Depression and Dementia: Peering Into Pro-inflammatory Paths

Published on August 24, 2022

Imagine depression and dementia as two villains teaming up to wreak havoc on the brain. This review delves into the intricate connection between these adversaries, focusing on the links between depression and Alzheimer’s disease. It reveals that depression not only poses a growing health problem but also increases the burden on healthcare budgets. By examining the physiological pathways, the review identifies depression as a significant risk factor for cognitive decline. It uncovers the role of pro-inflammatory mediators activated by depression, which leads to cerebral small vessel disease and a subsequent reduction in cerebral blood flow. These events, known to precede cognitive decline, mirror the impact of other dementia risk factors. However, treating depression does not always guarantee positive effects on later cognitive decline. The hypothesis suggests that only specific antidepressants that attenuate inflammation can alleviate such decline. Intriguingly, this review informs us that while depression is a treatable condition, its correlation with dementia calls for further exploration into potential treatment options.

This review highlights that depression is a growing health problem for the individual, and because of its high frequency in most societies, a growing burden on health care budgets. The focus of the review is the physiological links between depression and dementia, specifically Alzheimer’s disease. It suggests that depression is a significant risk factor for cognitive decline and explores the pathways that may lead depressed individuals to suffer this outcome. This review shows that depression and a number of its precursors activate pro-inflammatory mediators. These lead to cerebral small vessel disease with the consequent reduction in cerebral blood flow, which is known to precede cognitive decline. Thus, the impact of depression on the physiological events that lead to dementia is identical to the impact of other dementia risk factors recently reviewed. Depression is distinct, however, in being a relatively treatable condition, but the impact of treating depression on later cognitive decline is not always positive, leading to the hypothesis that only the antidepressants that attenuate inflammation alleviate subsequent cognitive decline.

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