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Gériatrie et Psychologie Neuropsychiatrie du Vieillissement

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Depression in the elderly: prodroma or risk factor for dementia? A critical review of the literature Volume 12, issue 3, Septembre 2014

Authors
Service hospitalo-universitaire de psychiatrie, Centre hospitalier de Versailles, France
* Tirés à part

A strong link between depression and dementia is now well documented in the literature. However, the nature of this relationship is much discussed. Are depression and dementia linked by comorbidity due to the frequency of both disorders in the aged? Can depression be a prodrome of dementia? Are recurrent depressive episodes a risk factor for dementia? Despite many methodological difficulties, strong arguments are developed in the litterature to support these various assumptions. It seems well established that depression can be the first symptoms of dementia, but the time between a depressive episode and the occurrence of dementia is very variable depending of authors. The highest risks to develop dementia after a depressive episode are high cultural level, depression severity, major dysexecutive syndrome and poor efficacy of antidepressant drugs. Most often, dementia following a depressive episode is dementia of the Alzheimer type. In addition, depressive episodes in adulthood seem to increase the risk of dementia occurence, but this hypothesis remains questionable. The influence of other risk factors, such as stress, depression severity and/or treatment with psychotropic drugs is just beginning to be reported in the literature. These topics are of concern for the clinician practice to develop preventive strategies in this population particularly vulnerable.