It is believed that depression can be "a spark that ignites the process of dementia or just a smudge of smoke announcing the appearance of the first symptoms"? Until today, there is no consensus on which of the two events is more true.
Suspicious changes in the brain in depressed patients
The volume of the hippocampus in depressed patients decreases compared to patients who were randomized without depression. This would be the result of cortisolemia in severe depression. The hypothesis that episodes of endogenous depression may be triggers of dementia are still intensively investigated, the more so because numerous epidemiological data do not confirm it.
Similar symptoms of depression and dementia make diagnosis difficult
Researchers - Gerling and colleagues - found that relatively often depressive symptoms predict the emergence of later Alzheimer's disease usually in educated people. However, this report has also been criticized by other researchers based on reports from epidemiology. As can be seen from the case described above, differentiation of depression and dementia can sometimes cause serious difficulties. The cognitive impairment in depression is treated as one of the features of this disease. However, if they are clear in the patient at the beginning of the disease, they disappear after effective pharmacological treatment (which is difficult to obtain in the case of dementia).
Diseases of the cerebral vessels developing and worsening depression
As a result, many researchers believe that rather vascular diseases that give evident changes in brain tissue may be the cause of the development and severity of depression than dementia itself. The heterogeneity of the two diseases seems to be determined. It is reported that about 20% of people with depression in the old age, in tests based on learning, get results suggesting dementia.
Four types of relationships between depression and dementia were identified:
• depression which is clinically depicted as dementia (the closest to the concept of pseudodermence)
• depression with secondary dementia (depressive symptoms are accompanied by a decrease in cognitive functions that subside as a treatment of depression syndrome)
• dementia clinically diagnosed as depression
• dementia with secondary depression
Nicotinism - accelerator of dementia
Of the many factors that can accelerate the dementia process, attention should also be paid to smoking. Smoking until late in life increases the risk of memory impairment. This is evidenced by the study of people over 65, in particular memory efficiency tests. The volunteer smokers were also subjected to standard tests for intelligence, which tests were repeated after a year of smoking. It was confirmed that there is an increased risk of loss of intellectual performance in smokers. This confirms the observation that smoking contributes to the gradual halting and hardening of the artery, thus exacerbating the flow of blood to the brain and other parts of the body.
Old age synonymous with dementia disease?
Although it may sound a bit cliché, people should think about old age in advance, be aware that it inevitably awaits them. They should be perfectly clear that they will have to face it. Seneca writes:
No one who thinks too much about prolonging him who takes a long life to great wealth can have a peaceful life. Think about it every day, so that you can quietly give up life, which many people hold on tightly and cling to, like those which the current of the river lifted up, cling to thorns and sharp rocks.Many unfortunates sweat between the fear of death and the torments of life: and they do not want to live and can not die. So, make your life more enjoyable, driving away all anxiety about them. No good does not please the owner if he is not prepared for losses in his soul. But also no loss is easier to bear than one in which you no longer feel the lack of a lost thing.
Moral letters to Liclius
Translation Stanisław Stabryła
Reconciling the inevitability of degeneration processes - the secret of aging cheerfully!
The secret of cheerful aging is also in the fact that it is necessary to clearly say what problems we will have to solve and then approach them matter-of-factly. Perhaps it will mean avoiding the cinema, if we find that we do not see the best, and the glasses do not correct the vision defects. Sometimes it means that you need to get a cane if there are more serious problems with walking or the danger of falling. Older people should also be sensitive to the problem of depression, especially on its first symptoms, although depression is not an inherent consequence of entering an elderly age. Women are more vulnerable to depression, they more often than men fall into it, but are also more willing to actively approach treatment that is supposed to cure them. Older men, on the other hand, may be more prone to suicide. In the US, the suicide rate in the group of men aged 85 and older is 63 cases per 100,000. people and only 6 for women of the same age. Separately you have to treat elderly people in their old age. Doctors remind that lonely women perform better than lonely men. Older divorces or widowers are more likely to suffer mental decline. That is why the experts stress: the stronger the social bonds of older people, the better. This is the best defense against old age, even if, taking into account the indications of the calendar, we are already entering the "third century".
Doctor of Medicine Janusz Krzyżowski
Psychiatrist
Private office tel. 22 833 18 68
00-774Warszawa, Dolna 4 lok. 15
