Depression in Cognitive Impairment

被引：0
作者：
Laurel D. Pellegrino
Matthew E. Peters
Constantine G. Lyketsos
Christopher M. Marano
机构：
[1] The Johns Hopkins University,Department of Psychiatry and Behavioral Sciences, Division of Geriatric Psychiatry and Neuropsychiatry
来源：
Current Psychiatry Reports | 2013年 / 15卷
关键词：
Dementia; Depression; Alzheimer’s disease; AD; Mild cognitive impairment; MCI; Neuropsychiatric symptoms; Genetics; Neuroimaging; Neurotrophins; Pharmacologic treatments; Electroconvulsive therapy; ECT; Geriatric disorders; Psychiatry;
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摘要：
Depression and cognitive disorders, including dementia and mild cognitive impairment, are common in the elderly. Depression is also a common feature of cognitive impairment although the symptoms of depression in cognitive impairment differ from depression without cognitive impairment. Pre-morbid depression approximately doubles the risk of subsequent dementia. There are two predominant, though not mutually exclusive, constructs linking pre-morbid depression to subsequent cognitive impairment: Alzheimer’s pathology and the vascular depression hypothesis. When evaluating a patient with depression and cognitive impairment, it is important to obtain caregiver input and to evaluate for alternative etiologies for depressive symptoms such as delirium. We recommend a sequential approach to the treatment of depression in dementia patients: (1) a period of watchful waiting for milder symptoms, (2) psychosocial treatment program, (3) a medication trial for more severe symptoms or failure of psychosocial interventions, and (4) possible ECT for refractory symptoms.
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