Depression in cognitive impairment

Laurel D. Pellegrino, Matthew E. Peters, Constantine G. Lyketsos, Christopher Mark Marano

Research output: Contribution to journalArticlepeer-review

38 Scopus citations


Depression and cognitive disorders, including dementia and mild cognitive impairment, are common in the elderly. Depression is also a common feature of cognitive impairment although the symptoms of depression in cognitive impairment differ from depression without cognitive impairment. Pre-morbid depression approximately doubles the risk of subsequent dementia. There are two predominant, though not mutually exclusive, constructs linking pre-morbid depression to subsequent cognitive impairment: Alzheimer's pathology and the vascular depression hypothesis. When evaluating a patient with depression and cognitive impairment, it is important to obtain caregiver input and to evaluate for alternative etiologies for depressive symptoms such as delirium. We recommend a sequential approach to the treatment of depression in dementia patients: (1) a period of watchful waiting for milder symptoms, (2) psychosocial treatment program, (3) a medication trial for more severe symptoms or failure of psychosocial interventions, and (4) possible ECT for refractory symptoms.

Original languageEnglish (US)
Article number384
JournalCurrent psychiatry reports
Issue number9
StatePublished - Sep 2013


  • AD
  • Alzheimer's disease
  • Dementia
  • Depression
  • ECT
  • Electroconvulsive therapy
  • Genetics
  • Geriatric disorders
  • MCI
  • Mild cognitive impairment
  • Neuroimaging
  • Neuropsychiatric symptoms
  • Neurotrophins
  • Pharmacologic treatments
  • Psychiatry

ASJC Scopus subject areas

  • Psychiatry and Mental health


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