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Depresión en la enfermedad de Alzheimer: ¿hay una relación temporal entre el comienzo de la depresión y el inicio de la demencia?

Published online by Cambridge University Press:  12 May 2020

Reinhard Heun
Affiliation:
Departamento de Psiquiatría de la Universidad de Bonn, Sigmund Freud Str. 25, 53105Bonn, Alemania
Martin Kockler
Affiliation:
Departamento de Psiquiatría de la Universidad de Bonn, Sigmund Freud Str. 25, 53105Bonn, Alemania
Ursula Ptok
Affiliation:
Departamento de Psiquiatría de la Universidad de Bonn, Sigmund Freud Str. 25, 53105Bonn, Alemania
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Resumen

Los pacientes con enfermedad de Alzheimer (EA) acuden a consulta a menudo por depresión mayor concurrente (DM). Para investigar las razones para esta comorbilidad, por ejemplo, que la DM sea un factor de riego para la EA o que ambos diagnósticos tengan características neurobiológicas comunes, se estudió la relación temporal entre el primer comienzo de la EA y de la DM en la vida del paciente; 57 de 146 pacientes con EA tenían un diagnóstico vital de DM. Se calculó la correlación entre las edades en el comienzo de la DM y la demencia. Se comparó la incidencia de DM en los pacientes con EA en varios intervalos de 5 años anteriores y posteriores al comienzo de la EA con la incidencia media de DM en la presente muestra de EA y con la incidencia esperada de DM en la población general. No se pudo encontrar una correlación significativa entre el comienzo de la EA y de la DM después de controlar la edad, el género y la puntuación del Mini Estado Mental. Sin embargo, la incidencia de DM los 5 años anteriores y posteriores al comienzo de la EA superó significativamente las incidencias esperadas: la DM se relaciona sólo parcialmente con la EA. Sin embargo, el aumento de incidencia de DM en los 5 años anteriores y posteriores al comienzo de la demencia puede indicar que un proceso neurobiológico común causa el declive cognitivo y la depresión en una submuestra de pacientes con EA.

Type
Artículo original
Copyright
Copyright © European Psychiatric Association 2003

