Department of Psychiatry, Tokyo Jikei University School of Medicine, 3-25-8, Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan.
Expert Rev Neurother. 2009 Nov;9(11):1667-76. doi: 10.1586/ern.09.106.
Depression and dementia, in particular Alzheimer's disease (AD), are critically important issues in the mental health of old age. Both conditions apparently reduce quality of life and increase the impairment of activities of daily living for elderly persons. AD usually shows poor prognosis owing to progressive neuronal degeneration, while depression is basically reversible. However, depressive symptoms are common in AD and occur in approximately 20-30% of patients with AD. Epidemiological studies have shown a possible pathological association between depression and AD. Some longitudinal studies have reported that depression is a prodromal sign or might be both a prodromal symptom of AD and a risk factor. Other studies have suggested that depressive symptoms appear to coincide with or follow the onset of AD rather than precede it. However, it still remains controversial whether depressive symptoms represent a risk factor for AD, whether they are an early symptom of neurodegeneration, or whether they are a reaction to early cognitive deficits. A better understanding of the link between AD and depression might have important clinical and research implications. This review provides an overview of current knowledge regarding a relation between depression and AD and also proposes a research and clinical perspective on depression in AD.
抑郁和痴呆，尤其是阿尔茨海默病（AD），是老年心理健康中至关重要的问题。这两种情况显然都会降低老年人的生活质量，并增加日常生活活动的损伤。AD 通常由于神经元进行性退化而预后不良，而抑郁基本上是可逆的。然而，AD 患者中常见抑郁症状，约有 20-30%的 AD 患者出现抑郁症状。流行病学研究表明抑郁和 AD 之间可能存在病理性关联。一些纵向研究报告称，抑郁是 AD 的前驱症状或可能既是 AD 的前驱症状又是危险因素。其他研究表明，抑郁症状似乎与 AD 的发病同时发生或紧随其后，而不是早于其发生。然而，抑郁症状是否代表 AD 的危险因素、是否是神经退行性变的早期症状，或者是否是对早期认知缺陷的反应，仍然存在争议。更好地了解 AD 和抑郁之间的联系可能具有重要的临床和研究意义。本文综述了目前关于抑郁和 AD 之间关系的知识，并对 AD 中的抑郁提出了研究和临床观点。
