Alzheimer's, Dementia & Mental Health
Apathy and Depression Predict Progression from Mild
Cognitive Impairment to Dementia
Mayo Clinic researchers will next study if treating
neuropsychiatric symptoms in MCI can delay the onset of dementia
July 12, 2010 - A new Mayo Clinic study finds that
apathy and depression significantly predict an individual's progression
from mild cognitive impairment (MCI), a disorder of the brain that
affects nerve cells involved in thinking abilities, to dementia,
including Alzheimer's disease and Lewy body dementia.
The study was
presented at the International Conference on Alzheimer's Disease in
Honolulu on July 11, 2010.
"An important area of study is the identification
of biomarkers and clinical predictors for the progression from normal
cognition to mild cognitive impairment and mild cognitive impairment to
dementia," says Yonas E. Geda, M.D., a Mayo Clinic neuropsychiatrist and
the study's lead investigator.
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Alzheimer's, Dementia & Mental Health |
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"We knew from previous smaller studies that
neuropsychiatric symptoms like depression, apathy and agitation seem to
predict progression from mild cognitive impairment to dementia, so we
set out to look at this hypothesis in a population-based setting with a
larger sample size."
Depression and apathy are neuropsychiatric symptoms
that are often difficult to distinguish, according to Dr. Geda.
Depression causes changes in mood, thinking, physical well-being and
behavior, while apathy is loss of motivation without associated feelings
of being depressed or blue.
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About Depression and Senior Citizens
 Of
the 35 million Americans age 65 and older, about 2 million
suffer from full-blown depression. Another 5 million suffer from
less severe forms of the illness.
Everyone feels blue or sad
now and then, but these feelings don't usually last long and
pass within a couple of days. When a person has depression, it
interferes with daily life and normal functioning, and causes
pain for both the person with depression and those who care
about him or her. Doctors call this condition "depressive
disorder," or "clinical depression."
Important life changes that
happen as we get older may cause feelings of uneasiness, stress,
and sadness. For instance, the death of a loved one, moving from
work into retirement, or dealing with a serious illness can
leave people feeling sad or anxious. After a period of
adjustment, many older adults can regain their emotional
balance, but others do not and may develop depression.
Depression is a common
problem among older adults, but it is NOT a normal part of
aging. In fact, studies show that most older adults feel
satisfied with their lives, despite having more physical
ailments. However, when older adults do suffer from depression,
it may be overlooked because they may be less willing to talk
about feelings of sadness or grief, and doctors may be less
likely to suspect or spot it.
If left untreated,
depression can lead to suicide.
>>
Read more from the National Institutes of Health
Website for Seniors |
As part of the Mayo Clinic Study of Aging, Dr. Geda
and a team of Mayo Clinic researchers identified 358 individuals with
mild cognitive impairment and used a questionnaire to collect data on
depression and apathy. Then, they prospectively followed individuals to
the outcome of dementia (a median of 2.8 years). Among 87 individuals
with depression, 30 (34.5 percent) developed dementia.
Of the 271 individuals without depression, 59 (21.8
percent) developed dementia. Among 60 individuals with apathy, 22 (36.7
percent) developed dementia. Of the 298 individuals without apathy, 67
(22.5 percent) developed dementia.
After adjusting for age, gender and education, the
researchers found that the individuals with mild cognitive impairment
and depression had a 66 percent increased risk of developing dementia
than those individuals with mild cognitive impairment without
depression. Likewise, the individuals with mild cognitive impairment and
apathy had a 99 percent increased risk of developing dementia than those
individuals with mild cognitive impairment without apathy.
"These findings highlight the importance of
thoroughly evaluating newly-diagnosed patients with mild cognitive
impairment for neuropsychiatric symptoms. The next step is to conduct a
study to find out if treatment of depression or apathy in MCI may delay
the onset of dementia," says Dr. Geda.
"This delay could have a huge impact on the quality
of life for individual patients and their families, not to mention the
broad public health implications of delaying the societal and economic
burden of dementia. In fact, a previous biostatistics study from our
colleagues at Johns Hopkins indicated that delaying dementia by a mere
one year could reduce the prevalence of Alzheimer's disease by nearly
800,000 million fewer cases in 2050."
Other members of the Mayo Clinic research teams
included Rosebud Roberts, M.B., Ch.B; David Knopman, M.D.; Teresa
Christianson; V. Shane Pankratz, Ph.D.; Bradley Boeve, M.D.; Walter
Rocca, M.D.; Robert Ivnik, Ph.D.; Eric Tangalos, M.D.; and Ronald
Petersen, M.D., Ph.D.
About Mayo Clinic
For information about research and education, visit
www.mayo.edu. MayoClinic.com (www.mayoclinic.com)
is available as a resource for your general health information.
