Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, State Key Laboratory of Medical Neurobiology and Ministry of Education Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China.
Institute of Science and Technology for Brain-Inspired Intelligence, Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China.
Biol Psychiatry. 2024 Jun 1;95(11):992-1005. doi: 10.1016/j.biopsych.2023.10.008. Epub 2023 Oct 20.
Depression and Alzheimer's disease (AD) are substantial public health concerns. In the past decades, a link between the 2 disease entities has received extensive acknowledgment, yet the complex nature of this relationship demands further clarification. Some evidence indicates that midlife depression may be an AD risk factor, while a chronic course of depression in late life may be a precursor to or symptom of dementia. Recently, multiple pathophysiological mechanisms have been proposed to underlie the bidirectional relationship between depression and AD, including genetic predisposition, immune dysregulation, accumulation of AD-related biomarkers (e.g., amyloid-β and tau), and alterations in brain structure. Accordingly, numerous therapeutic approaches, such as pharmacology treatments, psychotherapy, and lifestyle interventions, have been suggested as potential means of interfering with these pathways. However, the current literature on this topic remains fragmented and lacks a comprehensive review characterizing the association between depression and AD. In this review, we aim to address these gaps by providing an overview of the co-occurrence and temporal relationship between depression and AD, as well as exploring their underlying mechanisms. We also examine the current therapeutic regimens for depression and their implications for AD management and outline key challenges facing the field.
抑郁和阿尔茨海默病(AD)是重大的公共卫生问题。在过去几十年中,人们广泛认识到这两种疾病之间存在联系,但这种关系的复杂性需要进一步澄清。一些证据表明,中年抑郁可能是 AD 的一个风险因素,而晚年持续的抑郁可能是痴呆的前兆或症状。最近,提出了多种病理生理学机制来解释抑郁和 AD 之间的双向关系,包括遗传易感性、免疫失调、AD 相关生物标志物(如淀粉样蛋白-β和 tau)的积累以及大脑结构的改变。因此,许多治疗方法,如药理学治疗、心理治疗和生活方式干预,被认为是干扰这些途径的潜在手段。然而,目前关于这一主题的文献仍然很零散,缺乏全面综述来描述抑郁和 AD 之间的关联。在这篇综述中,我们旨在通过概述抑郁和 AD 的共病和时间关系以及探索其潜在机制来解决这些差距。我们还检查了目前用于治疗抑郁的治疗方案及其对 AD 管理的影响,并概述了该领域面临的主要挑战。
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