A new article in JAMA points to these relationships. Late life depression (LLD) is more likely to be resistant to treatment, associated with dementia, and with a higher burden of physical illness. Treatment failure leads to persistent depressive symptoms, depleted psychological well-being, increased disability, accelerated dementia, and increased mortality in older adults. Risk factors for LLD include cardiovascular risk factors (eg, metabolic syndrome), cerebrovascular disease, brain structural changes, physical comorbidity, and frailty. It seems that LLD may have specific mechanisms that are associated with age-related brain and systemic processes.
“Identifying and targeting biological processes associated with biological aging can ideally prevent, or at a minimum delay, the onset and progression of multiple chronic diseases and adverse age-related health outcomes that are typically observed in older adults.” There are abnormalities in the pathways within cells in LLD that control protein generation, folding, trafficking, and recycling within and outside the cell. Increased inflammation, reduced mitochondrial function, insulin resistance, and metabolic disease have also been described in LLD. Signaling proteins associated with inflammatory control, tissue remodeling, cell growth, cell cycle control, and metabolic regulation are involved in late life depression.
Treatment resistant LLD involves multiple interrelated biological pathways and functions. Addressing them concurrently may be much more effective than addressing them individually. A multifactorial assessment is more predictive of who will respond poorly to treatment in LLD. Similarly, a multifactorial intervention or optimal medical therapy mapped out in the diagram slows aging and delays chronic illness which may include LLD and dementia. These conditions are related and the best practice intervention to address them should address the molecular biology and signaling that causes them. We can slow aging and delay chronic illness now.
Absolutely! Here is something to think about:
https://youtu.be/9-RU87qXOdQ