Although these findings are observational, they could suggest that providing mental health treatment for people with Alzheimer's disease might slow the loss of independence, said senior author Yaakov Stern, PhD, professor of neuropsychology (in neurology, psychiatry, psychology, the Taub Institute for Research on Alzheimer's Disease and the Aging Brain and the Gertrude H. Sergievsky Center) at CUMC.
"This is the first paper to show that declines in function and cognition are inter-related over time, and that the presence of depression is associated with more rapid functional decline," said Dr. Stern, who also directs the Cognitive Neuroscience Division of the Department of Neurology at CUMC.
Because almost half of Alzheimer's patients have depression, the researchers, who were studying the long-term association between cognitive and functional abilities in the disease, also looked at the role of depressive symptoms in disease progression. They reviewed data that tracked changes in cognition, depression, and daily functioning in 517 patients with probable Alzheimer's at NewYork-Presbyterian Hospital/Columbia, Johns Hopkins School of Medicine, Massachusetts General Hospital, and the Hôpital de la Salpêtrière in Paris, France. Patients were assessed prospectively every six months for more than 5.5 years.
"Making a prognosis for Alzheimer's disease is notoriously difficult because patients progress at such different rates," said first author Laura B. Zahodne, PhD, a postdoctoral fellow in the cognitive neuroscience division in the Department of Neurology and the Taub Institute at CUMC. "These results show that not only should we measure patients' memory and thinking abilities, we should also assess their depression, anxiety, and other psychological symptoms that may affect their prognosis."
The title of the paper is "Coupled Cognitive and Functional Change in Alzheimer's Disease and the Influence of Depressive Symptoms" (JAD Volume 34/Issue 4 (March 2013)). Devangere Devanand, MD, professor of clinical psychiatry and neurology at CUMC, co-director of the Memory Disorders Center at NewYork-Presbyterian/Columbia, and director of the Division of Geriatric Psychiatry at the New York State Psychiatric Institute, also contributed to this paper.
The study was supported by grants from the National Institute of Aging (R01 AG007370 and T32 AG00261). This research was also supported by the Irving Institute for Clinical and Translational Research at CUMC, which is supported by the National Institutes of Health (NIH) Clinical and Translational Science Award (CTSA) program, through grant UL1 TR000040.
The authors declare no financial or other conflicts of interest.
The Taub Institute for Research on Alzheimer's Disease and the Aging Brain at Columbia University Medical Center is a multidisciplinary group that has forged links between researchers and clinicians to uncover the causes of Alzheimer's, Parkinson's and other age-related brain diseases and discover ways to prevent and cure these diseases. It has partnered with the Gertrude H. Sergievsky Center at Columbia University Medical Center, which was established by an endowment in 1977 to focus on diseases of the nervous system, and with the Departments of Pathology & Cell Biology and of Neurology to allow the seamless integration of genetic analysis, molecular and cellular studies and clinical investigation to explore all phases of diseases of the nervous system. For more information visit The Taub Institute at http://www.cumc.columbia.edu/dept/taub/.
Columbia University Medical Center provides international leadership in basic, pre-clinical, and clinical research; medical and health sciences education; and patient care. The medical center trains future leaders and includes the dedicated work of many physicians, scientists, public health professionals, dentists, and nurses at the College of Physicians and Surgeons, the Mailman School of Public Health, the College of Dental Medicine, the School of Nursing, the biomedical departments of the Graduate School of Arts and Sciences, and allied research centers and institutions. Columbia University Medical Center is home to the largest medical research enterprise in New York City and state and one of the largest faculty medical practices in the Northeast. For more information, visit cumc.columbia.edu or columbiadoctors.org.
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