The Connection Between Depression and Cognitive Impairment

Kostis Pattakos
Depression and Cognitive Impairment

As our population ages, there is a growing concern about its cognitive state and how it affects its decisions and health, both physical and mental. It is a well-known fact that Mild Cognitive Impairment (MCI) often goes undiagnosed, despite its likelihood to progress to dementia and its significant impact on mental health. 

The point we’ll emphasize in this report is that both MCI and depression can affect each other and make each other spiral down into worse conditions. This is why both must be diagnosed as early as possible and kept in check. Especially now that new digital tools allow for frequent and accessible diagnosis, aiding primary care physicians in their assessments and empowering patients directly.

The Relationship Between Depression and Cognitive Impairment 

As with most conditions affecting the same part of the body, mental and cognitive health have been proven to interact with each other profoundly. Depression and cognitive impairment are two conditions that make each other worse bidirectionally if left unchecked. Following one direction, it is a well-established fact that depression can cause symptoms like lapses or loss of memory, difficulty in paying attention, and even problems with speech and language, constituting what is known in the medical community as pseudodementia.

Following the other, getting diagnosed with some form of dementia has been reported to be a cause of chronic depression. According to a study published in the NCBI, “the reported prevalence of depression in MCI patients ranged between 16.9%–55%, whereas only 11%–30% of older adults presented significant depressive symptoms”. Another study from the NCBI reported that “Individuals with MCI were twice as likely to have a recent history of depression as their normal cognition counterparts”. The underlying pattern is clear to see: Cognitive impairment can cause depression, and depression can make cognitive impairment worse.

The Impact of Depression on Cognitive Impairment

Depression not only mimics symptoms of cognitive impairment but also significantly increases the likelihood of mild cognitive impairment (MCI) progressing to dementia. This connection between depression and the progression of cognitive decline highlights the importance of addressing mental health in patients with MCI. In their comprehensive study, which involved monitoring 114 MCI patients over an average period of three years, researchers Modrego and Ferrández provided significant insights into this relationship. They reported that “patients with mild cognitive impairment and depression are at more than twice the risk of developing dementia of Alzheimer type as those without depression”. The study by Modrego and Ferrández adds to a growing body of evidence that mental health is a crucial component in the management and prognosis of cognitive impairment.

The Benefits of Early Detection

It is for the above reasons that timely detection of depression plays a pivotal role in how MCI can evolve. The key point here is that MCI is more treatable in its early stages, for two main reasons. 

For one, early treatment can mean that MCI can slow down significantly, and even halt altogether, due to treatments being more effective when they start early. Cholinesterase inhibitors such as donepezil (Aricept), rivastigmine (Exelon), galantamine (Razadyne), Memantine, and other treatments have all been proven to work better when introduced in the early stages of dementia.

Another major factor is that the patient can be more involved and aware in the treatment process; they can understand all available options regarding medicine and procedures, and they can make more informed decisions, thus having a realistic sense of control over their condition. What is also important is that they can make decisions about their lifestyle, like adjusting their diet or exercising in a targeted manner. More on the above can be found in our blog post, Why Early Detection of Alzheimer’s Disease is Crucial for Better Outcomes

Since MCI and depression work in tandem, both conditions can benefit from an increased sense of agency and an improved lifestyle. This means that the same actions described above, like better dietary choices and exercise, can do wonders for the treatment of depression, which in turn can help reduce the symptoms even further, working like a reversed vicious circle.

Considering the closely intertwined relationship between depression and cognitive impairment, healthcare providers should prioritize enhancing connections between the two disorders and their treatments. Early detection of both MCI and depression with appropriate tools, such as LANGaware’s screening tools for mental and cognitive health, can prove invaluable for millions of people’s health.

Closing Thoughts

Recognizing the importance of early detection for both MCI and depression is crucial. The next step is to ensure that patients and healthcare providers integrate screenings into routine checks to take proactive measures. Early detection of these conditions is more accessible than ever, aiming to maintain them at early stages to enhance patients’ quality of life.

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