Depression symptoms in cognitively healthy older adults together with brain amyloid — protein deposits which are a biological marker of Alzheimer’s disease (AD) — could trigger changes in memory and thinking over time, according to a new study published in the journal JAMA Network Open.
“Our research found that even modest levels of brain amyloid deposition can impact the relationship between depression symptoms and cognitive abilities,” said Jennifer Gatchel, M.D., Ph.D., of the Massachusetts General Hospital (MGH) Division of Geriatric Psychiatry, and lead author of the study.
“This raises the possibility that depression symptoms could be targets in clinical trials aimed at delaying the progression of Alzheimer’s disease. Further research is needed in this area”
Increasingly, Alzheimer’s research has focused on the preclinical stage, when people have biological evidence of AD but no or minimal obvious symptoms, and when interventions might have the potential to prevent future decline of older adults.
Although previous studies have shown a link between depression and cognitive deficits in older adults, the new study is among the first to reveal that this association is influenced by the presence of cortical amyloid in unimpaired older adults, even when depression symptoms are mild to moderate.
Data were collected by researchers over a seven-year period from 276 community-dwelling older adults, all participants in the landmark Harvard Aging Brain Study (HABS).
They discovered a significant link between worsening depression symptoms and declining cognition over two to seven years that was influenced by AD pathology, as measured by PET imaging of brain amyloid.
“Our findings offer evidence that in healthy older adults, depression symptoms together with brain amyloid may be associated with early changes in memory and in thinking,” Gatchel said.
“Depression symptoms themselves may be among the early changes in the preclinical stages of dementia syndromes. Just as importantly, these stages represent a clinical window of opportunity for closely monitoring at-risk individuals, and for potentially introducing interventions to prevent or slow cognitive decline.”
The team also learned from their extensive work that not all older adults with depression symptoms and cortical amyloid will experience cognitive decline. Other risk factors that could affect the link between depression and cognition include brain metabolism and volume of the hippocampus, the part of the brain associated with learning and the forming of new memories.
The authors also note that other mechanisms may be involved and need to be investigated.
“These findings underscore the fact that depression symptoms are multi-factorial and may actually work synergistically with amyloid and related processes to affect cognition over time in older adults,” Gatchel said. “This is an area we will continue to actively study.”
Source: Massachusetts General Hospital