing AD, with an Odds Ratio (OR) of 12.9 (95% confidence interval (CI): 4.3–39.9), 2.8 (95% CI: 1.1–7.1) and 1.15 (95% CI: 1.1–1.2), respectively. Those subjects with treated dyslipidemia were less likely to develop AD (OR 0.47, 95% CI: 0.22–1.1). Therefore, depression and diabetes mellitus increase the risk of dementia, whereas treated dyslipidemia has been shown to reduce this risk.
Population aging that we are currently witnessing has led to an increase in chronic age-related diseases, with dementia and depression being highlighted. Several studies establish a relationship between dementia and depression, although without defining the mechanism that links them. Some studies establish depression as a prodrome of dementia, while others consider it a risk factor for dementia. One of the events that is common between dementia and depression is the inflammatory process. In depression, an increase in inflammatory cytokines has been described, which would justify the serotonergic, noradrenergic and dopaminergic dysfunction of depression. This increase entails altering the activity of the hypothalamic-pituitary-adrenal (HPA) axis, thus linking chronic stress to depression, and the consequent weakening of the blood-brain barrier (BBB), facilitating the passage of pro-inflammatory factors. In this line, recent studies suggest that inflammation could direct the development of the pathogenesis of dementia, particularly Alzheimer's disease (AD), once the pathology has begun. In addition, sustained exposure to pro-inflammatory cytokines characteristic of aging could alter the microglial function and the expression of enzymes responsible for amyloid peptide metabolism, aggravating the pathological process. In view of the involvement of the inflammatory process in both conditions, it is necessary to investigate the events which both conditions share, such as the inflammatory process, to know the involvement of the inflammatory process in both dementia and depression, possible relationship of these 2 conditions, and consequently, to establish the clinical approach to both conditions.
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