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Alzheimer's Disease Health Center

Alzheimer's Patients May Have Symptoms of Depression Years Before Diagnosis

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Dec. 9, 1999 (New York) -- Some key symptoms of depression such as lack of interest, loss of energy, and poor concentration are increased in elderly people in the years leading up to a diagnosis of Alzheimer's disease (AD), according to a report in the Dec. 10 issue of the journal Neurology. Unlike some previous reports suggesting that people who are depressed are more likely to develop AD or that people with AD become depressed by their mental deficits, the new study shows that the depressive symptoms are an early sign of AD and could be important in obtaining the diagnosis.

"Treatment for Alzheimer's disease is becoming increasingly successful, and the treatment is most likely to succeed if it's given early in the course of the disease," study author Lars Backman, PhD, states in a press release issued by the American Academy of Neurology. "Therefore, it is critically important to diagnose Alzheimer's as early as possible. Looking for these depression symptoms may be one way to identify who will develop Alzheimer's in a few years."

Backman and colleagues from the Stockholm Gerontology Research Center in Sweden examined 222 elderly individuals aged 74 years and older for presence of depressive symptoms and dementia. After 3 years, 34 individuals had received a diagnosis of AD.

Compared with nondemented individuals, those with AD were 50% more likely to have depressive symptoms. Lack of interest, in particular, was three times more common among people diagnosed with AD. There were no significant differences between the groups in most mood-related symptoms such as unhappiness or feelings of guilt, but those with AD tended to have more thoughts of death and complained more about memory problems. The groups did not differ in rates of another important depressive symptom, sleep disturbance.

An expert who reviewed the article for WebMD says the findings are interesting and fit with similar work published earlier this year showing that motivation-related depressive symptoms occurring prior to Alzheimer's are likely the result of early changes in the structure of the brain. Doctors and patients need to realize that there is a big difference between major depression occurring in an elderly person and the emergence of depressive symptoms that may be early signs of AD, says Eugene Rubin, MD, professor of psychiatry at Washington University School of Medicine in St. Louis.

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