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Depression and Alzheimer's Linked

Depression Boosts Risk of Dementia, but Does Not Increase During Early Alzheimer's, Studies Show

Depression and Alzheimer's Early Stages Study

In the second study, researchers from Rush University Medical Center, Chicago, looked at participants' state of mind during the very early stages of Alzheimer's disease and whether they tended to become more depressed.

Some experts have suggested depression is not a true risk factor but a consequence of the disease. If that is true, depression would likely increase as a person develops dementia.

For up to 13 years, researchers followed 917 participants of the Religious Orders Study, which launched in 1994 and includes Catholic nuns, priests, and monks. All were free of dementia at the study start and all agreed to donate their brains for autopsy at death so researchers can discover more information about Alzheimer's disease and other problems.

They were given annual exams, including tests of memory and other cognitive skills. During the follow-up, 190 developed Alzheimer's disease. Those with more depression at the beginning were found more likely to get it. But their depression didn't increase in the early stages.

"We found absolutely no evidence that depressive symptoms increased during that period [of early Alzheimer's],'" says Robert S. Wilson, PhD, professor of neurological sciences and behavioral sciences at Rush University Medical Center, Chicago, and the lead author.

"Even though it sort of makes sense that you would get depressed when you are losing cognition, it doesn't seem to be happening."

The research, he tells WebMD, "goes against the idea that depressive symptoms are a consequence not a risk factor of Alzheimer's disease."

The study is published in the Archives of General Psychiatry.

Second Opinions and Take-Home Message

The association found between depression and Alzheimer's risk was much stronger for early-onset depression than later onset, according to other experts. The risk between late onset depression and Alzheimer's was not statistically significant.

"People who have early-onset depression were found at an increased risk of Alzheimer's disease," says Wilson, the author of the study on depression during Alzheimer's early stages. "For those with late-onset depression, the results are not as conclusive."

The most conservative thing to say is that depression is a risk factor, more prominent with younger onset but also possibly operative at later ages as well,'' says David Knopman, MD, a neurologist at Mayo Clinic, Rochester, Minn., and an associate editor of Neurology.

While more research is needed to figure out the depression-Alzheimer's link, the results do suggest some practical advice, says Kennedy.

"If depression doubles or triples your risk, you want to make sure your depression is treated as aggressively as possible," he says. Whether that means medication, psychotherapy, exercise, or other means, he says, the point is to treat the depression effectively.

While some older people think depression is a natural part of aging, it is not, Kennedy says. Aggressive treatment of the depression is recommended, he says, at any age.

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