A Aging Psychiatry in Psychiatry (https://www frontiersin.org/journals/71) (https://www frontieIncrease the discoverability O)MelU maoiar-] celalee ee sar, Depression in Alzheimer's Disease: A Delphi Consensus on Etiology, Risk Factors, and Clinical Management (Bs Aguer-ont tips wm frontiesnorppeoplelul698100) | Roca Garcl- Ramos) Fanctco 3. Grands Pre’ | Jorge Lpes-Avarer IhtpelIwwacronternorg/psope/u/7748I), lore Manuel Montes RediguexItpe/Iwwrrontarnorgipeoplelu/226i77", Foavr Oaaran Rodrguer”, aver Olvera Pusyotps.//mmntrontersinrglpeopel/I214887F, Carmelo Peleg aero (tps twa rontesnor/peopelu/225570" and ess Porta Eessam (tps /wanerntersnog/peopel 944427)" ekround: Acheimers disease (AD) and other forms of dementia are among the most common cases of dssbility inthe elderly. Dementia soften sorpanie’ by depression, but specific diagnostic criteria and treatment approaches are slacking Th sty ied to gather expert apaions on ements. and depressed patent management o reduce helerogencly in everyday practiee, ‘methods: Prospective, multicenter, 2-roond Modified Delphi survey with sa questions regarding isk actors (1), signs and symptoms (7) agnosis Adisand treatment (27) of depression in dementia, wth apastcular focus on AD. The questionnaire was completed by a panel of 57 expert pyslciane in coeorsagencrative diseases (19 neurologts, 27 psychiatrists, and pita) “Retrlt Consensus was achieved in go (75.5%) ofthe tems: agreement in 39 (62-98) and disagreement in 7 (19.2%) ofthe. Among the most evant “iis, depression inthe edely was considered an carly sign (prodromal) and/or a demeata isk fetr, so routine cognitive check-ups in depressed ‘REPT be adopted, aided by clinical eles and information from relatives Creal interpretation af neuropeychological assesment most be ‘ted tin patients with depression at can undermine cognitive teomes. As agreed, depression nearly AD i characterized by somati symptoms ae erntated from apathy bythe presence of sadness, depressive thoughts and ey-moring awakening, In ater-phass, symptoms of dopressbon would include sleep-wake cycle reversal, agressive behavior, and agitation. Regardless ofthe stage of dementia, depression would accelerate (https://vS einovttinnnneagretered ieetne, veka i wan antdemseant ah nen omer Tos oe soma daastionandlne sea dun exmieda BeNcemnonecas than in cognitively healthy patents, nether dosage nor treatment duration should die. Ant-dementa cholinesterase inhibitors may have synergic cffct wth antidepressants, Exercise snd peychologial interventions shoo not be applied alone before any pharmacological teatmeat, eth do play aparin improving depressive symptoms is demented patients ‘Conclusions: This study sods ight on several unresolved nical challenges regarding depression in dementia patents Further studies and specfc recommendations fr thi comorbid patient population aril needed. Introduction ‘Aging the ranges rik tor oct wih dementia Not srs wth he apo the wr population, the uber feeling with eet Wwerdwieis expec oo 82 mln 2090 et debe 2050 Thus, consierig st deseata one ofthe est comon eases of dpi mong the ‘ler, ach estes wiv apse, motional fan pseton dere wferers ax wel asthe carrer andreas Th raed loa economie td eaene tem burden cat eed eer. Chronic and progres soit purmen the na alm of dementia, mre Ashime’ nse (AD) oath le erimon perch ar scl, Ly oxy an ntteporl dementia (FT) (0). Neropychisrc plomsike depen fn acompany andor precedes dementia onset (1,2). Arent metae sala deternel tht the presence a mj depression was 69% and 4 8X in al-cuse emt and in AD, respect (3) More sting wound one dof ‘heal pps wth depron dingo wth conamitan mi cet mpirment (CT (2) nat, hoop hat the pence of depesson Sarthe covenson of Cit AD tern ie), Gives thee kaon aon