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References

Bibliografía

American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 3rd ed., revised. Washington, DC: American Psychiatric Association; 1987.Google Scholar
Barkow, K, Heun, R, Üstün, TB, Gansicke, M, Maier, W, Wittchen, U. Self-reported age-at-onset of selected psychiatric diagnoses in general health care: test-retest reliability and its determinants. Acta Psychiatrica Scand 2002; 1 106:117–25.CrossRefGoogle Scholar
Boland, RJ. Depression in Alzheimer’s disease and other dementias. Curr Psychiatry Rep 2000;2:427–33.CrossRefGoogle ScholarPubMed
Buntinx, F, Kester, A, Bergers, J, Knottnerus, JA. Is depression in elderly people followed by dementia? A retrospective cohort study in general practice. Age Ageing 1996;25:231–3.CrossRefGoogle ScholarPubMed
Cummings, JL, Ross, W, Absher, J, Gornbein, J, Hadjiaghai, L. Depressive symptoms in Alzheimer disease: assessment and determinants. Alzheimer Dis Assoc Disord 1995;9:8793.CrossRefGoogle ScholarPubMed
Cummings, JL. Cognitive and behavioral heterogeneity : in Alzheimer’s disease: seeking the neurobiological basis. Neurobiol Aging 2000;21:845–61.CrossRefGoogle ScholarPubMed
Dufouil, C, Fuhrer, R, Dartigues, JF, Alperovitch, A. Longitudinal analysis of the association between depressive symptomatology and cognitive deterioration. AmJ Epidemiol 1996;144:634–41.CrossRefGoogle ScholarPubMed
Devanand, DP, Sano, M, Tang, MX, Taylor, S, Gurland, BJ, Wilder, D, Stern, Y, Mayeux, R. Depressed mood and the incidence of Alzheimer’s disease in the elderly living in the community. Arch Gen Psychiatry 1996;53:175–82.CrossRefGoogle ScholarPubMed
Eaton, W, Anthony, JC, Gallo, J, Cai, G, Tien, A, . Romanoski, A, Lyketsos, C, Chen, LS. Natural history of Diagnostic Interview Schedule/DSM-IV major depression. The Baltimore Epidemiologic Catchment Area follow-up. Arch Gen Psychiatry 1997;54:993–9.CrossRefGoogle ScholarPubMed
Fahim, S, van Duijn, CM, Baker, FM, Launer, L, Breteler, MM, Schudel, WJ, Hofman, A. A study of familial aggregation of depression, dementia and Parkinson’s disease. Eur J Epidemiol 1998;14:233–8.CrossRefGoogle ScholarPubMed
Fórstl, H, Burns, A, Luthert, P, Cairns, N, Lantos, P, Levy, R. Clinical and neuropathological correlates of depression in Alzheimer’s disease. Psychol Med 1992;22:877–84.CrossRefGoogle ScholarPubMed
Folstein, MF, Folstein, SE, McHugh, PR. Mini-mental state. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975;12:189–98.CrossRefGoogle Scholar
Geerlings, MI, Schoevers, RA, Beckman, AT, Jonker, C, Deeg, DJ, Schmand, B, Ader, HJ, Bouter, LM, Van Tilburg, W. Depression and risk of cognitive decline and Alzheimer’s disease. Results of two prospective community- based studies in The Netherlands. Br J Psychiatry 2000;176:568–75.CrossRefGoogle ScholarPubMed
Harwood, DG, Barker, WW, Ownby, RL, Bravo, M, Agüero, H, Duara, R. Depressive symptoms in Alzheimer’s disease. An examination among community-dwelling Cuban American patients. Am J Geriatr Psychiatry 2000;8:8491.CrossRefGoogle ScholarPubMed
Heun, R, Müller, H, Freyberger, HJ, Maier, W. Reliability of interview information in a family study in the elderly. Social Psychiatry Psychiatric Epidemiol 1998;33:140–4.CrossRefGoogle Scholar
Heun, R, Papassotiropoulos, A, Jessen, F, Maier, W, Breitner, JC. A family study of Alzheimer disease and early- and late-onset depression in elderly patients. Arch Gen Psychiatry 2001;58:190–6.CrossRefGoogle ScholarPubMed
Jorm, AF. Is depression a risk factor for dementia or cognitive decline? A review. Gerontology 2000;46:219–27.CrossRefGoogle ScholarPubMed
Migliorelli, R, Tesón, A, Sabe, L, Petracchi, M, Leiguarda, R, Starkstein, SE. Prevalence and correlates of dysthymia and major depression among patients with Alzheimer’s disease. AmJ Psychiatry 1995;152:3744.Google ScholarPubMed
O’Brien, J, Thomas, A, Ballard, C, Brown, A, Ferrier, N, Jaros, E, Perry, R. Cognitive impairment in depression is not associated with neuropathologic evidence of increased vascular or Alzheimer-type pathology. Biol Psychiatry 2001;49:130–6.CrossRefGoogle ScholarPubMed
Simpson, S, Baldwin, RC, Jackson, A, Burns, A, Thomas, P. Is the clinical expression of late-life depression influenced by brain changes? MRI subcortical neuroanatomical correlates of depressive symptoms. Int Psychogeriatr 2000;12:425–34.CrossRefGoogle ScholarPubMed
Steffens, DC, Plassman, BL, Helms, MJ, Welsh-Bohmer, KA, Saunders, AM, Breitner, JC. A twin study of lateonset depression and apolipoprotein E epsilon 4 as risk factors for Alzheimer’s disease. Biol Psychiatry 1997;41:851–6.CrossRefGoogle Scholar
Verhey, FR, Rozendaal, N, Ponds, RW. Dementia, awareness and depression. Int J Geriatr Psychiatry 1993;8:851–6.CrossRefGoogle Scholar
Videbech, P, Ravnkilde, B, Fiirgaard, B, Clemmensen, K, Egander, A, Rasmussen, NA, Christensen, T, Sangill, R, Rosenberg, R. Structural brain abnormalities in unselected in-patients with major depression. Acta Psychiatr Scand 2001;103:282–6.CrossRefGoogle ScholarPubMed
Wetherell, JL, Gatz, M, Johansson, B, Pedersen, NL. History of depression and other psychiatric illness as risk factors for Alzheimer disease in a twin sample. Alzheimer Dis Assoc Disord 1999;13:4752.CrossRefGoogle Scholar
Wittchen, HU. Reliability and validity studies of the WHO-Composite International Diagnostic Interview (CIDI): a critical review. J Psychiat Res 1994;28:5784.CrossRefGoogle ScholarPubMed
World Health Organisation. Composite International Diagnostic Interview. Geneva, Switzerland: División of Mental Health, World Health Organisation; 1990.Google Scholar
World Health Organization. Tenth revisión of the international classification of diseases. Chapter V (F): Mental and behavioural disorders (including disorders of psychological development). Clinical Descriptions and Diagnostic Guidelines. Geneva: WHO; 1991.Google Scholar
Zaudig, M, Mittelhammer, J, Hiller, W, Pauls, A, Thora, C, Morinigo, A, Mombour, W. SIDAM—a structured interview for the diagnosis of dementia of the Alzheimer type, multi-infarct dementia and dementias of other Etiology according to ICD-10 and DSM-III-R. Psychol Med 1991;21:225–36.CrossRefGoogle Scholar
Zubenko, GS, Moossy, J. Major depression in primary dementia. Clinical and neuropathologic correlates. Arch Neurol 1988;45:1182–6.CrossRefGoogle ScholarPubMed
Zubenko, GS, Moossy, J, Kopp, U. Neurochemical correlates of major depression in primary dementia. Arch Neurol 1990;47:209–14.CrossRefGoogle ScholarPubMed
Zweig, RM, Ross, CA, Hedreen, JC, Steele, C, Cardillo, JE, Whitehouse, PJ, Folstein, MF, Price, DL. The neuropathology of aminergic nuclei in Alzheimer’s disease. Ann Neurol 1988;24:233–42.CrossRefGoogle ScholarPubMed