Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, UK.
Department of Neurology, Imperial College Healthcare NHS Trust, London, UK.
J Alzheimers Dis. 2022;88(3):1179-1187. doi: 10.3233/JAD-220170.
Depression has been suggested to be a cause of reversible cognitive impairment but also a risk factor for neurodegenerative disease. Studies suggest that depression prevalence may be high in early onset dementia, particularly Alzheimer's disease, but this has not been systematically assessed in a biomarker-validated clinical dementia cohort to date.
To examine the prevalence, features, and association with amyloid pathology of lifetime depressive symptoms in a memory clinic cohort meeting appropriate use criteria for amyloid PET imaging.
We included 300 patients from a single-center memory clinic cohort that received diagnostic biomarker evaluation with amyloid PET imaging according to appropriate use criteria. History of lifetime depressive symptoms was retrospectively assessed through structured review of clinical correspondence.
One hundred forty-two (47%) patients had a history of significant depressive symptoms ('D+'). Of these, 89% had ongoing symptoms and 60% were on antidepressants at the time of presentation to our Clinic. Depressive symptoms were equally highly prevalent in the amyloid-positive and the heterogeneous group of amyloid-negative patients.
Approximately half of patients who meet appropriate use criteria for amyloid PET have a history of depressive symptoms. We suggest that depression is an important feature of both neurodegenerative and non-neurodegenerative cognitive impairment and may contribute to the diagnostic uncertainty behind referral to amyloid PET.
抑郁症被认为是导致认知障碍可逆的原因,也是神经退行性疾病的危险因素。研究表明,在早发性痴呆症(尤其是阿尔茨海默病)中,抑郁症的患病率可能很高,但迄今为止,尚未在经过生物标志物验证的临床痴呆队列中对此进行系统评估。
在符合正电子发射断层扫描(PET)成像适当使用标准的记忆诊所队列中,检查符合适当使用标准接受诊断生物标志物评估且进行正电子发射断层扫描(PET)成像的患者中,一生中出现抑郁症状的患病率、特征及其与淀粉样蛋白病理的相关性。
我们纳入了单中心记忆诊所队列中的 300 名患者,这些患者根据适当使用标准接受了诊断生物标志物评估,包括正电子发射断层扫描(PET)成像。通过对临床通讯的结构化审查,回顾性评估一生中抑郁症状的病史。
142 名(47%)患者有明显抑郁症状史(“D+”)。其中,89%有持续症状,60%在就诊时正在服用抗抑郁药。抑郁症状在淀粉样蛋白阳性和淀粉样蛋白阴性的异质患者组中同样普遍存在。
大约一半符合正电子发射断层扫描(PET)适当使用标准的患者有抑郁症状史。我们认为,抑郁症是神经退行性和非神经退行性认知障碍的重要特征,可能导致对淀粉样蛋白 PET 的诊断不确定性。