Depression in Patients With Dementia May Increase Risk for Heart Disease
Photoplethysmography, at high and low frequencies, was used to measure heart rate variability, which investigators interpreted to evaluate the autonomic nervous system.
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NEW YORK — Individuals with comorbid Alzheimer dementia and depression may have an increased risk for cardiovascular disease, according to data from a study presented at the 2018 annual meeting of the American Psychiatric Association, held May 5-9 in New York City.
Both severe depressive disorder and Alzheimer dementia have been associated with autonomic imbalance, in particular decreased parasympathetic activity. Patients with Alzheimer dementia have also been shown to have increased sympathetic activity.
The investigators, including presenter Dongwon Shin, identified 90 outpatients who met the criteria for Alzheimer dementia, according to the International Statistical Classification of Diseases and Health-related Problems, 10th revision. Patients with an additional diagnosis of severe depression (n=40) were matched for age and sex with patients who had Alzheimer dementia but no depression (n=50).
Early-stage dementia was evaluated on the Clinical Dementia Rating Scale and Scale for Medial Temporal Lobe Atrophy. Photoplethysmography, at high and low frequencies, was used to measure heart rate variability, which investigators interpreted to evaluate the autonomic nervous system.
Both frequencies were significantly lower in patients with depression, and the low- and high-frequency ratio was significantly higher (P <.001). Patients without depression had higher scores in time domain parameters (P <.05). These findings reflected a parasympathetic and sympathovagal imbalance, as well as lower complexity of heart rate variations, in patients with depression.
Shin recommended that clinicians take depression into careful consideration when treating patients with Alzheimer dementia, as the two conditions combined may predispose patients to cardiovascular disease more than either alone.
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Shin, D. A comparative study of photoplethysmography on Alzheimer's dementia with severe depression and without depression. Presented at: 2018 American Psychiatric Association (APA) Annual Meeting; New York, NY; May 5-9. Poster 116.