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The Interface Between Depression and Dementia

Published online by Cambridge University Press:  15 April 2020

C. Pinto
Affiliation:
Clínica de Psiquiatria e Saúde Mental, Centro Hospitalar São João, Porto, Portugal
M. Mota Oliveira
Affiliation:
Clínica de Psiquiatria e Saúde Mental, Centro Hospitalar São João, Porto, Portugal
A.M. Ribeiro
Affiliation:
Clínica de Psiquiatria e Saúde Mental, Centro Hospitalar São João, Porto, Portugal
S. Fonseca
Affiliation:
Clínica de Psiquiatria e Saúde Mental, Centro Hospitalar São João, Porto, Portugal

Abstract

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Introduction

Depression is highly prevalent in most dementias and it is associated with significant functional and cognitive decline, chronicity and high rates of medical comorbidity and mortality. The nature of the link between depression and dementia is still unclear. Given the projected growth of the older segment of the population, a better understanding of the link between them is important, especially for possible treatment and prevention.

Objectives

To review the complex relationship between late life depression and dementia, to discuss the underlying mechanisms and implications for the diagnosis and treatment of both conditions.

Methods

Review of the relevant literature published in the Medline database

Results

There is evidence to support the notion of depression as a risk factor as well as a prodromal symptom of dementia. It also shows that both conditions show similar neurobiological changes, either indicating shared risk factors or a common pattern of neuronal damage. The likely underlying biological mechanisms include vascular disease, hippocampal atrophy, increased deposition of β-amyloid plaques and inflammatory changes. These processes are not mutually exclusive and more likely synergistic, which explains the substantial variability of findings from the literature.

Conclusions

This work highlights that strategies to promote prevention, early diagnosis and adequate treatment of depression may have a major impact in reducing the risk or delaying dementia in older adults. Additionally, more conclusive research on the underlying neurobiological pathways, may pave the way for more effective treatment of both depression and dementia.

Type
Article: 1470
Copyright
Copyright © European Psychiatric Association 2015
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