Fade To Blank: Depression and Dementia
Written by craig
'Another reason to be depressed over depression . . .
Maybe I should stop reading research articles. At times they can really be depressing, but these latest two give just enough information to raise a personal question for me that simply can't be answered yet.
Both are from the most recent edition (volume 75, issue 1) of Neurology, a scholarly journal where the mere titles of the articles tend to fly over my head in an incomprehensible blur. (What exactly are "" anyway?) The first one, by Dr. Dotson, et al, came up with the following:
Our findings support the hypothesis that depression is a risk factor for dementia and suggest that recurrent depression is particularly pernicious. Preventing the recurrence of depression in older adults may prevent or delay the onset of dementia.
'Fair enough: the more depressed you are, the more likely you are to literally "lose" your mind. Now, if that information doesn't make you even more depressed, what will? (Unfortunately, their last sentence is still just conjecture.)
So, wouldn't it just be logical to assume that people would start to feel a little depressed if they noticed they were beginning to mentally "crumble around the edges ?" Apparently not, according to the fine folks at the Rush Alzheimer's Center who wrote article number two.
In those with annual follow-up, neither AD [Alzheimer's Disease] nor its precursor, mild cognitive impairment, was associated with change in informant report of depressive symptoms during a mean of 3 years of observation. Conclusion: Depressive symptoms show little change during the development and progression of AD to a moderate level of dementia severity.
So, how are these two seemingly conflicting findings possible? Well, it seems that whatever level of depression you have going into Alzheimer's, you keep. However, if you have more depression to begin with, you're more likely to end up with Alzheimer's. (This is the nightmare version of a self-fulfilling prophecy!)
The above findings can be explained at least three ways. In the first scenario, one might posit that depression does something to make the brain more vulnerable to dementia, specifically Alzheimer's. Or, it could be that whatever causes the dementia also causes depression as a kind of harbinger of doom. Finally, we could be looking at a combination of the two.
Now, for my (so far) unanswered question . . . Both of my parents went through dementia as they went through their 80s. Mother struggled with depression for much of her adult life. I've had the benefit of many years on a quite effective antidepressant, so there have been no major depressive problems for me in, well, many years.
Could it be that these pills become the aspirin (taken to reduce likelihood of heart problems) of the future, where we all take them to reduce the possibility of going blankly into that good night?
Or am I preordained to slowly lose those precious mental functions anyway, being one of those "lucky" few who is able to maintain the last fading wisps of a song in his heart as he sits on the floor of a musty old nursing home in his day-old diaper? The data's just not in yet and, believe me, I've been looking.
Peace.