6 depressive symptoms linked to a higher risk of dementia

Six particular depressive symptoms, when experienced in midlife, predict the risk of dementia more than two decades later, according to a new study led by researchers at University College London (UCL) in the United Kingdom.

Depression in midlife has long been considered a risk factor for dementia later in life. However, new findings published in The Lancet Psychiatry suggest that this relationship is due to a small set of specific symptomsmore than depression in general.

These symptoms are: lose confidence in myself; not being able to face problems; not feeling warmth and affection for others; feeling nervous and tense all the time; being dissatisfied with the way tasks are performed and difficulty concentrating.

Researchers say that focusing on these six symptoms when treating patients with depression in midlife may reduce their risk of dementia later in life, but that more research is needed about this link.

“Our findings show that the risk of dementia is linked to a set of depressive symptoms, rather than to depression as a whole. This symptom-based approach gives us a much clearer view of who might be most vulnerable decades before dementia develops,” said lead author Dr. Philip Frank (UCL Division of Psychiatry).

The everyday symptoms that many people experience in midlife appear to contain important information about long-term brain health. Paying attention to these patterns could open new opportunities for early prevention.

The researchers analyzed data from 5,811 adults middle-aged women who participated in the Whitehall II study, a British longitudinal cohort initiated in 1985 and funded by the Medical Research Council and Wellcome. Depressive symptoms in midlife were assessed among 1997 and 1999when all participants were dementia-free and middle-aged (45-69 years, with an average age of 55 years), using a questionnaire covering 30 symptoms common depressives.

Subsequently, the health status of the participants was monitored during 25 years through national health registries, recording dementia diagnoses until 2023. During this period, the 10.1% developed dementia. The long follow-up period allowed the researchers to investigate associations between symptoms and dementia, which originated long before the typical neurodegenerative changes appeared.

Analyzes showed that participants classified as depressed (those reporting five or more symptoms) in midlife had a 27% higher risk of developing dementia later. However, this increased risk was exclusively due to the six specific symptoms in adults younger than 60 years. In particular, loss of self-confidence and difficulty coping were each associated with an increase of approximately 50% in the risk of dementia.

Researchers note that symptoms such as loss of self-confidence, difficulty coping with problems, and poor concentration can lead to less social participation and fewer cognitively stimulating experiences, both important to maintain cognitive reservethat is, the ability of the brain to cope with damage or disease, allowing normal thinking and function to be maintained even when the brain is physically affected.

In contrast, other depressive symptoms, including sleep problems, suicidal ideation, or low mood, did not show a significant association with long-term dementia.

The teacher Mika Kivimäkifrom UCL’s School of Brain Sciences, who led the Whitehall II study and co-authored the paper, said: “Depression does not have a single form: symptoms vary widely and often overlap with anxiety.” “We discovered that these nuanced patterns can reveal who is at greater risk of developing neurological disorders. This brings us closer to more personalized and effective mental health treatments,” he says.

There is limited evidence that Treating dementia in midlife could reduce risk of developing it laterbut it is needed more research to better understand how best to reduce the risk of dementia. Additionally, the researchers also acknowledge that more research is still needed in different populations to confirm how widely these findings apply.

Finally, they remember that it is important to keep in mind that not all people who have depression will develop dementia, and people with dementia will not necessarily develop depression.