betwee depresion and AD andthe incresng rata of dementia and cammany cre seve edo arta he pic ues abd manageent feomoridpaents Hower, dees in ADis stil udedingsed ad, herlre, dered ut ely aa convegueoceaf he ek “HERUURPTIEBc ertera tose pression nha (6). This ota, alles by the once of ome atoms. Therese lo lsepances inept sine reper ae patients wha tendo underestimate tie spss. On he ter and depeton esgnton by earpvervare depending oo estes an personal reunstance (7) ‘Omens tie, or ep pd een pin tn pe on a re i 1 “ili aber topo va cant msg een Besar cond ote epee Cro tendon erat rvs On ss heist Deets nt epee pt ges 2 Fea din iho ep meen af pie ih eon ei. pa non AD teh a gen peo ‘AREHEE ince al conse experts have rod experince in managing sul patents, we expel obtain specie diagnostic hms others not nude in curent “Che sce prope ne ay tcp nie nomen be pe ps Saree B ‘and Methods (nttps:ifv©, DenBtSpaBeRRRN ARNIS NMeNemiee eermrameEirnonas, wmsTsNMerEnns ‘Tine a Modif Deg ey (>=) bandon toon onsen enn are Ataal tke of 58 tems wera it actin earn rik tore (signe and mpm), agnon(9) and trement (2 of depron in AD at oer dees Parkgate spon othe tems ote quesinnsiein he ret aued Upon revs ofthe tate ad comment made by palit, hey recone ete fr whic noses could ot be eahal in the senda. To doo, ey annymouly ase treo agreement heey lemon sing gle odin ot ae sae A sore ae ranging om wa se expres disagreement he owe the val the songe the dsr) 406, balay ween treet ad danreement (ving ae of emonsizated tendeny ovard Snare) nd 99, agreement withthe tem higher the ane, the Songer greene. Consens on cach item wat decided acu to the RANDY/UCLA eters, whe athe neti ofthe act umber of utp ate bee wth aac aside hepa roa which contains the median (9). or tstane, ges median of consensus arent aaa <2 putea oft Deh -Saly (N= $7) te tn oti the 7-9 ein Participants “Themdy wale by Sif Cartes compo of ein pins (4 phir lit in the fd of eredegenerave dass inthe ‘tery. Dt smsgned tthe Commit ere: Desgnng the ey wn polo ting he tonne, ptorng the tia abe endanger Inertia teres, -Althoug nfm spl se eel aval fr Dep td, ua umber of 0-40 pula wa ial etna a appeopist ardingto tndard recommended pacts), Polly $7 hyn (27 en ad 0 womes) were vite and all med! pai nvosd inthe caro AD pn were cover ewalogs 17 pyehints and gv, which rors the tito nthe eal lnelpatn)- Allo them hen iinet ees athe Bed were _dreegety herpes daring sonbel selection procs 5), belong etsy basal with pred eogrphialdatibuton throu he sont. Processing prsonalinfreuton compl with al data poeso napa ws and eulations. "Statigtical Analysis "itt otras ots ra eso athe ee 99 ne aetna i eh NE dopaded on reap os being cast er rpc. ene itera wis infor of th nmin and whee oct kita or dsagreomet cond be eked fora en ter, or stant asta the vale 5 hid coresponded tater arent oe eeesio, expecially in thelr (Tble 88) 59, ‘hee incoherent mio the ener bet scrounge pppoe ofthe ity nal al) asap fi and a already _iiedbdiredapresion fen vole in the progression af MCI ino flown denen, 24), depres eewdodementa can havo propmsticmpktons deren patie whe comps abst mbetve memory las. Al, he se of thirterm can ab ferential agos a eprint cpa symp {82Bodementa) maybe comand with event ond peda a pitino] oes the Presence of Depression Interfere With Neuropsycholagical Astessment in AD Patients? "sre gee hat omptoms of epeson undermine neropeycolgl txt etn patie wth AD CT 98) and so nesropychsoe asessment shold al aniepreat reine catcmescan be eeredin repro ate st copsive symptoms Tse 849). tance withthe previs quo, ronal and prefrontal exci deen give ppt peal stride Gress intel over cme lggste and vuoi ingest). Ths low cogaiivepermance in eprae alc be a tlc fo AD digas Fr hie ei, cet een postpooe ul ndqute vest’ of