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Depression a Risk of Dementia and Mild Cognitive Impairment

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Highlights:
  • People with depression are more likely to develop mild cognitive impairment (MCI).
  • They are also more likely to develop dementia.
  • Thus, treatments for depression may help maintain cognitive health among older MCI patients.

Depression a Risk of Dementia and Mild Cognitive Impairment

Depression and mood symptoms may put people at an increased risk of dementia, research at Boston University School of Medicine (BUSM) finds.

The study also finds that treatment of symptoms of depression may help improve or maintain cognitive functioning in some older patients diagnosed with MCI.

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Risk of dementia and cognitive impairment in depression
Individuals with mild cognitive impairment often have progressive memory and cognitive impairment, and eventually are unable to function independently with daily tasks, leading up to a diagnosis of dementia. However, not all patients get worse; some even recover fully to normal cognition.

In mild cognitive impairment, patients complain of memory and other cognitive difficulties and performance on formal neuropsychological testing is abnormal for age, but these problems do not interfere with routine independent functioning.
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Measuring neuropsychiatric symptoms such as depression, anxiety, agitation and irritability, helps to predict who will progress from normal cognition to MCI, and then who will either progress from MCI to AD dementia or revert back to normal cognition.

The research team, analyzed data from 6,763 individuals participating in longitudinal research studies at 34 Alzheimer's Disease Centers across the U.S that are currently or were previously funded by the National Institute on Aging. The data from all centers are then entered into a database at the National Alzheimer's Coordinating Center.

Research into depression, dementia, and cognitive functions
In this study, all participants were cognitively normal at the time of their first examination and were then followed from two to 12 years, with an average of five years. The participants, whose average age was 72, received annual neurologic examinations and evaluations of their memory and cognitive functioning as well as their neuropsychiatric symptoms. Study partners (e.g., significant others) also rated participants' neuropsychiatric symptoms and level of functioning.

A team of doctors finds that, at each evaluation, participants were diagnosed as either cognitively normal, MCI, or Alzheimer's disease Dementia.

Individuals with normal cognition were more likely to progress to MCI if they had more depression, anxiety and other mood symptoms and people who had progressed to MCI were more likely to progress even further to AD dementia if they had more of these neuropsychiatric symptoms.

What is remarkable was that one in every three participants who had progressed to MCI reverted back to normal cognition, and that the participants who reverted back had significantly lower neuropsychiatric symptoms and a greater reduction in depression symptoms.

To conclude, improvements in depression and mood symptoms led to a greater likelihood of cognitive improvement. Robert Stern, author of the study commented "The implication is that successfully identifying and providing effective treatment for these neuropsychiatric symptoms, including depression, may potentially improve or maintain cognitive functioning in many older adults. There are many possible explanations for these findings and further research is needed to address this important issue."

References :
    Evaluation and Treatment of Depression May Reverse Memory and Cognitive Difficulties in Older Adults with Mild Cognitive Impairment - (https://www.bumc.bu.edu/busm/2018/03/27/evaluation-and-treatment-of-depression-may-reverse-memory-and-cognitive-difficulties-in-older-adults-with-mild-cognitive-impairment/)

    Source: Medindia

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