Alzheimer’s and Depression have significant overlap

By Dr. Alan Kadish

In a study looking at blood flow in the brain of 4500+ patients, researchers were able to distinguish the difference between those with depression, depression and cognitive dysfunction or both with between ~83%-86% accuracy. They used a SPECT scanner to obtain a high tech 3-D image of the patient’s blood flow in the brain.

A SPECT scanner is a high tech imaging device that in some ways resembles an MRI in appearance, however with different technology. A gamma-emitting radioisotope (a radionuclide) substance is given via an IV and a camera looks at the the brain from 360 degrees.

With the increasing number of patients displaying the appearance of being demented and having depression or a combination  it’s critical to determine the underlying disorder. With the overlap in symptoms this technology is a welcome addition to our evaluations. 

In using this technology we can now distinguish between the two or the combined more effectively. The use of SPECT imaging is not common place and tends to be expensive, typically in the $~2000 range. The treatments are very different and can be personalized appropriately.

At the Center of Health we use cognitive evaluation software, used on a computer and game like to do our initial evaluations. It can give great insight into your brain function and direct us to the appropriate next steps.

Call us at the Center and arrange for a brain evaluation. Better function for a better life. 541.773.3191

Is it Depression or Dementia? Brain SPECT Imaging Helps Distinguish Them

15 February 2017

Neuroimaging of decreased blood flow in specific regions of the brain can differentiate between depression and cognitive disorders, according to a new report in the Journal of Alzheimer’s Disease.

Amsterdam, NL, February 15, 2017 – Does a patient have depression or a cognitive disorder (CD) such as Alzheimer’s disease or both? Since both disorders have overlapping symptoms, how can a clinician tell them apart to make the appropriate diagnosis? In a new article published in the Journal of Alzheimer’s Disease, researchers have found that single photon emission computed tomography or SPECT, can help to distinguish between these diagnostic categories.

Comparison of Both Dementia and Depression Patients

In one of the largest studies of its kind, 4541 subjects were examined, 847 of whom were diagnosed with dementia, 3269 with depression, and 425 with both conditions. Using brain SPECT imaging, a nuclear medicine study that measures blood flow and activity, researchers found that people with cognitive disorders had reduced blood flow in multiple brain areas compared to those with depression, particularly in the hippocampus, temporal, and parietal lobes.

They also found that SPECT could distinguish depression from CDs with 86% accuracy. Also, brain SPECT imaging showed the ability to identify depression or dementia in people with both with 83% accuracy.

“This is a critical clinical question that has practical implications for patient management and treatment,” explained lead researcher and psychiatrist Daniel G. Amen, MD. “These disorders have very different prognoses and treatments and being able to improve diagnostic accuracy can improve outcomes for some patients.”

The Breakdown

The authors write, “Cognitive impairment is present in approximately half of persons who have late onset depression and depression is evident in 9-65% of individuals with dementia. Studies have indicated that the prevalence of depression in patients with mild cognitive impairment is 25%. Consequently, it is often challenging to diagnostically disentangle depression and cognitive disorders from one another.”

Traditionally, depression can be diagnosed using tools such as the Beck Depression Inventory, the most widely used psychometric test for measuring the level of depression. However, there was no statistically significant difference in the burden of depression symptoms on this inventory between individuals with both depression and CDs compared to persons with either condition. This increases the difficulty of distinguishing these disorders on the basis of depression symptom severity alone.

“One of the greatest new insights of the past decade is the linkage of depression to the psychology of late-life cognitive decline. Raji and coworkers extend the approach to the biological substrate by an elegant imaging approach. These studies further place brain aging on a firm biological basis,” added George Perry, PhD, Editor-in-Chief of the Journal of Alzheimer’s Disease and Dean and Professor of Biology University of Texas at San Antonio.

If you or a loved one is experiencing symptoms of Alzheimer’s disease, dementia or depression, Amen Clinics can help. We will help you learn more about your brain and assist with early diagnosis and intervention. Call us today at (855) 899-7807 or visit our website to schedule a visit.

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Dr. Kadish is an unusual physician often referred to as a "doctor detective". His expertise is the evaluation and treatment of complex disorders, typically after other physicians have been stumped, is renowned. He provides care for all family members and has additional training in autistic spectrum disorders and chronic complex diseases.