Depressive symptoms are commonly seen in Alzheimer’s disease and are difficult to successfully treat, because it is challenging to distinguish those of clinical depression and those of cognitive deterioration. Both conditions have many overlapping symptoms. According to many experts, while selective serotonin reuptake inhibitors (SSRIs) are the best option to treat depression, they appear to be less effective in those with Alzheimer’s.
A Muddy Mix
For many years, clinicians have had difficulties distinguishing the differences between clinical depression and the symptoms of dementia-related illnesses. Depressive symptoms can reflect the progression of Alzheimer’s and be a result of further neurodegenerative changes. Accuracy of an Alzheimer’s diagnosis may itself be difficult at times, let alone detangling symptoms of depression from cognitive impairment.
Why Is This Important?
Depression is not the only psychiatric condition that may accompany Alzheimer’s. Other symptoms include changes in mood, perception, anxiety and behavior. Such a combination of symptoms alongside cognitive decline can negatively impact quality of life. They can also quicken the progression of mild cognitive impairment to more severe decline.
Which Comes First? Depression or Alzheimer’s?
Research indicates that depression precedes dementia in 10% to 15% of cases. On the other hand, individuals with mild cognitive impairment are at a higher risk for developing late-life depression. Depressive symptoms can also occur in many people with mild cognitive impairment, increase the risk for developing Alzheimer’s disease as well as speed up the progression of the disease.
SSRIs: What Are They Good For?
SSRIs have shown to be generally effective in older adults who have depressive symptoms in the absence of cognitive impairment, and can be a safe alternative to other drugs. Among those with cognitive problems, selective serotonin reuptake inhibitors might be effective when prescribed early in the disease. Another benefit is that they may slow the progression of cognitive deterioration associated with Alzheimer’s disease.
Take Away
The number of people being diagnosed with neurodegenerative conditions is increasing. Depression is a common condition that occurs with many of these disorders, including Alzheimer’s disease. It is challenging to accurately diagnose depression when it presents with many cognitive disorders, so the choice of medication becomes tricky as well. While SSRIs have been largely effective for older adults without cognitive disorders, they appear to be less effective in people diagnosed with Alzheimer’s. Despite this, SSRIs may be more effective in slowing the progression of cognitive decline, changing how they will be used now and in the future.