Skip to main content
SpringerLink
Log in

Depression in Dementia

  • Chapter
  • First Online:
Neuropsychiatric Manifestations in Neurological Diseases

  • 56 Accesses

Abstract

We chose depression as the first BPSD to discuss, not only because of its high prevalence in people with dementia but also because of the challenges in identifying depression in these patients in a busy clinical setting. This difficulty is particularly pronounced because of the overlap of symptoms between the two conditions, the lack of standardized diagnostic criteria, and the low reliability of self-report and informant-based measures. Missing the diagnosis of depression can lead to grave consequences, given its strong association with an increased risk of suicide and the exacerbation of cognitive decline and functional impairment. Moreover, the clinical course, treatment, and prognosis differ significantly between patients with depression and those without. Despite these challenges, there are scales to assist in the assessment and diagnosis of depression in dementia. Additionally, a comprehensive and person-centered treatment approach, integrating both nonpharmacological and pharmacological interventions, can be effective in managing depression in individuals with dementia. Hence, it is crucial for clinicians to possess the necessary knowledge and skills to identify and manage depression in people with dementia.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Institutional subscriptions

References

  1. Apostolova LG, Cummings JL. Neuropsychiatric manifestations in mild cognitive impairment: a systematic review of the literature. Dement Geriatr Cogn Disord. 2008;25(2):115–26. https://doi.org/10.1159/000112509.

    Article  PubMed  Google Scholar 

  2. Panza F, Frisardi V, Capurso C, D’Introno A, Colacicco AM, Imbimbo BP, Santamato A, Vendemiale G, Seripa D, Pilotto A, Capurso A, Solfrizzi V. Late-life depression, mild cognitive impairment, and dementia: possible continuum? Am J Geriatr Psychiatry. 2010;18(2):98–116. https://doi.org/10.1097/JGP.0b013e3181b0fa13.

    Article  PubMed  Google Scholar 

  3. Monastero R, Mangialasche F, Camarda C, Ercolani S, Camarda R. A systematic review of neuropsychiatric symptoms in mild cognitive impairment. J Alzheimers Dis. 2009;18(1):11–30. https://doi.org/10.3233/JAD-2009-1120.

    Article  PubMed  Google Scholar 

  4. Edwards ER, Spira AP, Barnes DE, Yaffe K. Neuropsychiatric symptoms in mild cognitive impairment: differences by subtype and progression to dementia. Int J Geriatr Psychiatry. 2009;24(7):716–22. https://doi.org/10.1002/gps.2187.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Rosenberg PB, Mielke MM, Appleby B, Oh E, Leoutsakos JM, Lyketsos CG. Neuropsychiatric symptoms in MCI subtypes: the importance of executive dysfunction. Int J Geriatr Psychiatry. 2011;26(4):364–72. https://doi.org/10.1002/gps.2535.

    Article  PubMed  Google Scholar 

  6. Ismail Z, Elbayoumi H, Fischer CE, Hogan DB, Millikin CP, Schweizer T, Mortby ME, Smith EE, Patten SB, Fiest KM. Prevalence of depression in patients with mild cognitive impairment: a systematic review and meta-analysis. JAMA Psychiatry. 2017;74(1):58–67. https://doi.org/10.1001/jamapsychiatry.2016.3162.

    Article  PubMed  Google Scholar 

  7. Ballard C, Bannister C, Solis M, Oyebode F, Wilcock G. The prevalence, associations and symptoms of depression amongst dementia sufferers. J Affect Disord. 1996;36(3–4):135–44. https://doi.org/10.1016/0165-0327(95)00072-0.

    Article  CAS  PubMed  Google Scholar 

  8. Enache D, Winblad B, Aarsland D. Depression in dementia: epidemiology, mechanisms, and treatment. Curr Opin Psychiatry. 2011;24(6):461–72. https://doi.org/10.1097/YCO.0b013e32834bb9d4.

    Article  PubMed  Google Scholar 

  9. Weiner MF, Doody RS, Sairam R. Prevalence and incidence of major depressive disorder in Alzheimer’s disease: findings from two databases. Dement Geriatr Cogn Disord. 2002;13:8–12.

    Article  PubMed  Google Scholar 

  10. Stern Y, Tang MX, Albert MS, Brandt J, Jacobs DM, Bell K, Marder K, Sano M, Devanand D, Albert SM, Bylsma F, Tsai WY. Predicting time to nursing home care and death in individuals with Alzheimer disease. JAMA. 1997;277(10):806–12.

    Article  CAS  PubMed  Google Scholar 

  11. González-Salvador MT, Arango C, Lyketsos CG, Barba AC. The stress and psychological morbidity of the Alzheimer patient caregiver. Int J Geriatr Psychiatry. 1999;14(9):701–10.

