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Depression and dementia: differentiation and comorbidity

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The relationship between cognitive impairment (CI) and depression is complicated: h\the latter can be one of the symptoms of Alzheimer’s disease or may precede the onset of CI. Depression also has cognitive symptoms that alter the clinical presentation of the disease. Patients with depressive pseudodementia experience difficulties concentrating, confusion concurrent with impaired memory and thinking, whereas the patient’s answers to certain questions often resemble the vague pseudoamnestic pattern of the impairment. Mnestic disorders occur in at least 40% of patients with depression, and if the latter is diagnosed in the patient who already has dementia, the rate of cognitive decline may be faster. The mechanisms underlying the development of CI can also affect the development of depression. When assessing the risk of dementia in depression, it is necessary to take into account the time from the onset of a major depressive episode until moderate CI appears, to carry out a detailed analysis of neuropsychological testing for Alzheimer’s disease and to use the current lifetime markers for amyloidosis and neurodegeneration. Serotonergic antidepressants and non-pharmacological cognitive behavioral and psychotherapeutic procedures play the most important role in the treatment of depression and dementia.

About the Authors

V. Yu. Lobzin
Department of Nervous System Diseases, S.M. Kirov Military Medical Academy, Ministry of Defense of Russia; Acad. S.N. Davidenkov Department of Neurology, I.I. Mechnikov North-Western State Medical University, Ministry of Health of Russia
Russian Federation

Vladimir Yuryevich Lobzin

6, Academician Lebedev St., Saint Petersburg 194044
41, Kirochnaya St., Saint Petersburg 191015 

A. Yu. Emelin
S.M. Kirov Military Medical Academy, Ministry of Defense of Russia
Russian Federation

Department of Nervous System Diseases

6, Academician Lebedev St., Saint Petersburg 194044


1. Bennett S, Thomas AJ. Depression and dementia: cause, consequence or coincidence? Maturitas. 2014;79(2):184-90. doi: 10.1016/j.maturitas.2014.05.009

2. Wiels W, Baeken C, S. Engelborghs S. Depressive symptoms in the elderly an early symptom of dementia? A systematic review. Front Pharmacol. 2020;11(34). doi: 10.3389/fphar.2020.00034

3. Perini G, Cotta Ramusino M, Sinforiani E, et al. Cognitive impairment in depression: recent advances and novel treatments. Neuropsychiatr Dis Treat. 2019;15:1249-58. Pub. 2019 May 10. doi: 10.2147/NDT.S199746

4. Srisurapanont M, Bautista D, Chen C-H, et al. Subjective memory and concentration deficits in medication-free, non-elderly Asians with major depressive disorder: prevalence and their correlates. J Affect Disord. 2015;171:105-10. doi: 10.1016/j.jad.2014.09.007

5. American Psychiatric Association Diagnostic and statistical manual of mental disorders. 5 th ed. Washington, DC; 2013.

6. MKB-10. Mezhdunarodnaya statisticheskaya klassifikatsiya bolezney i problem, svyazannykh so zdorov'yem, 10-y peresmotr [ICD-10. International Statistical Classification of Diseases and Health Problems, 10th revision]. Geneva: WHO – Moscow: Meditsina; 1995. Vol. 1. P. 315, 317, 320, 510-11 (In Russ.).

7. Milyukhina IV. Pathogenesis, clinical features, and treatments of depression in Parkinson's disease. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2019;11(2):93-9. doi: 10.14412/2074-2711-2019-2-93-99 (In Russ.).

8. Peters SK, Dunlop K, Downar J. Corticostriatal-thalamic loop circuits of the salience network: A central pathway in psychiatric disease and treatment. Front Syst Neurosci. 2016;10:104. Pub. 2016 Dec 27. doi: 10.3389/fnsys.2016.00104

9. Fettes P, Schulze L, Downar J. Cortico-striatal-thalamic loop circuits of the orbitofrontal cortex: promising therapeutic targets in psychiatric illness. Front Syst Neurosci. 2017;11:25. doi: 10.3389/fnsys.2017.00025

10. Kutlubaev MA. The role of frontal-subcortical circuits in the development of obsessive-compulsive disorders. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2016;8(2):107-12. doi: 10.14412/2074-2711-2016-2-107-112 (In Russ.).

11. Salo KI, Scharfen J, Wilden ID, et al. Confining the concept of vascular depression to late-onset depression: A meta-analysis of MRIdefined hyperintensity burden in major depressive disorder and bipolar disorder. Front Psychol. 2019;10:1241. Pub. 2019 May 31. doi: 10.3389/fpsyg.2019.01241

12. Kolpakov YaV, Yaltonskiy VM. The phenomenon of rumination in the structure of anxietydepressive experiences in young people. Meditsinskaya psikhologiya v Rossii: elektron. nauch. zhurn. 2013;3(20). Available at: (accessed 01.06.2020) (In Russ.).

