Depression May Set You Up
September 29th, 2014 by NHI
The symptoms of early Alzheimer’s disease tend to parallel depression; so closely, in fact, it often makes it hard for doctors to diagnose which affliction the patient has.
If it’s depression, there are multiple options for treatment, both mainstream and alternative. But if it’s Alzheimer’s … the prognosis isn’t as positive.
But there’s an additional piece to the puzzle. . .
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For years, neuroscientists and psychologists have not known how—or even if—depression affects onset of mild cognitive impairment (MCI), dementia, or Alzheimer’s disease.
Is depression a cause of Alzheimer’s disease?
Is it a risk factor? Is it a neurological marker that signals dementia is on the way?
Or is it something else entirely?
One thing is for sure: depression is all-too common in Alzheimer’s patients. And thanks to a massive analysis from Rush University, we might finally have another piece to the Alzheimer’s puzzle.
This is the data we’ve been waiting for
In the 1990s, two cohort studies of the elderly were performed: the Religious Orders Study and the Rush Memory and Aging Project.
These long-term clinical studies featured three necessary components: data on depression, cognitive decline, and post-mortem examination of brain tissue for signs of damage and disease.
The two studies provided the data scientists had been waiting for to fill in the blanks.
At the beginning of each study, the 1,764 participants were healthy, with no signs of cognitive impairment, and the majority showed no signs of depression. The average starting age was 76.6 years old.
Over nearly eight years, 52% developed MCI and 18% developed dementia.
During the study, 680 participants passed away. Autopsies were conducted on most to measure signs of Alzheimer’s disease, such as beta-amyloid plaques and tau tangles.
This is what the researchers found:
- As age increased, symptoms of depression increased slightly.
- 50% of people with mild cognitive impairment were more depressed before the MCI diagnosis.
- The 18% that developed dementia were more depressed before dementia onset, but were less depressed after dementia had set in.
- Higher levels of depression were associated with more rapid cognitive decline, regardless of how much damage was found in the deceased participant’s brain tissue.1
So what does all this mean?
“These findings are exciting because they suggest depression truly is a risk factor for dementia,” Dr. Robert Wilson, lead author of the study said. “If we can target and prevent or treat depression and causes of stress we may have the potential to help people maintain their thinking and memory abilities into old age.”
And it appears that depression isn’t necessarily a sign of Alzheimer’s, as the post-mortem autopsies suggest.
Though more research is required to reach a firm conclusion, Dr. Doug Brown, director of R&D at the Alzheimer’s Society agreed. “This interesting study suggests that depression could be a risk factor, separate from the biological processes thought to cause dementia,” he said.2
Easy, at-home treatments for depression in the elderly
If depression is indeed a warning sign of on-coming dementia, there are multiple action steps you can take to prevent it in yourself or your loved ones:
Take in some “vitamin sunshine”. Vitamin D is one of the body’s most powerful antioxidants, and exposure to sunlight increases serotonin as well. (Bright halogen lights inside help, too!)
Exercise as much as possible. Studies show exercise can be as effective as prescription antidepressants.
For people whose movement is impaired, a walk around the house or to the end of the street is an excellent start. 3 Doing something – even a tiny bit – is better than doing nothing. Don’t imagine that because you can’t do a full workout “it’s no use.”
Boost your mood with the right nutrients—and avoid inflammatory foods. Eat a “thumb size” of healthy fats per meal, while avoiding processed food and refined carbohydrates (especially white flour and sugar). These simple steps are a great start, especially for those with low appetite.4
What about antidepressants?
Antidepressants should be used only as a very last resort … if ever.
If this is news to you, consider this: One study from the University of Pennsylvania concluded that commonly prescribed sertraline (brand names Zoloft, Lustral) might not be indicated for treatment of depression in Alzheimer’s disease at all—and many of those who took it suffered severe side effects. 5
I’ll throw in a personal note here. My mother, then in a nursing home, was giving antidepressants including Paxil when she started showing signs of severe dementia. She went sharply downhill following that. We didn’t know any better and did what the doctor said.
As research continues into the important connection between depression and dementia, I’ll keep you updated.