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. 2020 Jan-Mar;14(1):1-6.
doi: 10.1590/1980-57642020dn14-010001.

Depressive disorders in the elderly and dementia: An update

Natália S Dias  1 , Izabela G Barbosa  1   2 , Weihong Kuang  3 , Antonio L Teixeira  1   4   5
Affiliations

Depressive disorders in the elderly and dementia: An update

Natália S Dias et al. Dement Neuropsychol. 2020 Jan-Mar.

Abstract
in English, Portuguese

The relationship between depressive disorders in the elderly and dementia, particularly Alzheimer's disease (AD), is highly complex. While the nature of this relationship is still a matter of debate, differential diagnosis and treatment remain a great clinical challenge. We review recent findings on the conundrum of depressive disorders in the elderly and AD. There is a biological continuum between depressive disorders in the elderly - or at least a subgroup of them - and AD. While elderly subjects with depression and patients with AD exhibit higher circulating levels of pro-inflammatory molecules and lower BDNF than matched controls, CSF levels of Aβ42 can discriminate AD from depressive disorders in the elderly. The role of antidepressant treatment as a strategy to minimize the risk of AD remains to be established.

A relação entre transtornos depressivos em idosos e demência, particularmente a doença de Alzheimer (DA), é altamente complexa. Embora a natureza desse relacionamento ainda seja motivo de debate, o diagnóstico e o tratamento diferenciais continuam sendo um grande desafio clínico. Revisamos descobertas recentes sobre o dilema de transtornos depressivos em idosos e DA. Existe um contínuo biológico entre os transtornos depressivos em idosos – ou pelo menos um subgrupo deles – e a DA. Enquanto indivíduos idosos com depressão e pacientes com DA exibem níveis circulantes mais altos de moléculas pró-inflamatórias e menor BDNF do que os controles correspondentes, os níveis de Aβ42 no LCR podem discriminar a DA de distúrbios depressivos em idosos. O papel do tratamento antidepressivo como estratégia para minimizar o risco de DA ainda precisa ser estabelecido.

Keywords: Alzheimer’s disease; dementia; depression; differential diagnosis; therapeutics.

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Conflict of interest statement

Disclosure: The authors report no conflicts of interest.

Figures

Figure 1
Figure 1. The complex interplay of biomarkers in the depressive disorders – Alzheimer’s disease continuum.
See this image and copyright information in PMC

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