Treatment of depression will keep the mind
It has long been clear that depression is associated with an increased risk of dementia. A new study provides evidence that timely treatment of depression can reduce the risk of developing dementia (in certain groups of patients).
There are more than 55 million people living with dementia worldwide. This is a severe neurocognitive disorder, mainly affects the elderly. There is no effective treatment for dementia; it is important to find methods to slow its development and minimize its manifestations.
Probably, the work carried out by Chinese scientists will help in this: about important observations — in an article published in the journal Biological Psychiatry (Yang et al., Depression, Depression Treatments, and Risk of Incident Dementia: A Prospective Cohort Study of 354,313 Participants), — report Professor Jin-Tai Yu (Jin-Tai Yu), Professor Wei Cheng and their colleagues.
Professor Yu and Professor Cheng used data from the UK Biobank, a long—term (launched in 2006 and designed for more than 30 years of observations) project that studies the health dynamics of 500,000 volunteers. Information on more than 350,000 people is involved, including 46,280 people with depression. Over time, 725 of these depressed patients developed dementia.
Previous studies examining whether depression treatments (medications and psychotherapy) can reduce the risk of dementia have yielded mixed results.
"Older people seem to experience various forms of depression over time," says Professor Yu. "Thus, individual variability of symptoms can lead to a different risk of developing dementia, as well as to heterogeneity in the effectiveness of depression treatment in relation to the prevention of dementia."
To eliminate this heterogeneity, the researchers divided the participants into four groups according to the course of their depression:
- an increasing course in which mild initial symptoms steadily become heavier;
- a decreasing course that begins with symptoms of moderate or high severity, but subsequently demonstrates a decrease in the severity of manifestations;
- chronically high level of persistent severe depressive symptoms;
- chronically low, in which mild or moderate symptoms of depression persist continuously.
As expected, the study found that depression increases the risk of developing dementia — by a convincing 51% compared to participants who do not suffer from depression. However, the degree of risk seems to depend on the course of depression. Those with increasing, chronically high, or chronically low depression were more vulnerable to dementia; those with declining depression levels were not at greater risk than participants without depression.
People with depression at a late age who have received treatment for depression have a lower risk of developing dementia over time than people with untreated depression.
Most of all, it is important to know whether it is possible to reduce the increased risk of developing dementia by receiving treatment for depression. Overall, participants with depression who received treatment had a reduced risk of developing dementia by about 30% compared to participants who did not receive treatment. When the researchers divided the participants according to the course of depression, they saw that patients with an increasing and chronically low course of depression had a lower risk of developing dementia with treatment — but patients with a chronically high course do not receive any benefit from treatment in terms of risk of developing dementia.
"Ineffective treatment of depression is associated with a significant risk of developing diseases," the editor of the journal comments on the results Biological Psychiatry John Krystal. This means that elderly people with depression at a late age need timely treatment of depression, and, as Professor Cheng notes, "treatment of depression at a late age can not only weaken affective symptoms, but also delay the onset of dementia."
"Our results shed light on some of the results of previous work," Professor Cheng notes. "Differences in the effectiveness of different treatment courses for depression may explain the discrepancy in the data from previous studies."
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