2026-06-29T07:44:41Zhttps://docta.ucm.es/rest/oai/request
oai:docta.ucm.es:20.500.14352/1187902025-03-18T16:03:49Zcom_20.500.14352_14col_20.500.14352_15
Docta Complutense author Agüera Ortiz, Luis Fernando author García-Ramos García, María Del Rocío author Grandas Pérez, Francisco J. author López Álvarez, Jorge author Montes Rodríguez, José Manuel author Olazarán Rodríguez, Francisco Javier author Olivera Pueyo, Javier author Pelegrin Valero, Carmelo author Porta Etessam, Mariano Jesús 2025-03-14T13:45:53Z 2025-03-14T13:45:53Z 2021 Agüera-Ortiz L, García-Ramos R, Grandas Pérez FJ, López-Álvarez J, Montes Rodríguez JM, Olazarán Rodríguez FJ, et al. Depression in Alzheimer’s Disease: A Delphi Consensus on Etiology, Risk Factors, and Clinical Management. Frontiers in Psychiatry. 2021;12. 10.3389/fpsyt.2021.638651 https://hdl.handle.net/20.500.14352/118790 1664-0640 https://doi.org/10.3389/fpsyt.2021.638651 https://pubmed.ncbi.nlm.nih.gov/33716830/ Background: Alzheimer's disease (AD) and other forms of dementia are among the most common causes of disability in the elderly. Dementia is often accompanied by depression, but specific diagnostic criteria and treatment approaches are still lacking. This study aimed to gather expert opinions on dementia and depressed patient management to reduce heterogeneity in everyday practice. Methods: Prospective, multicenter, 2-round Modified Delphi survey with 53 questions regarding risk factors (11), signs and symptoms (7), diagnosis (8), and treatment (27) of depression in dementia, with a particular focus on AD. The questionnaire was completed by a panel of 37 expert physicians in neurodegenerative diseases (19 neurologists, 17 psychiatrists, and 1 geriatrician). Results: Consensus was achieved in 40 (75.5%) of the items: agreement in 33 (62.3%) and disagreement in 7 (13.2%) of them. Among the most relevant findings, depression in the elderly was considered an early sign (prodromal) and/or a dementia risk factor, so routine cognitive check-ups in depressed patients should be adopted, aided by clinical scales and information from relatives. Careful interpretation of neuropsychological assessment must be carried out in patients with depression as it can undermine cognitive outcomes. As agreed, depression in early AD is characterized by somatic symptoms and can be differentiated from apathy by the presence of sadness, depressive thoughts and early-morning awakening. In later-phases, symptoms of depression would include sleep-wake cycle reversal, aggressive behavior, and agitation. Regardless of the stage of dementia, depression would accelerate its course, whereas antidepressants would have the opposite effect. Those that improve cognitive function and/or have a dual or multimodal mode of action were preferred: Duloxetine, venlafaxine/desvenlafaxine, vortioxetine, tianeptine, and mirtazapine. Although antidepressants may be less effective than in cognitively healthy patients, neither dosage nor treatment duration should differ. Anti-dementia cholinesterase inhibitors may have a synergistic effect with antidepressants. Exercise and psychological interventions should not be applied alone before any pharmacological treatment, yet they do play a part in improving depressive symptoms in demented patients. Conclusions: This study sheds light on several unresolved clinical challenges regarding depression in dementia patients. Further studies and specific recommendations for this comorbid patient population are still needed. eng Attribution 4.0 International Depression in Alzheimer's Disease: A Delphi Consensus on Etiology, Risk Factors, and Clinical Management journal article 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URL https://docta.ucm.es/bitstreams/cb59803f-b521-4ec3-8a8f-662f41e3f1ac/download File MD5 e84beb45e2a77c5835b6d04705bbe357 1074329 application/pdf Depression_in_Alzheimer's.pdf URL https://docta.ucm.es/bitstreams/a769169a-3c1b-4925-a772-0f0d85ec2b2f/download File MD5 7290e40547cd5a4a75c2ed6343d5d0de 101428 text/plain Depression_in_Alzheimer's.pdf.txt