Depressive Symptoms in Alzheimer's Disease: Natural Course and Temporal Relation to Function and Cognitive Status

Holtzer, Roee; Scarmeas, Nikolaos; Wegesin, Domonick J.; Albert, Marilyn; Brandt, Jason; Dubois, Bruno; Hadjigeorgiou, George; Stern, Yaakov

doi:10.1111/j.1532-5415.2005.00535.x

Cited by 87 publications

(106 citation statements)

References 45 publications

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“…There seems to be an increase in symptoms as cognitive performance levels drop from average to moderate and a decrease in symptoms as cognitive functioning declines to the level of poor cognitive functioning or elderly people are diagnosed with AD. This decline was also found in earlier research [8,16,23] , which investigated depressive symptoms in AD patients. The researchers suggested that depression becomes less common as dementia and cognitive decline become more severe.…”

Section: Discussionsupporting

confidence: 55%

“…In the investigation of depressive symptomatology in AD various conclusions were also drawn. Some researchers found depressive symptoms were not related to cognitive status in AD [19,20] , while other researchers found depression to be common in the early phase of AD, and then decreased over time [8,16,[21][22][23] . Overall, there does not seem to be any consensus on whether and if so, how symptoms of anxiety and depression are related to the phase of cognitive decline.…”

Section: Introductionmentioning

confidence: 99%

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Symptoms of Anxiety and Depression in the Course of Cognitive Decline

Bierman

Comijs

Jonker

et al. 2007

Dement Geriatr Cogn Disord

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Background/Aims: Anxiety and depression are common inpatients with cognitive decline and Alzheimer’s disease (AD), and recognition and treatment of these symptoms can improve their quality of life. The present study investigates anxiety and depression in different phases of cognitive decline. Methods: The sample consisted of five groups of elderly people in different phases of cognitive decline; four from a community-based sample (Longitudinal Aging Study Amsterdam), and one group of elderly people diagnosed with AD. ANOVAs were performed to investigate group differences in the severity and prevalence of anxiety and depression, and comorbid anxiety and depressive symptoms. Results: The prevalence rates of anxiety, comorbid anxiety and depressive symptoms and depressive symptoms follow a pattern of an increasing prevalence as cognitive performance declines and a decrease in the prevalence when cognitive functioning is severely impaired. AD patients report fewest anxiety symptoms. Conclusion: We found that the prevalence of anxiety symptoms, depressive symptoms and comorbid anxiety and depressive symptoms seems to increase in the early phase of cognitive decline, and decreases as cognitive functioning further declines. Elderly diagnosed with AD report less anxiety as expected, probably due to lack of insight caused by AD.

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Section: Discussionsupporting

confidence: 55%

Section: Introductionmentioning

confidence: 99%

Symptoms of Anxiety and Depression in the Course of Cognitive Decline

Bierman

Comijs

Jonker

et al. 2007

Dement Geriatr Cogn Disord

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“…First, depressive symptoms did not increase with the onset of MCI and slightly decreased after dementia onset. Although this is not consistent with prior reports of a very slight increase in depressive symptoms before dementia onset, 13,14 it is consistent with reports of stable 14 or declining 36 depressive symptoms after dementia onset and the lack of an association of cognitive level [37][38][39] and cognitive change 40 with change in depressive symptoms. Second, neither level of depressive symptoms nor change in symptoms over time was related to common neuropathologic lesions associated with cognitive decline and dementia.…”

Section: Model B)contrasting

confidence: 44%

Clinical-pathologic study of depressive symptoms and cognitive decline in old age

