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Manjeet S. Bhatia
01 July 2013
This is an excellent meta analysis of 23 studies by Breno S.Diniz andhis team indicating depression as a risk factor for vascular dementia and Alzheimer's disease.The risk may be contributed directly or indirectly. Direct linkage could be that Late- life depression is a precursor for dementia (more commonly for vascular dementia)The severity of depression needs to be analysed as increase in severity of depression carries a higher risk for dementia (Chen et al, 2007). The linkage may indirect i.e.depression predisposing or leading to cardiovascular diseases (e.g.hypertension, coronary artery disease), medical disorders (e.g. diabetes mellitus, dyslipidemia)and other comorbid psychiatric disorder (alcohol dependence)(Saunderset al 1991), which may increase the risk for dementia. The contribution of drugs used in treating depression or medicaldisorders also need to be understood.It is equally true that mood disorder(usually depression) is the commonest presentation in dementia especially Alzheimer's disease. Therefore,it becomes equally important to conduct follow up studies to analyse how many patients with late-life depression at time of presentation have co morbid dementia or they develop it in the course of illness (Ownby et al, 2006).There is need to develop biological markers to differentiate pseudo-dementia (due to depression) from true dementia. These markers can also help in detecting at risk patients for dementia, especially Alzheimer's disease.This meta analysis has opened the door for studies to determine depression as a riskfactor for dementia. References:1. Chen Z, Wei L,Qin X,McCracken C, Copeland JR. Severity of depression and risk for subsequent dementia: cohort studies in China and the UK.Br J Psychiatry 2008;193:373-377.2.Saunders PA, Copeland JR, Dewey ME, Davidson IA, McWilliam C, Sharma V, Sullivan CI. Heavy drinking as a risk factor for depression and dementia in elderly men. Findings from the Liverpool longitudinal community study. Br J Psychiatry 1991; 159: 213-6.3. Ownby RL, Crocco E, Acevedo A, John V, Loewenstein D. Depression and risk for Alzheimer disease: systematic review, meta-analysis, and meta regression analysis. Arch Gen Psychiatry 2006 ; 63: 530 -8.
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Conflict of interest: None declared
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