Worsening Depression in Older Adults May Be Early Indicator of Dementia

MedicalResearch.com Interview with:

Saira Saeed Mirza, MD, PhD Department of Epidemiology Erasmus MC, Rotterdam

Dr. Saira Saeed Mirza

Saira Saeed Mirza, MD, PhD
Department of Epidemiology
Erasmus MC, Rotterdam

MedicalResearch.com: What is the background for this study? What are the main findings?

Dr. Mirza: Depressive symptoms appearing in late-life have been extensively studied for their relationship with dementia. They not only very frequently occur in demented patients, but also predict dementia. In this context, depressive symptoms have largely been assessed at a single time point only. However, depression is a disorder which remits and relapses, and symptoms do not remain same over the years. Given this pattern of disease progression, it is more important to study the course of depression over time in relation to long-term health outcomes such as dementia, rather than assessing it at a single time-point, which will neglect the course of depression. This is important as people follow different courses of depression, and different courses of depression might carry different risks of dementia.

When we studied the course of depressive symptoms over 11 years in community dwelling older adults in Rotterdam, and the subsequent risks of dementia, we observed that only those who had increasing or worsening depressive symptoms were at a higher risk of dementia. In this group of people, about one in five persons developed dementia. Interestingly, people suffering from high depressive symptoms at a single time point were not at a higher dementia risk than those without depressive symptoms.

MedicalResearch.com: What should clinicians and patients take away from your report?

Dr. Mirza: Low depressive symptoms or symptoms that fluctuate overtime may not have a lasting influence on health and may not be a sign of underlying pathological changes related to dementia, but worsening symptoms of depression in older adults may be an early indicator of dementia and require attention.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Dr. Mirza: We are still in process to investigate and learn about the pathology of dementia, and possible links between depression and dementia. On one hand, they could be two disorders or manifestations of a common underlying cause, whereas on the other hand, depression could just be a reaction to the ongoing cognitive changes perceived by the individual. Since dementia is multifactorial, future research should examine not only biological factors such as vascular disease, inflammation, and stress related markers, but also lifestyle factors such as physical activity and social networking as potential risk factors of dementia and possible links between depression and dementia. 

MedicalResearch.com: Is there anything else you would like to add?

Dr. Mirza: Increasing depressive symptoms might be an early marker of dementia. Importantly, these symptoms of depression might not reach the threshold of clinically diagnosed depression, but are still of clinical relevance and concern. Older individuals with worsening depressive symptoms should seek help as early as possible, as it might provide a window of opportunity for early intervention and to slow the progression of disease.

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.


10-year trajectories of depressive symptoms and risk of dementia: a population-based study

Mirza, Saira Saeed et al.
The Lancet Psychiatry , Volume 0 , Issue 0 ,
DOI: http://dx.doi.org/10.1016/S2215-0366(16)00097-3
Published Online:29 April 2016

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Last Updated on May 3, 2016 by Marie Benz MD FAAD