Depressive symptoms in neurodegenerative diseases

Abstract

Depressive symptoms are very common in chronic conditions. This is true so for neurodegenerative diseases. A number of patients with cognitive decline and dementia due to Alzheimer’s disease and related conditions like Parkinson’s disease, Lewy body disease, vascular dementia, frontotemporal degeneration amongst other entities, experience depressive symptoms in greater or lesser grade at some point during the course of the illness. Depressive symptoms have a particular significance in neurological disorders, specially in neurodegenerative diseases, because brain, mind, behavior and mood relationship. A number of patients may develop depressive symptoms in early stages of the neurologic disease, occurring without clear presence of cognitive decline with only mild cognitive deterioration. Classically, depression constitutes a reliable diagnostic challenge in this setting. However, actually we can recognize and evaluate depressive, cognitive or motor symptoms of neurodegenerative disease in order to establish their clinical significance and to plan some therapeutic strategies. Depressive symptoms can appear also lately, when the neurodegenerative disease is fully developed. The presence of depression and other neuropsychiatric symptoms have a negative impact on the quality-of-life of patients and caregivers. Besides, patients with depressive symptoms also tend to further decrease function and reduce cognitive abilities and also uses to present more affected clinical status, compared with patients without depression. Depressive symptoms are treatable. Early detection of depressive symptoms is very important in patients with neurodegenerative disorders, in order to initiate the most adequate treatment. We review in this paper the main neurodegenerative diseases, focusing in depressive symptoms of each other entities and current recommendations of management and treatment.

Keywords: Neurodegenerative diseases; Alzheimer; Depressive symptoms; Frontotemporal degeneration; Vascular dementia; Lewy body disease; Depression; Dementia

Core tip: Neurodegenerative diseases commonly associate depressive symptoms. Depressive symptoms of neurodegeneration occur both in the beginning and in the main course of neurodegenerative diseases. They can dominate the clinical picture mostly in the first stage of disease. Besides, depressive symptoms decrease quality of life of patient and relatives in every stage of disease. This is certainly an usual condition in Alzheimer’s disease, by far the main cause of dementia worldwide. Such a situation often happens in neurodegenerative diseases. Depressive symptoms are treatable and its treatment can improve perceived health status and welfare of patients and relatives.