depression dementia

Is Depression an Early Sign of Dementia?

By Simon Spichak, MSc | June 17th, 2022

Dementia and depression are connected. Here's what you need to know about the relationship between the two health conditions.

More than 60 percent of people with dementia are also diagnosed with depression. In some cases, studies indicate that depression might even cause the brain to age faster. Both conditions have similar symptoms which occasionally lead to a mixed-up diagnosis. This has led many scientists and clinicians to seek to understand this connection. 

Some of the questions researchers are now asking: Does depression always occur before dementia? And if so, is it part of the disease process — an early symptom of depression? Or does it have a causative relationship with the neurodegeneration that follows? We don’t yet know the answers, but we do know there are some very complex interactions between these two diseases. 

There are a couple things we know that depression and dementia have in common: For starters, these conditions both occur at very high rates in older populations, both are complex in their origin, and neither is easy to treat. Here are a few other things we know so far:

Depression can cause cognitive impairment

When we think about the symptoms of depression, cognitive impairment hardly comes to mind. The most prominent symptoms include profound sadness, extreme fatigue and loss of joy.

But as many as three in five people diagnosed with depression will experience some form of memory loss or cognitive impairment. Depression affects working memory — the process that keeps important information handy in the short-term. It is responsible for remembering directions, names of people you’ve only just met, and also for more complex planning and thoughts.

Other effects of this cognitive impairment involve confusion, behavioral changes, and difficulty with doing everyday tasks. That sounds a bit like the early stages of dementia, doesn’t it? It is unsurprising that many people with depression are mistakenly diagnosed with dementia, while many with dementia are diagnosed with depression.

Depression is a risk factor for dementia

Many studies have found that people who are diagnosed with depression are more likely to develop dementia and experience earlier onset. Treating depression may also have a protective effect, reducing the risk of developing dementia later in life. 

But since dementia and depression occur so often, figuring out whether they’re caused by similar processes in the brain is difficult. There may be common factors that contribute to the onset of both depression and dementia. Both depression and dementia are more likely to affect women. Both also involve dysfunction in the brain’s immune system

Dementia and depression are both treatable — but to varying extents

One big difference between dementia and depression is that the latter is easier to treat. While it may take one to two years of trying different medications and therapists, many people do go into remission

On the other hand, there is currently only one disease-modifying treatment approved for Alzheimer’s — Biogen and Eisai’s drug Leqembi. Beyond the sheer question of whether it does in fact do what it was designed to do, the drug is difficult to access, not to mention expensive for people outside of clinical trials.

Speaking with a doctor and getting the right diagnosis is important for treatment. Some older adults who are diagnosed with depression could experience more cognitive impairment when treated with some, but not all, antidepressants while others have been found to lower the risk of developing dementia 

Understanding depression may help us better understand dementia

There is even overlap in clinical trials, where researchers are looking at the effectiveness of depression treatments for some symptoms of dementia. A recent analysis found that the antidepressant drug fluoxetine may show promise in improving cognitive symptoms in Alzheimer’s.

Together, depression and dementia may be two of the most challenging medical issues that we face in the coming decades. However, learning what depression and dementia have in common could help us treat depression and reduce the risk of some forms of dementia.

UPDATE: 3 March 2024, 9:36 P.M. ET. The article previously stated that Aduhelm was the only approved treatment. Since then, Leqembi has been approved by the FDA. In February 2024, Biogen took Aduhelm off the market, citing financial concerns. Although the drug did receive accelerated, conditional FDA approval for the treatment of early Alzheimer’s disease in 2021, it is no longer available to new patients. The company announced it would sunset trials in May 2024 and cease supplying the drug to current patients in November 2024.

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2 thoughts on “Is Depression an Early Sign of Dementia?

  1. This is fascinating, my husband, who has a diagnosis of Alzheimer’s disease, had periods of depression for years before he was diagnosed with dementia.
    I would love to know more about the links.
    Thank you

  2. I’ve never seen my mother depressed until this onset of dementia. She knows her good brain is failing. she cries. It is painful to my heart to watch her like this. she has had MANY struggles in her life, but this is too much for her to handle

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