Depressiya i dementsiya u pozhilykh: diagnosticheskie i terapevticheskie aspekty


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Abstract

Depression and dementia are two most common psychiatric syndromes in elderly patients, which often accompany each other, engaging in complex interaction. On the one hand, depression debuting in the elderly often is prodromal phenomenon, emerging in the early stages of vascular or degenerative diseases of the brain and leading to dementia. On the other hand, dementia manifesting at an early age can be considered as a risk factor for the further development of depression. The influence of depression may be mediated by cortisol hypersecretion, activating neuroinflammatory processes in the brain, associated with the deposition of amyloid in the brain, as well as insufficient production of trophic factors. Frequent combination of cognitive and affective symptoms requires regular neuropsychological screening of patients with depression, and clinical suspicion of signs of depression in patients with dementia. In clinical practice, an error diagnosis of depression in patients with developing dementia is more common than a mistaken diagnosis of dementia in patients with depression. As a first-line treatment for depression in patients with dementia, selective serotonin reuptake inhibitors are recommended. In patients with dementia, antidepressant with a cholinesterase inhibitor or memantine, and in some cases, with atypical antipsychotic or mood stabilizing agents are the most effective combinations.

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About the authors

O. S Levin

E. E Vasenina

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