    Article  PubMed  Google Scholar 

  12. Lee ATC, Fung AWT, Richards M, Chan WC, Chiu HFK, Lee RSY, Lam LCW. Risk of incident dementia varies with different onset and courses of depression. J Affect Disord. 2021;282:915–20. https://doi.org/10.1016/j.jad.2020.12.195. Epub 2020 Dec 30.

    Article  PubMed  Google Scholar 

  13. Alexopoulos GS. Depression in the elderly. Lancet. 2005;365(9475):1961–70.

    Article  PubMed  Google Scholar 

  14. Kok RM, Reynolds CF 3rd. Management of depression in older adults: a review. JAMA. 2017;317(20):2114–22.

    Article  CAS  PubMed  Google Scholar 

  15. Alexopoulos GS. Mechanisms and treatment of late-life depression. Transl Psychiatry. 2019;9(1):188.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Ghahremani M, Nathan S, Smith EE, McGirr A, Goodyear B, Ismail Z. Functional connectivity and mild behavioral impairment in dementia-free elderly. Alzheimers Dement (N Y). 2023;9(1):e12371. https://doi.org/10.1002/trc2.12371.

    Article  PubMed  Google Scholar 

  17. Pearson JL, Conwell Y. Suicide in late life: challenges and opportunities for research. Introduction. Int Psychogeriatr. 1995;7(2):131–6. https://doi.org/10.1017/s104161029500192x.

    Article  CAS  PubMed  Google Scholar 

  18. Li X, Xiao Z, Xiao S. Suicide among the elderly in mainland China. Psychogeriatrics. 2009;9(2):62–6. https://doi.org/10.1111/j.1479-8301.2009.00269.x.

    Article  PubMed  Google Scholar 

  19. Alexopoulos GS, Abrams RC, Young RC, Shamoian CA. Cornell scale for depression in dementia. Biol Psychiatry. 1988;23(3):271–84. https://doi.org/10.1016/0006-3223(88)90038-8.

    Article  CAS  PubMed  Google Scholar 

  20. Mourao RJ, Mansur G, Malloy-Diniz LF, Castro Costa E, Diniz BS. Depressive symptoms increase the risk of progression to dementia in subjects with mild cognitive impairment: systematic review and meta-analysis. Int J Geriatr Psychiatry. 2016;31(8):905–11. https://doi.org/10.1002/gps.4406.

    Article  PubMed  Google Scholar 

  21. Nelson JC, Delucchi K, Schneider LS. Efficacy of second generation antidepressants in late-life depression: a meta-analysis of the evidence. Am J Geriatr Psychiatry. 2008;16(7):558–67. https://doi.org/10.1097/JGP.0b013e3181693288.

    Article  PubMed  Google Scholar 

  22. Bishop MM, Fixen DR, Linnebur SA, Pearson SM. Cognitive effects of vortioxetine in older adults: a systematic review. Ther Adv Psychopharmacol. 2021;11:20451253211026796. https://doi.org/10.1177/20451253211026796.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Christensen MC, Schmidt SN, Grande I. Effectiveness of vortioxetine in patients with major depressive disorder and early-stage dementia: the MEMORY study. J Affect Disord. 2023;338:423–31. https://doi.org/10.1016/j.jad.2023.06.024.

    Article  CAS  PubMed  Google Scholar 

  24. Devanand DP, Pelton GH, D’Antonio K, Ciarleglio A, Scodes J, Andrews H, Lunsford J, Beyer JL, Petrella JR, Sneed J, Ciovacco M, Doraiswamy PM. Donepezil treatment in patients with depression and cognitive impairment on stable antidepressant treatment: a randomized controlled trial. Am J Geriatr Psychiatry. 2018;26(10):1050–60. https://doi.org/10.1016/j.jagp.2018.05.008.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Omranifard V, Shirzadi E, Samandari S, Afshar H, Maracy MR. Memantine add on to citalopram in elderly patients with depression: a double-blind placebo-controlled study. J Res Med Sci. 2014;19(6):525–30.

    CAS  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China

    Allen T. C. Lee & Linda C. W. Lam

  2. Division of Neurology, Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China

    Vincent C. T. Mok

Authors
  1. Allen T. C. Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Vincent C. T. Mok
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Linda C. W. Lam
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Allen T. C. Lee .

Editor information

Editors and Affiliations

  1. Department of Neurology, Gangneung Asan Hospital, University of Ulsan, Gangneung, Korea (Republic of)

    Jong S. Kim

Rights and permissions

Reprints and permissions

Copyright information

© 2024 The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Lee, A.T.C., Mok, V.C.T., Lam, L.C.W. (2024). Depression in Dementia. In: Kim, J.S. (eds) Neuropsychiatric Manifestations in Neurological Diseases. Springer, Singapore. https://doi.org/10.1007/978-981-97-1821-4_6

Download citation

  • DOI: https://doi.org/10.1007/978-981-97-1821-4_6

  • Published:

  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-97-1820-7

  • Online ISBN: 978-981-97-1821-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation