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- David Dubin
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Posts in category LENS Treated Disorders
Is their A Relationship Between Depression and Dementia?
A study by neuropsychiatric researchers at Rush University looked at and dementia and depression. The study is in the July 30, 2014, online issue of Neurology®, the journal of the American Academy of Neurology.
Up until now studies have shown that people with depression are more likely to develop dementia, but it hasn’t been clear how the relationship works. Do both problems develop from the same underlying problems in the brain? Or does the relationship of depression with dementia have nothing to do with dementia-related pathology? This would suggest depression truly is a risk factor for dementia, and that if we can treat depression and causes of stress there may be the potential to help people maintain their thinking and memory.
The study involved 1,764 people. Participants were screened every year for 8 years for symptoms of depression, such as loneliness. A total of 680 people died during the study. Autopsies were performed on 582 of them to look for the plaques and tangles in the brain that are the signs of dementia along with any other brain damage.
Nine hundred twenty two (922) people, or 52 percent of the participants, developed the mild problems with memory and thinking that is often a precursor to Alzheimer's. A total of 315 people, or 18 percent, developed dementia.
However, the researchers found no relationship between how much damage was found in the brain and the level of depression people had. There was also no relationship in the change in depression over time. In other words, overt damage in the brain is not directly related to the level of depression.
People who developed mild cognitive impairment were no more likely to have any change in depression than people without MCI. People with dementia were more likely to have a higher level of depression before the dementia started, but they had a more rapid decrease in depression after dementia developed. In other words, depression was an independent risk factor for dementia, but once dementia started there was a better improvement in that depression.
Having a higher level of depression was associated with more rapid decline in thinking and memory skills, accounting for 4.4 percent of the difference in decline that could not be correlated to the level of damage in the brain.
As is usual with the brain, things are more complex than they initially seem to be.
How is it that Lamotrigine, an antiepileptic, can help depression, a seemingly different disorder altogether? And why can Prozac, an antidepressant, help reduce anxiety? Or an antipsychotic for schizophrenia help depression? In other words, how is it that drugs for one type of major psychiatric disorder treat the symptoms of another type?
The root causes of psychiatric illnesses such as bipolar disorder, major depression, schizophrenia, autism and ADHD are far from understood. Even so for more than 125 years, clinicians have based diagnosis on groups of symptoms observed in patients. Many psychiatrists have thought for a long time now that the current categories don’t really make sense, and that new categories should be based not on symptoms but on the underlying biology.
Moving in that direction more than 300 scientists at 80 research centers in 20 countries scientists have now found that the five psychiatric disorders mentioned above share a common genetic basis. The overlap of these disorders was highest between schizophrenia and bipolar; moderate for bipolar and depression and for ADHD and depression; and low between schizophrenia and autism.
These findings still leave much of the inherited genetic contribution to the disorders unexplained. And none of this accounts for the non-inherited genetic factors that go into determining what a person is like. However, they demonstrate that science is now moving toward understanding the molecular basis of psychiatric illness, which could provide insight into the biological pathways that may predispose someone to health or disease. All this could ultimately lead to new treatments.
Genetic inheritance does not mean our fate is carved in stone, i.e. that because we are wired in a particular way genetically our fate is sealed. This is because it has become increasingly clear over the last 10 years or so that environmental factors determine which of our genes are “turned on” and which are “turned off”. In the scientific literature this is often spoken of as which genes are “expressed” and which are not. Whether your genes are turned on or turned off matters just as much as much as which genes you have.