Kunte¹,

Wilson²,

Kronenberg³

et al. 2015

Neurology

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Objective: To clarify the relationship between depressive symptoms and the clinical and neuropathologic manifestations of dementia. Methods:In a clinical-pathologic cohort study, 1,764 older persons without cognitive impairment at enrollment completed annual clinical evaluations for a mean of 7.8 years. The evaluations included assessment of depressive symptoms (10-item Center for Epidemiological Studies Depression Scale) and cognitive function (battery of 17 performance tests). A total of 582 individuals died during follow-up and underwent a uniform neuropathologic examination to quantify b-amyloid plaques and tau tangle density in multiple brain regions and identify neocortical Lewy bodies, hippocampal sclerosis, and gross and microscopic cerebral infarcts.Results: Level of depressive symptoms slightly increased during follow-up. Incident mild cognitive impairment (52.2%) was associated with higher level of depressive symptoms before the diagnosis but not with change in symptoms after the diagnosis; incident dementia (17.9%) was associated with higher symptom level before dementia onset and with more rapid decline in symptoms after dementia onset. None of the neuropathologic markers was related to level of depressive symptoms or change in symptoms over time. In a mixed-effects model adjusted for the neuropathologic markers, higher level of depressive symptoms averaged over evaluations was associated with more rapid global cognitive decline, accounting for 4.4% of the variability in decline not attributable to the neuropathologic markers. Depressive symptoms did not modify the association of the neuropathologic markers with cognitive decline. Conclusion:In old age, depressive symptoms have an association with cognitive decline that is independent of the neuropathologic hallmarks of dementia. Late-life depressive symptoms are associated with an increased rate of cognitive decline 1,2 and risk of mild cognitive impairment (MCI) 3,4 and dementia. 1,5,6 The main hypotheses about the association, which are not mutually exclusive, are that depressive symptoms are a consequence of cognitive decline; depressive symptoms and cognitive decline are manifestations of the same underlying neuropathology; depressive symptoms alter the association of pathology with declining cognition; and depressive symptoms have an independent association with cognitive decline.

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“…Consistent with this idea, longitudinal studies of patients with AD identified in medical settings and followed longer than the present study suggest that depressive symptoms may eventually decrease in the disease. 30,31 The relation of depression to the pathologic features of AD has been difficult to establish. In a small study of persons without dementia, depression was associated with elevated cortical uptake of Pittsburgh Compound B, suggesting elevated ␤-amyloid.…”

Section: Discussionmentioning

confidence: 99%

Temporal course of depressive symptoms during the development of Alzheimer disease

Wilson¹,

Hoganson²,

Rajan³

et al. 2010

Neurology

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Objective: To characterize change in depressive symptoms before and after the onset of dementia in Alzheimer disease (AD). Method:We used data from the Chicago Health and Aging Project, a longitudinal cohort study of risk factors for AD in a geographically defined population of old people. Two subsets were analyzed. In 357 individuals who developed incident AD during the study, self-report of depressive symptoms (Center for Epidemiologic Studies Depression Scale) was obtained at 3-year intervals for a mean of 8 to 9 years. In 340 individuals who agreed to annual data collection, informant report of depressive symptoms (Hamilton Depression Rating Scale) was obtained for a mean of 3 years after a diagnosis of AD (n ϭ 107), mild cognitive impairment (n ϭ 81), or no cognitive impairment (n ϭ 152). Results:The incident AD group reported a barely perceptible increase in depressive symptoms during 6 to 7 years of observation before the diagnosis (0.04 symptoms per year) and no change during 2 to 3 years of observation after the diagnosis except for a slight decrease in positive affect. In those with annual follow-up, neither AD nor its precursor, mild cognitive impairment, was associated with change in informant report of depressive symptoms during a mean of 3 years of observation. Conclusion:

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Depressive Symptoms in Alzheimer's Disease: Natural Course and Temporal Relation to Function and Cognitive Status

Cited by 87 publications

References 45 publications

Symptoms of Anxiety and Depression in the Course of Cognitive Decline

Symptoms of Anxiety and Depression in the Course of Cognitive Decline

Clinical-pathologic study of depressive symptoms and cognitive decline in old age

Temporal course of depressive symptoms during the development of Alzheimer disease

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