summary
background Depression in later life is often accompanied by cognitive deficits that can mimic those of (beginning) dementia. These deficits are expected to vanish when the depression lifts, but this does not always happen.
aim To provide an overview of recent research into cognitive deficits in older patients with depression.
method The recent literature was reviewed selectively.
results The cognitive deficits of older persons with depression often persist and are not related to the severity of the symptoms, remission status or the use of antidepressants. Imaging research in clinical and epidemiological populations strongly suggests that these cognitive deficits are due to neuropathological changes of microvascular origin. Some people with depression run an increased risk of developing dementia.
conclusion The triad ‘depression-cognitive impairment-vascular disease’ may identify individuals at increased risk of dementia and is sometimes, accompanied by neurodegenerative and neuroinflammatory processes. The treatment of vascular disease in older adults with depression is therefore a promising starting-point for the selective prevention of dementia.