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The association between depression and cognitive impairment in type 2 diabetes 

The association between depression and cognitive impairment in type 2 diabetes
Chapter:
The association between depression and cognitive impairment in type 2 diabetes
Author(s):

Calum D. Moulton

and Clive Ballard

DOI:
10.1093/med/9780198789284.003.0009
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date: 31 October 2020

Type 2 diabetes (T2D) is an established risk factor for vascular dementia and Alzheimer’s disease, yet, the reasons are incompletely understood. To date, intervention studies targeting isolated risk factors, such as hypertension or hyperglycaemia, have proved unsuccessful. Several well-designed cohort studies have suggested that depression predicts cognitive decline in patients with T2D. However, these studies, all of later-life depression, have not fully excluded the potential for clinical overlap between depression and dementia. Mechanisms linking depression and cognitive decline may include increased vascular risk and activation of the innate inflammatory response. Future cohort studies are needed to test the effects of earlier life depression on cognitive outcomes in T2D. Mechanistic research is needed to define pathways by which depressive symptoms could lead to both vascular dementia and beta-amyloid accumulation. Finally, intervention studies should test whether depression is a potential target for the primary- or secondary prevention of cognitive decline in T2D.

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