Abstract
Depression and cognitive impairment are both common conditions in old age, and frequently
occur together. However, accurate figures of the co-occurrence are not available.
The inter-relationship between the two clinical entities is still complex and not
well understood. Clearly depression can be a psychological reaction to cognitive decline,
and thus may also appear as an early symptom in dementing individuals. However, recent
data suggest that depression, and in particularly late-life depression, can also be
a risk factor for Alzheimer's disease (AD).
The relationship between the two clinical entities should be seen in view of observations
of white matter changes both in AD and in depression. Since these white matter changes
are thought to frequently reflect vascular changes, the concept of “vascular depression”
has been advanced. Vascular changes in the brain occur commonly in demented individuals
and conversely depression is frequent co-occurrence in vascular disease. Additionally
neurotransmitter loss may occur in both, particularly monoaminergic disturbances which
is characteristic of depression but may occur also in AD. The same is true for hippocampal
atrophy, which is characteristic of AD but has also been described in depression.
Here we review the complex relationships between dementia and depression and suggest
that excessive release of corticosteroids may have a neurotoxic effects.
Keywords
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Article info
Publication history
Published online: April 06, 2009
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© 2009 Published by Elsevier Inc.
