Volume 29, Issue 159, May 2025

Treatment of depression comorbid with dementia among the elderly patients

Adrianna Witkowska^1♦, Julia Piotrowska¹, Aleksandra Łubińska-Kowalska¹, Adrianna Domańska¹, Krzysztof Julian Długosz², Antonina Teresa Witkowska³, Barbara Anna Zapalska⁴, Agata Żak- Gontarz⁵, Aleksandra Minda⁶, Justyna Janikowska⁷, Monika Wendland⁸

¹Medical Department, University of Warmia and Mazury, Aleja Warszawska 30, 11-082 Olsztyn, Poland
²Clinical University Hospital in Olsztyn, Aleja Warszawska 30, 11-041 Olsztyn, Poland
³Praga Hospital of the Transfiguration of the Lord Aleja Solidarności 67, 03-401 Warsaw, Poland
⁴Independent Public Central Clinical Hospital of University Clinical Center of Medical University of Warsaw, Banacha 1A, 02-097 Warsaw, Poland
⁵Stefan Cardinal Wyszyński Provincial Specialist Hospital SPZOZ in Lublin, Aleja Kraśnicka 100, 20-718 Lublin, Poland
⁶The Infant Jesus Clinical Hospital, Lindleya 4, 02-005 Warsaw, Poland
⁷National Medical Institute of the Ministry of the Interior and Administration in Warsaw, Wołoska 137, 02-507 Warsaw, Poland
⁸Mazovian "Bródnowski" Hospital in Warsaw, Kondratowicza 8, 03-242 Warsaw, Poland

^♦Corresponding author
Adrianna Witkowska, Medical Department, University of Warmia and Mazury in Olsztyn Aleja Warszawska 30, 11-082 Olsztyn, Poland

ABSTRACT

Depression is a frequently encountered comorbidity in individuals with dementia, posing significant diagnostic and therapeutic challenges. Among older adult population, clinical manifestations often do not represent a typical phenotype of depressive symptoms, which poses a challenging issue in the differential diagnosing process and requires engaging additional clinical assessment tools for guiding patient management. Conjunction of multimorbidity and polypharmacy in these individuals, creates obstacles in the pharmacological treatment of depression, because of higher risk of adverse drug reactions and interactions. In this review we present a comprehensive summary of the clinical approach to depression in the context of dementia. We discuss development of those two diseases, while identifying senior patients at increased risk of depression, and latest treatment strategies. Further, we draw attention to the fact that according to mildly cognitively impaired individuals’ consideration of efficacy and safety profiles of particular classes of antidepressants is extremely significant. Obtaining sufficient treatment requires a holistic approach to our patients, therefore we included in this review non-pharmacological interventions, which may enhance medication.

Keywords: depression, dementia, antidepressants in elderly, geriatrics, comorbidity

Medical Science, 2025, 29, e73ms3562

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DOI: https://doi.org/10.54905/disssi.v29i158.e73ms3562

Published: 27 May 2025