Depression in Alzheimer’s disease: is there a temporal relationship between the onset of depression and the onset of dementia?

Abstract

Alzheimer's disease (AD) patients often present with concurrent major depression (MD). To investigate the reasons for this comorbidity, e.g. MD being a risk factor for AD, or both diagnoses having a common neurobiology, the temporal relationship between the first onset of AD and of MD during lifetime was investigated-57 out of 146 AD patients had a lifetime diagnosis of MD. The correlation between the ages at onset of MD and dementia was calculated. The incidence of MD in AD patients in several 5-year-intervals before and after the onset of AD was compared with the average incidence of MD in the present AD sample and with the expected incidence of MD in the general population. No significant correlation between the onset of AD and of MD could be found after controlling for age, gender and the Mini-Mental-State. However, the incidence of MD 5 years before and after the onset of AD significantly exceeded the expected incidences-MD is only partially related to AD. However, the increased incidence of MD within 5 years before and after the onset of dementia may indicate that a common neurobiological process causes cognitive decline and depression in a subsample of AD patients.

Depression in Patients With Mild Cognitive Impairment Increases the Risk of Developing Dementia of Alzheimer Type

“…22 It has been suggested that the increased incidence of depression in patients with AD points to a common neurobiological basis for both diseases. 23 An important finding in our work is that most patients with MCI and depression responded poorly to antidepressants and developed dementia; this may help to individualize the risk of dementia more accurately. A cohort of 112 patients with MCI was followed up for 3 years, and depression at baseline was associated with conversion to AD but not with a more rapid cognitive decline.…”

Is lower cognitive function in one spouse associated with depressive symptoms in the other spouse?

“…It is widely known that depression and dementia oftentimes co-exist (Heun, Kockler, & Ptok, 2002;Heun, Kockler, & Ptok, 2003). Depression is the most prevalent mental disorder in the U.S. population (Robins & Regier, 1991) and is the most widely studied psychiatric outcome in the caregiving literature (Clyburn, Stones, Hadjistavropoulos, & Tuokko, 2000;Yee & Schulz, 2000).…”

“…However, the deleterious effects of dementia have been well-established. Persons with dementia or Alzheimer's disease (AD) Correspondence (Heun et al, 2002;Heun et al, 2003), higher rates of disability (Schulz et al, 2002;Thomas, 2001), and a number of other behavioral disturbances (McCann, Gilley, Bienias, Beckett, & Evans, 2004). Furthermore, there is ample evidence that caregivers to individuals with cognitive impairment, specifically dementia, experience a host of deleterious outcomes (Dura, Stukenberg, & Kiecolt-Glaser, 1991;Grant et al, 2002;Moritz, Kasl, & Ostfeld, 1992;Schulz, Visintainer, & Williamson, 1990;Schulz et al, 1995).…”

Depressive Symptoms and Incident Cognitive Impairment in Cognitively Well‐Functioning Older Men and Women

“…Some authors suggest that common risk factors, particularly cerebrovascular pathology or a common underlying neurobiological process for depression and cognitive decline or dementia may explain this. [14][15][16][17][18] The vascular depression hypothesis has been invoked to explain the observed sex difference in risk of cognitive decline or dementia after depression. The limited data from a recent study 11 support the suggestion that depression in older men might reflect a form of vascular depression associated with cerebral vascular pathology or multi-infarct disease that may amplify the process of dementia or cognitive decline and accelerate the onset of dementia symptoms.…”