000102109 001__ 102109
000102109 005__ 20260108141540.0
000102109 0247_ $$2doi$$a10.3389/fpsyt.2021.638651
000102109 0248_ $$2sideral$$a124332
000102109 037__ $$aART-2021-124332
000102109 041__ $$aeng
000102109 100__ $$aAgüera-Ortiz, L.
000102109 245__ $$aDepression in Alzheimer''s Disease: A Delphi Consensus on Etiology, Risk Factors, and Clinical Management
000102109 260__ $$c2021
000102109 5060_ $$aAccess copy available to the general public$$fUnrestricted
000102109 5203_ $$aBackground: Alzheimer''s disease (AD) and other forms of dementia are among the most common causes of disability in the elderly. Dementia is often accompanied by depression, but specific diagnostic criteria and treatment approaches are still lacking. This study aimed to gather expert opinions on dementia and depressed patient management to reduce heterogeneity in everyday practice. Methods: Prospective, multicenter, 2-round Modified Delphi survey with 53 questions regarding risk factors (11), signs and symptoms (7), diagnosis (8), and treatment (27) of depression in dementia, with a particular focus on AD. The questionnaire was completed by a panel of 37 expert physicians in neurodegenerative diseases (19 neurologists, 17 psychiatrists, and 1 geriatrician). Results: Consensus was achieved in 40 (75.5%) of the items: agreement in 33 (62.3%) and disagreement in 7 (13.2%) of them. Among the most relevant findings, depression in the elderly was considered an early sign (prodromal) and/or a dementia risk factor, so routine cognitive check-ups in depressed patients should be adopted, aided by clinical scales and information from relatives. Careful interpretation of neuropsychological assessment must be carried out in patients with depression as it can undermine cognitive outcomes. As agreed, depression in early AD is characterized by somatic symptoms and can be differentiated from apathy by the presence of sadness, depressive thoughts and early-morning awakening. In later-phases, symptoms of depression would include sleep-wake cycle reversal, aggressive behavior, and agitation. Regardless of the stage of dementia, depression would accelerate its course, whereas antidepressants would have the opposite effect. Those that improve cognitive function and/or have a dual or multimodal mode of action were preferred: Duloxetine, venlafaxine/desvenlafaxine, vortioxetine, tianeptine, and mirtazapine. Although antidepressants may be less effective than in cognitively healthy patients, neither dosage nor treatment duration should differ. Anti-dementia cholinesterase inhibitors may have a synergistic effect with antidepressants. Exercise and psychological interventions should not be applied alone before any pharmacological treatment, yet they do play a part in improving depressive symptoms in demented patients. Conclusions: This study sheds light on several unresolved clinical challenges regarding depression in dementia patients. Further studies and specific recommendations for this comorbid patient population are still needed. ©
000102109 540__ $$9info:eu-repo/semantics/openAccess$$aby$$uhttps://creativecommons.org/licenses/by/4.0/deed.es
000102109 590__ $$a5.435$$b2021
000102109 592__ $$a1.279$$b2021
000102109 594__ $$a4.6$$b2021
000102109 591__ $$aPSYCHIATRY$$b38 / 143 = 0.266$$c2021$$dQ2$$eT1
000102109 593__ $$aPsychiatry and Mental Health$$c2021$$dQ1
000102109 591__ $$aPSYCHIATRY$$b48 / 155 = 0.31$$c2021$$dQ2$$eT1
000102109 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion
000102109 700__ $$aGarcía-Ramos, R.
000102109 700__ $$aGrandas Pérez, F.J.
000102109 700__ $$aLópez-Álvarez, J.
000102109 700__ $$aMontes Rodríguez, J.M.
000102109 700__ $$aOlazarán Rodríguez, F.J.
000102109 700__ $$0(orcid)0000-0001-9243-0339$$aOlivera Pueyo, J.$$uUniversidad de Zaragoza
000102109 700__ $$0(orcid)0000-0002-4036-4541$$aPelegrin Valero, C.$$uUniversidad de Zaragoza
000102109 700__ $$aPorta-Etessam, J.
000102109 7102_ $$11007$$2745$$aUniversidad de Zaragoza$$bDpto. Medicina, Psiqu. y Derm.$$cArea Psiquiatría
000102109 773__ $$g12 (2021), 638651 [16 pp]$$tFrontiers in Psychiatry$$x1664-0640
000102109 8564_ $$s1074329$$uhttps://zaguan.unizar.es/record/102109/files/texto_completo.pdf$$yVersión publicada
000102109 8564_ $$s2621772$$uhttps://zaguan.unizar.es/record/102109/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada
000102109 909CO $$ooai:zaguan.unizar.es:102109$$particulos$$pdriver
000102109 951__ $$a2026-01-08-14:13:50
000102109 980__ $$aARTICLE