dpresion hasbeen pli and patents symptonatlgy has ben flawed avert: Absence of ute ‘epee pon epee gto emir would pinpoints ngsingaeredeeneave poss pl eager would beindesve others pl depresion reenact degre a aearuegeeraton, whee 2 compre cog ein woul orp opr ent aghanis poe gementa. B WIA Ane Most Speci Signs and Symptoms of Depression In AD? (nttps:i/vins sna spss ell mp nietanst ssn neat hope sas of seat et aOR EN nnacomnonanoanas ®. arcs 1B cnt Ralan 8etmera lps wh dereso: Dalya feastiony, xPmarngswaleine, phoma, ee Tae 3S) tconta, eth core ofA advances, he etic dri ele by behavioral apt uch a reto, ghon,and eves ofthe ‘Sopa cyl ule 81), Caen CHGS alo roi clear and spe lags dance fo this subset of patients 10,57, 59 |s tAppropriate to Use the Term “Depression” In Older Patients With Advanced AD? ‘mde connect wit te quan above caper unuinousy commended talking shot symptoms af depres’ of depres de” (Tae S88) aot the ack of depression specif last eter nthe ltr sages AD Stn I Dlgpct ctr for pression in Alhetmer ease and ter ements) ‘When aed about FT ptt, epondent refed the tht prion arr ptm tee cae (Tl 4 809) Tole with the esa very eens reve on neuropaycise pmpoms in diferent ype of met ound tht toether ith AD, FTD shows the pes prevalence of depresion (3). Aart forth gven the alos abson oie symptom sarin enc presentation of FTD may be eons with lnnsonet nd primary pei inet In fc, MB rigid by Teagan ea a ery manettions of TD and ahaugh hey sabe praca _emptams of ole rms of damenti, paiess who pres wih the epi the oe lou cogaitve sympa) ae mote prone Lo eel FID has AD (25,50, Is Autoiytle Behavior Less Frequent In Dementia Patients With Comorbid Depression? Conse of opinion oa the xen of util hari thee ptt cl ut be gna (Tae 4), _ sia matsp ie prob bens ofthe xene contr dat, Some sais id ot spr gia anak hetwec dementia GLEN (c),oters dently on scion between demi and ual ation, ecor completion, expec so ter dere diagnos sekndect 55,5568), which sports th a that aaron fnetional lin ineenes sca landor pte ith terior sin fen rsaceorone tctarophicoucome. nthe ie, APA une fr deprenion cose hat pent wih depression a dementia soaibe ats rial ‘UjosQibgfalry sve ee seid wih sel ok in emet sueb ss bopelesoest, preserved al, younge ae, wie race, pes inpatient pyc "Sone, antidepressant and anal presgin and estan to anicholneserases (5 “il'Blagnostic Criteria for Depression in Alzheimers Disease and Other Dementias| {Aidt Sime Depression Diagnostic Criterla Applicable to all Dementia ‘tg ht the ed to eth spe depeson diagno teria forthe diferent nites tht can present wit ementn(AD, Pacino dase, FD, tc) sys he stages fhe desea syndrome Tae 4b S25) bense fhe ese oper yp tha ae acadiag othe deg ‘avendmgeation (se $12 a 8 to Distinct Dementia Stages? B (nttps:ftvirs bnaleslot tees danse ta Seams denen is andrbe atin aniie sity NERA ennoanas Sara ttn Me st tte cae matt neem are newt eee mein atone, ae ee a CSS awe ete ls lePosstbie to Differentiate Depression From Apathy n AD Patents? -Avoued during thie study, sees, depressive cous and eay-morningwasing are peal ated open in deme 2). ‘pays the met preset comorbidity abated wih depression in ADI the Cate County Say, 27% of AD pans sulle eo spay ad ofthe 40% ao ‘ad depression Desi the hgh co-osarenc, pithy antes an ndepeoden lineal ent om depression ad has pei ie exten 6 69). Apat rom ‘he consonu poms fond ihe pant say feng fu, law sft ad opelesnet re more somo in depen haan pay). ra ot spaty (Tbe ‘Can Neuroimaging Eate the Dagnosls of Depression in AD? pre cheddar! arlmaringichniqt as sf gmt sous Taio Sn buco opin on tonal urimaning wa ot srighfovard (Sle S29, “Toit, there at alfa iomarkrs avalible to ago depression nth prtens oan deni, st sre! nesrimaging may be vaubioln range ogee arin of