노인 우울증과 알츠하이머 치매

• Published in: Journal of the Korean Society of Biological Psychiatry Vol. 32; no. 1; pp. 1 - 8
• Main Authors: 김기원, Kiwon Kim
• Format: Journal Article
• Language: Korean
• Published: 대한생물정신의학회 01.04.2025
• Subjects: 정신과학
• ISSN: 1225-8709; 1225-8709
• DOI: 10.22857/kjbp.2025.32.1.001

Late life depression (LLD) is common and characterized by specific cognitive decline, numerous comorbidies accompanied by consideration of polypharmacy, and heavy disability. Distinct structural and functional changes observed in neuroimaging lead to neurobehavioral symptoms in this population. Dysfunction of the default mode network, cognitive control network, anterior salience network, and positive valence system circuits brings about negative self-referential rumination, executive function problem, troubles in attention, and reward processing deficit. Due to frequent cognitive impairment in LLD and strong association between Alzheimer's dementia (AD) and depressive symptoms, discrete elaboration is difficult. There are various linkages between LLD and AD in pathophysiologies including neuroinflammation, vascular disease, and neurodegeneration. These etiological hypotheses are supported by clinical manifestations, cognitive measurements, neuroimage and related molecular findings. Therefore, LLD is thought to be a risk factor for AD which should be managed. However, other perspectives on LLD suggest it as a prodromal manifestation of AD or as prognostic factor to predict disease progression. Consistent research with eligible criteria with homogenous diagnosis, cognitive and symptom measurement, and long-term follow-up studies would be needed to better understand the relationship between LLD and AD.