Depression and Dementia

iStock_000068724623_MediumWhen it comes to the relationship between depression and dementia, a chicken or egg question seems to arise, Rick and I agree on PodMed this week. Who wouldn't be depressed at receiving a diagnosis of dementia?  And if one is depressed, it stands to reason that other cognitive processes might be affected.  So this study, published in the Lancet Psychiatry, followed over 3000 study participants since 1990 and took a look at the course of depression, not just a single snapshot, to try to discern the relationship. Investigators conclude that in folks with progressive and unremitting depression, there does seem to be a relationship with the development of dementia, while in those whose depression resolves or remains low such a relationship is not seen.

Admittedly, of the cohort of 3000+ people, all of whom were free of dementia at the outset, only 434 developed dementia, with the number whose depression was progressive much lower than that.  It would be compelling, of course, if the cohort had been 10 times that and the same conclusions found.  The authors speculate that depression that is unremitting and progressive may be a prodrome for dementia and if this is validated, may prove helpful in targeting people for testing potential interventions, and we agree.

Other topics this week include the most common emergency surgeries in JAMA Surgery, and management of insomnia as well as a look at long term complications of implanted defibrillators in Annals of Internal Medicine.  Until next week, y'all live well.

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