depeason, One ofthe main ccm f ing pte eminon compote (SPECT) bain poze iain (PET trogapky that the ck nah pee (0. "EET TRET REE esencedoc pve te wy forthe we fac tecsoue and dine scrote mares or depron ia AD pais. abe a sed oom analysis, Karaas ets. sugested that lier an depression como mayb character bya sate pattor of gray mater loss hat nggernt natn eine of he semarmator tem atthe right halamtr() Inthe samen, and dnt earer on, Rah anja wre gcse oro nersiging techigus, nan difsion-weighed inagig mesg white mtr rac disruption ard ratings tional MR, to previ “nigerian los on Doth functional and structural abormalitis shared by pttonts with late depression anor MC! (38) Ober sods show that (8 "filconyacne (FDC) and nyc PET ecniqes aw nin wsesrent regal gee mtaol an ety plage deption, rpc, and asain with copie, heir bd physical performances MCT snd AD 72) ‘his Therg Other Usetl Approaches to Diagnosing Depression in Dementia? "Refit once hat reinivescan mae dflerencein refining dgnors of deren in eta Tabs 49) and tht he Coral Ss fr Depeson is SG PERE is wel for eceeing patients in every clini practice (Tube; 836) "Gadus tend to niin and rtonalize ther behavioral and emotional syptoms by inking th o specif stations or the mere aging process, yet Geen s “astern ii feature of theater. This bissed sarmalton may hinder the digooss af depression during patent interviews. Therefore, data gtherd trom BD rsativssdcarevrs can ai the task nd complete tbe cel information. tnttps://vS inonBhdgy 598 beh matchs common esomencton om APS. HENS an th ifr ln St haley ase aes ee ARR sem eae tet nd ae aa RUE AERIO RNG TIA amnion rma! (1S tps 2,702 ‘ther scales ete GerreDepresion Sele (605) ote Dentin Mond Atsessent Sale DMAS) ay be win hee aes, bl CSDD hows Le ies perfrmanc, Moreover, alinn-soted sealethat oles carers which an sset nhs lel contest sit llows bypassing fhe aforementioned pet er IV. Antidepressant Treatment for Dementia and Alzheimer's Disease Patients Is Antidepressant Medication Effective n Treating Depression in Eldery Patents With AD? Consensus cold be ached comforably in ort th lc antidepres fr his india (Te Sa thought was lo ard hats elie a omen patents han inthe absence of eve problems Ise 5840, Rearing te teater xen, experts rete presi ath ower ss of tapenade exerci in AD ptt thot healthy patents S42 908 S59 Pharmacloialthrey fr depresionn dementia eommende by mak CPCs abd with ome vation 7,577). Wheres the Worl Heath Organ (WIIO) gusto consider that pein dap are waren i ene of maderateseere depres (NICE emphases the ely ashe eet rae on ess ba), Oters chaste Fourth Canad ConenasConeenc onthe Digna Teen of Dementia (CCCDTD4) "eeommends droopy i or-pharaclgca teaent fal Among sec aso eh the sary of ss oa dogs tisoteringo mention the existence of toned ess of depression tha ulna rece ‘woo the ned fr eters, wch may uti thigh plat ft overve in AD rl, 79) Ale mesa shaw that ansdepresant rug response aes pon ogi prormunce scr, wheelies do ot eupprt ste, Despite ti aon am thiconsesae tt etna! ar shoul ot be ‘option n erent patents even nl antderestant eine ers Fhe gens uly ave several edie eomobidie an therfore are expose polar ay alto dose dusts compared to demet reaver, experts sre themselves sch pnp Tl 5 49 an Stn te eof inaterapeti does andthe csrrene otek “dorenicance. \ Should Aaticdamentia Cholinesterase inhibitors Be Used to Treat Depression in Alzheim ‘ers cknwedgd te postive ete of cineca nibitors (Ca) on depressive sympeoms and he ptativsyerim wth depressants to ea depen nthe content ofA Ta $9 and 87), However, te orden which the bald be adnired allman Tao 898d 8) Patients? a gmer seas of se eset to pharmaclpil keratin for depression dementia oom the mos labs epanton or isk of nents 90 he cna thn cuestisamae Adio