There is a growing appreciation that depression may be a presenting syndrome of dementia.

This study intends to show that the presence of cognitive impairment in a depressive episode in older people may have important prognostic implications in developing dementia.

In this study a first group of 17 depressed patients with mild cognitive impairment (MMSE over 26) was compared with a second group of 18 depressed patients with mild to moderate cognitive impairment (MMSE bellow 26). The mean age for both groups was 68. The depression was measured using the MADRS scale. All the patients included were severely depressed at the inclusion. Both groups showed important improvement of the depressive episode, following the treatment with antidepressants (escitalopramum, sertralinum, venlafaxinum).

Both groups were followed for 2 years after the depression resolution.

In the first group of patients the MMSE was 26 at baseline and 26 or over at discharge.

In the second group of patients the score of MMSE had a value of minimum 17 at baseline and a maximum of 26 at discharge.

Five patients (three in the first group and two into second group) did not complete the 2 years follow up period.

Over the period of 2 years, 37% of patients from the second group developed a dementia, comparing with only 14% of the patients from the first group.

After 2 years, the patients with depression and significant cognitive impairment had twice the risk of developing dementia as those who had only depression.