Is there risk of cognitive decline for those who suffer from both depression and diabetes?
The stress of managing diabetes every day and the effects of diabetes on the brain may contribute to depression. In the US, according to the NIMH, people with diabetes are twice as likely to develop depression. Conversely, depression may affect physical and mental health, increasing the risk for diabetes or making diabetic symptoms worse. Studies suggest that having depression and diabetes puts healthy cognitive aging in danger.
A study in the journal JAMA Psychiatry found that the risk of dementia was higher among people with comorbidity than in people with depression or type 2 diabetes alone. A Danish cohort study compared 95,691 individuals with both depression and type 2 diabetes (3.9% of 2,454,532 adults) with adults having neither conditions, and it found that adults with both conditions showed a 117% greater risk of dementia.
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Depression is linked to increased cortisol levels, autonomic nervous system dysregulation, and increased inflammation, which worsen glycemic control. Dr. Charles Reynolds studies healthy aging extensively to find links between depression and the biological diseases of brain aging. Cognitive decline as a result of dementia includes Alzheimer’s disease, which is caused by neural changes, and vascular dementia, caused by cerebrovascular disease.
Dr. Reynolds stated, “We do not yet know whether the treatment of prevalent cases of depression protects brain health and delays the onset of dementia, although this hypothesis is plausible.” The specialist in geriatric psychiatry of the University of Pittsburgh Medical Center developed the idea that poor mental health has direct effects on one’s well-being, affecting glucose control, diabetes management, diet and exercise.
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New research demonstrates that depression is a risk factor for cognitive decline in patients with type 2 diabetes, and the decline happens relatively quickly and needs to be monitored.
“Our study demonstrates depression-induced cognitive decline in diabetic patients occurs over a relatively short time period (40 months),” Mark Sullivan, MD, PhD, professor of psychiatry and behavioral sciences at University of Washington, Seattle, told Medscape Medical News.
He added that the decline affects psychomotor speed, verbal memory, and executive function. It affects all patient subgroups: by age, gender, previous cardiovascular disease, baseline cognition, getting intensive or standard glucose, blood pressure, and lipid control. He found that it is important to diagnose and treat depression in patients with diabetes to preserve their cognition, but a separate treatment trial is needed to prove that depression treatment actually prevents dementia in diabetic patients. Though further research is needed, this study shows that although diabetes and depression have their own individual risks, having both affects the brain and puts one at a higher risk for rapid development of cognitive decline.
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