Department of Psychiatry and Psychotherapy, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Straße 62, 50937, Cologne, Germany.
Max-Planck-Institute for Metabolism Research, Gleueler Str. 50, 50931, Cologne, Germany.
Transl Psychiatry. 2020 May 20;10(1):160. doi: 10.1038/s41398-020-0839-1.
It is broadly acknowledged that the onset of dementia in Alzheimer's disease (AD) may be modifiable by the management of risk factors. While several recent guidelines and multidomain intervention trials on prevention of cognitive decline address lifestyle factors and risk diseases, such as hypertension and diabetes, a special reference to the established risk factor of depression or depressive symptoms is systematically lacking. In this article we review epidemiological studies and biological mechanisms linking depression with AD and cognitive decline. We also emphasize the effects of antidepressive treatment on AD pathology including the molecular effects of antidepressants on neurogenesis, amyloid burden, tau pathology, and inflammation. We advocate moving depression and depressive symptoms into the focus of prevention of cognitive decline and dementia. We constitute that early treatment of depressive symptoms may impact on the disease course of AD and affect the risk of developing dementia and we propose the need for clinical trials.
人们普遍认为，通过管理风险因素，可以改变阿尔茨海默病（AD）痴呆的发病。虽然最近有几项关于预防认知能力下降的指南和多领域干预试验涉及生活方式因素和风险疾病，如高血压和糖尿病，但系统地缺乏对已确定的风险因素——抑郁或抑郁症状的特别提及。在本文中，我们回顾了将抑郁与 AD 和认知能力下降联系起来的流行病学研究和生物学机制。我们还强调了抗抑郁治疗对 AD 病理的影响，包括抗抑郁药对神经发生、淀粉样蛋白负担、tau 病理学和炎症的分子影响。我们主张将抑郁和抑郁症状纳入预防认知能力下降和痴呆的重点。我们认为早期治疗抑郁症状可能会影响 AD 的疾病进程，并影响发展为痴呆的风险，因此我们建议开展临床试验。
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