13. Truyevtsev DV, Sagalakova OA. Rumination in the context of metacognition, maladaptive schemes and mental rigidity. Izvestiya AltGU. 2011;(2-2):69-73 (In Russ.).

14. Du Pont A, Rhee SH, Corley RP, et al. Rumination and psychopathology: are anger and depressive rumination differentially associated with internalizing and externalizing psychopathology? Clin Psychol Sci. 2018;6(1):18-31. doi: 10.1177/2167702617720747

15. Jacob Y, Morris LS, Huang KH, et al. Neural correlates of rumination in major depressive disorder: A brain network analysis. Neuroimage Clin. 2020;25:102142. doi: 10.1016/j.nicl.2019.102142

16. Tyuvina NA, Prokhorova SV, Maksimova TN, Verbitskaya MS. Cognitive impairments in depression and Alzheimer's disease: differential diagnosis and approaches to therapy. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2019;11(3):116-23. doi: 10.14412/2074-27112019-3-116-123 (In Russ.).

17. Yemelin AYu, Lobzin VYu, Vorob'yev SV. Kognitivnyye narusheniya: Rukovodstvo dlya vrachey [Cognitive Impairment: A Guide for Physicians]. Moscow; 2019. 416 p. (In Russ.).

18. Devanand DP, Sano M, Tang MX, et al. Depressed mood and the incidence of Alzheimer's disease in the elderly living in the community. Arch Gen Psychiatry. 1996;53(2):175-82.

19. Byers AL, Yaffe K. Depression and risk of developing dementia. Nat Rev Neurol. 2011;7(6):323-31. doi: 10.1038/nrneurol.2011.60

20. Taylor WD, McQuoid DR, Payne ME, et al. Hippocampus atrophy and the longitudinal course of late-life depression. Amer J Geriatr Psychiatry. 2013;22(12):1504-12. doi: 10.1016/j.jagp.2013.11.004

21. Bastida DJ, Puig PN, Font JD. La depresion: un predictor de demencia. Revista Espanola de Geriatria y Gerontologia: Organo Oficial de la Sociedad Espanola de Geriatria y Gerontologia. 2016;51(2):112-8. doi: 10.1016/j.regg.2015.10.008

22. Diniz BS, Butters MA, Albert SM, et al. Late-life depression and risk of vascular dementia and Alzzheimer's disease: systematic review and meta-analysis of communitybased cohort studies. Br J Psychiatry. 2013;202(5):329-35. doi: 10.1192/bjp.bp.112.118307

23. Mourao RJ, Mansur G, Malloy-Diniz LF. Depressive symptoms increase the risk of progression to dementia in subjects with mild cognitive impairment: systematic review and metaanalysis. Int J Geriatr Psychiatry. 2016;31(8):905-11. doi: 10.1002/gps.4406

24. Saczynski JS, Beiser A, Seshadri S, et al. Depressive symptoms and risk of dementia: the Framingham Heart Study. Neurology. 2010;75:35-41. doi: 10.1212/WNL.0b013e3181e62138

25. Wilson RS, Barnes LL, Mendes de Leon CF, et al. Depressive symptoms, cognitive decline, and risk of AD in older persons. Neurology. 2002;59:364-70. doi: 10.1212/WNL.59.3.364

26. Rodriguez RM, Martinez A-E, Rodriguez R. Depression as a risk factor for Alzheimer's disease: evidence and role of Nursing. Enfermeria Global. 2019;55:628-42. doi: 10.6018/eglobal.18.3.346711

27. Wise J. Depression is not a risk factor for dementia, large cohort study concludes. BMJ. 2017;357:j2409. doi: 10.1136/bmj.j2409

28. Almeida OP, Hankey GJ, Yeap BB, et al. Depression as a modifiable factor to decrease the risk of dementia. Transl Psychiatry. 2017;(7):e1117. doi: 10.1038/tp.2017.90

29. Lee HB, Lyketsos CG. Depression in Alzheimer’s disease: heterogeneity and related issues. Biol Psychiatry. 2003;54(3):353-6. doi: 10.1016/S0006-3223(03)00543-2

30. Ostroumova OD, Karavashkina EA. Combination therapy for cognitive and emotional impairments in patients with arterial hypertension. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2017;9(1):84-9. doi: 10.14412/2074-2711-2017-1-84-89 (In Russ.).

