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Lifelong Depression May Increase Risk of Vascular Dementia, While Depression Later in Life May Signal Alzheimer's Disease

May 9, 2012

Source: Archives of General Psychiatry

Woman in Swing with Alzheimer's disease
Image courtesy of Kate Richards

Depressive symptoms that occur during middle age and later in life are associated with an increased risk of developing vascular dementia, while symptoms that only occur late in life are more likely to be the initial signs of Alzheimer's disease, according to University of California at San Francisco and Kaiser Permanente researchers.

The study, which appears in the current issue of the Archives of General Psychiatry, is the first to examine how the timing of depression is more likely to lead to either Alzheimer's disease or vascular dementia in the long term. The researchers explain that vascular dementia, the second most common type of dementia, develops when impaired blood flow to parts of the brain deprives cells of nutrients and oxygen.

"The findings have important public health implications because they raise hope that adequate treatment of depression in midlife may reduce dementia risk, particularly vascular dementia, later in life," added Rachel Whitmer, Ph.D., a research scientist at the Kaiser Permanente Northern California Division of Research and the principal investigator of the study.

UCSF and Kaiser Permanente investigators examined the association between depressive symptoms and dementia over the course of 45 years in a longitudinal study of more than 13,000 long-term members of the Kaiser Permanente Northern California integrated care delivery system. The study population consisted of members who participated in a voluntary health examination called the Multiphasic Health Checkup in San Francisco and Oakland during 1964-1973 when they were 40-55 years old.

Participants were evaluated for depressive symptoms during middle age as part of the Multiphasic Health Checkup and again in late life between 1994 and 2000. Between 2003 and 2009, 3,129 participants were diagnosed with dementia.

Though more research is needed, the findings suggest that depression that starts in late life may be an initial symptom of Alzheimer's disease, while chronic depression over the life course may reflect a long-term process of changes to blood flow in the brain associated with increased risk of vascular dementia.

Adapted from Kaiser Permanente

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