Depression in cognitive impairment

Laurel D. Pellegrino, Matthew E. Peters, Constantine G. Lyketsos, Christopher M. Marano

Research output: Contribution to journalArticlepeer-review

Abstract

Depression and cognitive disorders, including dementia and mild cognitive impairment, are common in the elderly. Depression is also a common feature of cognitive impairment although the symptoms of depression in cognitive impairment differ from depression without cognitive impairment. Pre-morbid depression approximately doubles the risk of subsequent dementia. There are two predominant, though not mutually exclusive, constructs linking pre-morbid depression to subsequent cognitive impairment: Alzheimer's pathology and the vascular depression hypothesis. When evaluating a patient with depression and cognitive impairment, it is important to obtain caregiver input and to evaluate for alternative etiologies for depressive symptoms such as delirium. We recommend a sequential approach to the treatment of depression in dementia patients: (1) a period of watchful waiting for milder symptoms, (2) psychosocial treatment program, (3) a medication trial for more severe symptoms or failure of psychosocial interventions, and (4) possible ECT for refractory symptoms.

Original languageEnglish (US)
Article number384
JournalCurrent psychiatry reports
Volume15
Issue number9
DOIs
StatePublished - Sep 2013

Keywords

  • AD
  • Alzheimer's disease
  • Dementia
  • Depression
  • ECT
  • Electroconvulsive therapy
  • Genetics
  • Geriatric disorders
  • MCI
  • Mild cognitive impairment
  • Neuroimaging
  • Neuropsychiatric symptoms
  • Neurotrophins
  • Pharmacologic treatments
  • Psychiatry

ASJC Scopus subject areas

  • Psychiatry and Mental health

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