31. Asmer MS, Kirkham J, Newton H, et al. Meta-analysis of the prevalence of major depressive disorder among older adults with dementia. J Clin Psychiatry. 2018;79(5):17r11772. doi: 10.4088/JCP.17r11772

32. Kuring JK, Mathias JL, Ward L. Prevalence of depression, anxiety and PTSD in people with dementia: A systematic review and metaanalysis. Neuropsychol Rev. 2018;28:393-416. doi: 10.1007/s11065-018-9396-2

33. Olin JT, Schneider LS, Katz IR, et al. Provisional diagnostic criteria for depression of Alzheimer disease. Am J Geriatr Psychiatry. 2002;10(2):125-8. doi: 10.1097/00019442200203000-00003

34. Azimova YuE, Ishchenko KA, Rachin AP, et al. Depression and dementia: two sides of the same coin. RMZh. 2016;(24):1616-9 (In Russ.).

35. Wang YC, Tai PA, Poly TN, et al. Increased risk of dementia in patients with antidepressants: A meta-analysis of observational studies. Behav Neurol. 2018;2018:5315098. Pub. 2018 Jul 10. doi: 10.1155/2018/5315098

36. Cassano T, Calcagnini S, Carbone A, et al. Pharmacological treatment of depression in Alzheimer’s disease: A challenging task. Front Pharmacol. 2019;10:1067. doi: 10.3389/fphar.2019.01067

37. Rao V, Spiro JR, Rosenberg PB, et al. An open-label study of escitalopram (Lexapro) for the treatment of 'Depression of Alzheimer's disease' (dAD). Int J Geriatr Psychiatry. 2006;21(3):273-4. doi: 10.1002/gps.1459

38. Siddique H, Hynan LS, Weiner MF. Effect of a serotonin reuptake inhibitor on irritability, apathy, and psychotic symptoms in patients with Alzheimer's disease. J Clin Psychiatry. 2009;70(6):915-8. doi: 10.4088/JCP.08m04828

39. Su J-A, Chang CC, Wang H-M. Antidepressant treatment and mortality risk in patients with dementia and depression: a nationwide population cohort study in Taiwan. Ther Adv Chron Dis. 2019;10:1-14. doi: 10.1177/2040622319853719

40. Miliukhina IV. The use of vortioxetine for the correction of depression in Parkinson's disease: an example of clinical cases. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2019;11(3):78-82. doi: 10.14412/2074-2711-2019-3-78-82 (In Russ.).

41. Sanchez C, Asin KE, Artigas F. Vortioxetine, a novel antidepressant with multimodal activity: review of preclinical and clinical data. Pharmacol Ther. 2015;145:43-57. doi: 10.1016/j.pharmthera.2014.07.001

42. Cumbo E, Cumbo S, Torregrossa S, et al. Treatment effects of vortioxetine on cognitive functions in mild Alzheimer’s disease patients with depressive symptoms: A 12 month, openlabel, observational study. J Prev Alz Dis. 2019;3(6):192-7.

43. Emelin AYu, Litvinenko IV, Lobzin VYu. Errors in the management of patients with Alzheimer's disease: analysis of problems and ways of their solution. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2019;11(4):141-6. doi: 10.14412/2074-27112019-4-141-146 (In Russ.).

44. Burke AD, Goldfarb D, Bollam P, et al. Diagnosing and treating depression in patients with Alzheimer’s disease. Neurol Ther. 2019;8:325-50. doi: 10.1007/s40120-019-00148-5

45. Qaseem A, Wilt TJ, McLean RM, Forciea MA. Noninvasive treatments for acute, subacute, and chronic low back pain: A clinical practice guideline from the American College of Physicians. Ann Intern Med. 2017;166(7):514-30. doi: 10.7326/M16-2367

46. Mendelevich EG. Alzheimer's disease: some pharmacological and non-pharmacological approaches to correcting neuropsychiatric disorders. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2018;10(3):129-34. doi: 10.14412/2074-27112018-3-129-134 (In Russ.).

47. Parfenov VA. Management of patients with chronic nonspecific lumbar pain. Meditsinskiy sovet. 2019;(1):40-5 (In Russ.).

48. Larouche E, Hudon C, Goulet S. Mindfulness mechanisms and psychological effects for aMCI patients: A comparison with psychoeducation. Complement Ther Clin Pract. 2019;34:93-104. doi: 10.1016/j.ctcp.2018.11.008

49. Woods B, O'Philbin L, Farrell EM, et al. Reminiscence therapy for dementia. Cochrane Database Syst Rev. 2018;(3):CD001120. doi: 10.1002/14651858.CD001120.pub3

For citation:

Lobzin V.Yu., Emelin A.Yu. Depression and dementia: differentiation and comorbidity. Neurology, Neuropsychiatry, Psychosomatics. 2020;12(4):100-106. (In Russ.)

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