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Timely treatment of depression could reduce the risk of dementia
Depression has long been linked to an increased risk of dementia, and now a new study provides evidence that timely treatment of depression could reduce the risk of dementia in certain groups of patients. More than 55 million people worldwide live with dementia, a debilitating neurocognitive disorder that primarily affects older adults. There is no effective treatment for dementia, but finding ways to minimize or prevent dementia would help reduce the burden of the disease. The work by Jin-Tai Yu, MD, PhD, Huashan Hospital, Shanghai Medical College, Fudan University, and Wei Cheng, PhD, Institute of Science and Technology for Brain-Inspired Intelligence,...
Timely treatment of depression could reduce the risk of dementia
Depression has long been linked to an increased risk of dementia, and now a new study provides evidence that timely treatment of depression could reduce the risk of dementia in certain groups of patients.
More than 55 million people worldwide live with dementia, a debilitating neurocognitive disorder that primarily affects older adults. There is no effective treatment for dementia, but finding ways to minimize or prevent dementia would help reduce the burden of the disease.
The study, led by Jin-Tai Yu, MD, PhD, Huashan Hospital, Shanghai Medical College, Fudan University, and Wei Cheng, PhD, Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China, appears in Biological Psychiatry, published by Elsevier.
Professor Yu and Professor Cheng used data from the UK Biobank, a population-based cohort of over 500,000 participants. The current study included more than 350,000 participants, including 46,280 participants with depression. During the course of the study, 725 of the depressed patients developed dementia.
Previous studies examining whether depression treatments such as pharmacotherapy and psychotherapy could reduce the risk of dementia have produced mixed results, leaving the question unresolved. “Older people appear to experience different patterns of depression over time,” Professor Yu said. “Therefore, intra-individual variability in symptoms may lead to differential risk of dementia as well as heterogeneity in the effectiveness of depression treatment in the context of dementia prevention.”
To address this heterogeneity, the researchers then divided participants into one of four depression trajectories: an increasing trajectory, in which mild initial symptoms steadily increase; decreasing course, starting with moderate or severe symptoms but then decreasing; chronic high course with persistent severe depressive symptoms; and chronic low course, in which mild or moderate depressive symptoms persist throughout.
As expected, the study found that depression increased the risk of dementia - by a staggering 51% compared to non-depressed participants. However, the degree of risk depended on the course of depression; Individuals with increasing, chronically high, or chronically low levels of depression were more susceptible to dementia, whereas those with decreasing levels were not at greater risk than participants without depression.
The researchers particularly wanted to know whether the increased risk of dementia could be reduced by treating depression. Overall, depressed participants who received treatment had about a 30% lower risk of dementia compared to untreated participants. When the researchers separated participants by depression trajectory, they found that those with increasing and chronic low depression trajectories saw a lower risk of dementia with treatment, while those with chronic high depression trajectories saw no benefit from treatment in terms of dementia risk.
Here too, the progression of ineffectively treated depression poses a significant medical risk.”
John Krystal, MD, Editor, Biological Psychiatry
He notes that “in this case, symptomatic depression increased the risk of dementia by 51%, while treatment was associated with a significant reduction in this risk.”
“This suggests that timely treatment of depression is needed in people with depression in late life,” Professor Cheng added. “Providing depression treatment to people with depression in advanced age could not only alleviate affective symptoms but also delay the onset of dementia.”
“The new findings also shed light on previous work,” said Professor Cheng. “The differences in the effectiveness of different depression treatments may explain the discrepancy between previous studies.”
Source:
Reference:
Yang, L., et al. (2022) Depression, depression treatments and risk of dementia: A prospective cohort study with 354,313 participants. Biological Psychiatry. doi.org/10.1016/j.biopsych.2022.08.026.
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