Why Do Conventional Antidepressants Fail in Alzheimer's Patients?

Depression in Alzheimer's patients has different risk factors than depression in older persons without the condition, with potential implications for treatment.

Highlights:

Depression is common in people with Alzheimer's disease, but conventional antidepressants are often ineffective in treating it
A new study by the University of Bristol found that risk factors for depression in Alzheimer's patients are different from those in older adults without the condition
This suggests that depression in Alzheimer's may have a different underlying mechanism and that novel therapeutic targets may be needed to treat it effectively

Depression in Alzheimer's patients has different risk factors than depression in older persons without the condition, suggests a large new study published in the Journal of Alzheimer's Disease. The study, sponsored by the University of Bristol, examined almost 2,000 patients with Alzheimer's to determine why conventional antidepressants are useless for those living with depression in Alzheimer's.

Risk Factors for Alzheimers Disease
Cognitively normal adults exhibiting atrophy of their temporal lobe or damage to blood vessels in the brain are more likely to develop Alzheimer’s disease.

‘Depression in Alzheimer's patients has different risk factors than depression in older adults without the condition, revealing a need for alternative treatment approaches. Let's increase awareness and support those affected by this double blow.’

Depression in Alzheimer's Patients: A Unique Challenge for Treatment

Depression is widespread in dementia, affecting up to 16% of those with Alzheimer's disease, but it is unknown why it is more prevalent in those with Alzheimer's than in older adults without dementia. People with dementia-related depression appear to have different symptomatology, with fewer signs of appetite loss and beliefs that life isn't worth living. Antidepressants that are now accessible are ineffective, making depression difficult to treat.

Alzheimer's disease is a physical brain disease that affects 900,000 individuals in the UK, according to the Alzheimer's Society, which co-funded the research.

To find potential novel therapeutic targets, researchers from Bristol's Dementia Research Group [2] wanted to see if risk variables are known to raise the likelihood of depression in persons without dementia and also increased the chance of depression in those with Alzheimer's.

The team analyzed depression ratings on 2,112 Alzheimer's patients and compared them to data from 1,380 participants with normal cognition using data from three major dementia-focused cohorts.''

Diseases Related to Old Age
Ageing is referred to the accumulation of changes that brings a person closer to death.

Study Finds Different Risk Factors for Depression in Alzheimer's Patients

Their findings indicate that risk variables for depression in Alzheimer's appear to differ from those for depression, implying a separate pathological mechanism, even though a family or past history of depression was the strongest individual risk factor, implying a probable hereditary predisposition. People with Alzheimer's who were depressed were more likely to acquire apathy and other non-memory signs of the disease than those who were not depressed.

"The incidence of depression is increased in those with Alzheimer's compared to older people without dementia," said Dr Lindsey Sinclair [3], the study's lead author and a Clinical Research Fellow at the University of Bristol's Dementia Research Group. "It is extremely distressing for patients and may make caring for them more difficult."

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Understanding the Link between Depression and Alzheimer's Disease is the Key to Better Treatment

It is critical to try to understand what changes occur in the brains of people with Alzheimer's disease who also have depression, as this may help us find potential new therapy targets.

"Our findings indicate that depression in Alzheimer's disease appears to have different risk factors than depression in people who do not have dementia."

This lends credence to prior hypotheses that depression in Alzheimer's may have a different underlying etiology than depression in those who do not have dementia, and may explain why antidepressants are ineffective in treating it."

"Depression has a detrimental influence on your day-to-day life, and if you have Alzheimer's, it may be a double blow," said Dr Richard Oakley, Associate Director of Research at the Alzheimer's Society, which co-funded the study.

"We know that persons with Alzheimer's disease have higher rates of depression than healthy adults, but we don't know why." According to this study, there could be several reasons why someone with Alzheimer's disease develops depression.

"This may explain why antidepressants are less successful for those with both depression and Alzheimer's disease, and we may need to reconsider how we treat it."

"More research is needed to understand the link between the two disorders so that we can better treat and help those who are suffering from mental illness."

"If you or someone you care about is suffering from depression in addition to dementia, please see your doctor or contact the Alzheimer's Society."

Source-Medindia

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