With Bruce Willis’s recent revelation on Instagram that he is suffering from frontotemporal dementia. It has renewed conversation around mental health.
We try to explore a bigger facet of mental health issues which revolves around depression and dementia. The two are closely related, and a patient with depression may have an increased risk of developing dementia later in life. Studies have shown that patients who have experienced early-life depression are more than twice as likely to develop dementia later on, and those who have had severe depression or episodic or recurring depression are also at a greater risk. Long-term and severe depression may damage the brain and increase the likelihood of developing cognitive decline and dementia. Depression can lead to other lifestyle factors such as poor sleep and lack of exercise, which have also been linked to a higher risk of dementia.
“The symptoms of depression include feeling sad most of the day, having trouble with normal activities, and becoming forgetful which lasts for at least two weeks. Similarly, in dementia, patients may experience forgetfulness leading to loss of memory, hallucinations, and delusions,” says Dr. Shobha N, Consultant, Neurologist and Stroke Physician, Manipal Hospital Malleshwaram.
In India, nearly 8.8 million live with dementia. The lifetime risk of depression is quite high (around 20%) which means 1 out of 5 of us can develop depression, and that itself is a risk factor for dementia in later life.
There is a significant association between depression symptoms and the development of dementia, particularly Alzheimer’s disease. “Depressive symptoms during young adulthood were at a higher risk for developing dementia later in life. Reducing depressive symptoms during young adulthood may help reduce the risk of developing dementia later on,” says Dr. Gautami Nagabhirava, Senior Neuropsychiatrist, Kamineni Hospital, Hyderabad.
People who are diagnosed with depression in their 20s and 30s have a higher risk of developing dementia later in life. This was compared to those without a diagnosis of depression or depressive symptoms. Those who had been diagnosed with depression by general psychiatry were at an even higher risk for developing late-life dementia.
Depression coexists with cognitive decline in 10% of late life dementia patients. “Depression has the biggest impact on the development of dementia, when compared to other factors in life. Therefore, it is important to consider depression as one of many potential factors which can increase an individual’s risk for developing dementia later in life,” adds Dr Nagabhirava.
Types of Dementia
There are two main types of dementia: Alzheimer’s and vascular dementia. “Vascular dementia is more related to early-life depression, which can lead to an increased risk of Alzheimer’s dementia later on. Depression and dementia share common physiological mechanisms, with depression leading to heart attacks or brain strokes that can cause brain damage and ultimately lead to dementia,” adds Dr. Shobha N.
High levels of cortisol hormone caused by anxiety can also lead to brain damage, and inflammation caused by cytokines can impair the brain’s anti-inflammatory mechanisms, leading to dementia. Additionally, depression can lead to the formation of amyloid plaques and tangles in the brain, which contribute to dementia.
Prevention
Dementia risk can be reduced through dementia prevention, which may involve the treatment of anxiety disorders, as well as any other diagnosed mental disorder. “Bipolar disorder is one such condition that can increase a person’s chances of developing dementia later in life if it is not properly managed. Additionally, poor social support and psychosocial contributors are two modifiable risk factors that must be addressed to prevent dementia,” believes Dr Nagabhirava.
To prevent the risk of developing dementia, it is essential to treat depression effectively and regularly screen patients for memory issues. If there are any signs of forgetfulness or minimal cognitive impairment, it must be treated early through medications. “Medications such as cholinesterase inhibitors may help, along with lifestyle modifications such as exercise, a healthy diet, and maintaining social relationships. Regular follow-up and treatment of depression can help reduce the risk of developing dementia later in life, especially for female patients who are considered to be more prone to dementia,” opines Dr. Shobha N.
Low education level has also been shown to increase an individual’s risk four times. Therefore, providing educational opportunities or resources may help reduce the chances of development. There are numerous factors that contribute to the diagnosis and progression of a dementia-related disorder. Understanding these potential risks and taking preventive measures may help reduce an individual’s likelihood of developing this cognitive impairment in later life.
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