title: Depression in Alzheimer's disease: epidemiology, mechanisms, and management.
abstract: Depression occurs with a high prevalence of up to 50% in patients with Alzheimer's disease (AD) and increases the caregivers' burden. Depression symptoms can precede clinical diagnosis of AD for years or occurs around the onset of AD, although the etiology and pathologic mechanism of depression in AD pathogenesis remain unclear. Here, we provide an overview on recent studies, indicating that genetic factors, neuroanatomic changes, vascular risk factors, and the imbalance of neurotransmitters might contribute to depressive symptoms in AD. Tau pathology and amyloid-β accumulation also correlate with depression in AD. In addition, the alteration of hypothalamic-pituitary-adrenal axis, inflammatory pathway, and neurotrophin deficiency are the possible biological mechanisms linking depression and AD, and might become the potential targets for AD treatment. Current data support that antidepressants are promising to alleviate the symptom, though the efficacy is controversial. Moreover, antidementia medication and non-pharmacological interventions can be potential choices. In this review, we describe the prevalence and clinical course of depression in AD, analyze the underlying mechanisms, and discuss the possible management strategies for depression in patients with AD.
authors.affiliation: Department of Neurology, The Affiliated Hospital of Qingdao University, Qingdao, China Department of Neurology, Qingdao Municipal Hospital, School of Medicine, Qingdao University, China.
authors.forename: Song
authors.initials: S
authors.lastname: Chi
authors.affiliation: Department of Neurology, Qingdao Municipal Hospital, School of Medicine, Qingdao University, China.
authors.forename: Jin-Tai
authors.initials: JT
authors.lastname: Yu
authors.affiliation: Department of Neurology, Qingdao Municipal Hospital, College of Medicine and Pharmaceutics, Ocean University of China, China.
authors.forename: Meng-Shan
authors.initials: MS
authors.lastname: Tan
authors.affiliation: Department of Neurology, Qingdao Municipal Hospital, School of Medicine, Qingdao University, China Department of Neurology, Qingdao Municipal Hospital, College of Medicine and Pharmaceutics, Ocean University of China, China.
authors.forename: Lan
authors.initials: L
authors.lastname: Tan
mesh_terms: D000544:Alzheimer Disease / Q000150:complications* / Q000453:epidemiology; D003863:Depression / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D019468:Disease Management; D006801:Humans; D012307:Risk Factors
keywords: Alzheimer's disease; depression; epidemiology; mechanism; therapy