Ces indeprwed er patents do ole tbe ore fle than eideprenats ane 3-80), though ore ty geet Serpe). Hee combustion trp me have bee segue Jeo salty concras (rage iteratoos) For aac, eticbsiprge aden my anaginh ft of Cale 9), 0 eonarrent te ofa gece iad une hers sey epialnemenine hat rch Ipipine deer ruc ae AD a Lewy Bay Diese. In elation otis, CPCs hghight the signees of sichainege side lets wes oan 28 “alent fr dementia patents (67 9, 20,59. Aetnwttmen (nttps:i/v2 ‘i gh io ein i A sas fe hapa a aeRO IE AMS NAc ensnccses rps shiner sr amy By dentin, b= Since the ely of sents seo liked oe nearer prone ‘proves of elt ny so be avasegens or depres epg. Should Memantine rescibed in Depressed Alzheimers Disente Patents? ‘soar from endian for ade to are AD, ra ented be reacod on he avenge any) of memantine depceason etmeat nthe pans Cates 90), (Contorant etmeat wth nips nd memastoe sowed god depres a connote pints ngiv deine, 8). owen, oe seis re needed to stale whether combing CMB or memantine with eetderesn a any ded cogs alive, of actin benefits Which Antidepressant Drug Groups Are More Appropriate for Depressive Symptoms in Dementia? ‘in dant, etdpresnt th mie metanims of acon (al ge ike ena denenlnne or dle miranpine a wlan othe kimodalvctintine] were peered over tery ths palo expes (Table: 0, 805,84 S48, sb Sf). Unio Ss were comsidre eas ahd wol-lrted gs ris ination abe s $4), whence aniepesants TCAD nldig arrping wee not eeommonded abe 844 end S50, ‘Agxmeltne nd Popopion con ot each cha conenee Tae 5849 9385. ‘SRisae sil the fsbo aniepresants io fat atts th any ambit and in pvntderestion 7,8) Some tude pin toward aiher stein ofthe SSRI verte compare wi oer antidepests euating moe tan oe neureranmnter pata (6, oles fod ne advantage for ‘sertraline, onto, or mrteapoe va plceboncogately pated patente wth epeaon (7, Ax gt by Lamipone and other eet, mthoolgel Sitges in randomised conto ls may bebo he party ore among thee ces on adorn etme eA) which dst the ‘haleng of etblshog dear recreations Pesci of Slee lo qutionble note cline cndton sch apt. SSRs nah mations can lave sn aathopenie eet (2) slong cnsensu could not be obtsloe earth sein patents wil seve apathy (ae: S49) ay beast “mneeshexpapton snd ee the de anlar repice hem with an-S aerate aceon sass sae tha SSRs (tloram or srtalioe) abd TEAS ave sla ec, bt Ss te pero avd ahold tes (0). Hats TEAS were taremende bythe pel eter, doe to safety omer Norn wasnt tn exon although it spent behest ofan). This coneensae | MeSSpen gute et only CPG ecmendatns ut aera oe pobshl eter for drag resepioninthe ee ke the Beers and STOPP-START ere (6, i ‘Ao vth SSRs, consulted CPCs alo rewomnend ter drugs ike bupropion, venlafaxine, and mirtazapine which shows tha there iso pefrene a one peti ae “poi Over others (6) This contrasts with the opinion ofthe experts inthe present dyin favor of ual or maltimodal antidepressant, spay ‘itt desventaixing lowing, vraapin, ad vrei. In previous consensus on depression in the ery, experts ha also agred a the specie Sues Gual-ction antidepressants compared to SSRI in get depression). Tn faiths Ben proposed hat subyroup of dementia patents with depression “fitted by both affective and payholoial symptoms (pessimism and Tosser) ca benefit the mas wit miazapine. Tis subgroup of pation id not ‘sit tey problems, which seems countrintive sinc inazapne, wit sedative proper, is more effective inpatients with uch contin (9). Sle opinions on bupropion and agamdatne among patipants were ota tims We hypothe tat his maybe det increased risk of convlsions east ws burosion uptake. However, ts aonserotonerse a ratheratvating fects (6) woud make it atl for AD where more nocadenesic umptoms pals apa sydrome in AD. Noeidence cou be found to explain te lack of consensus toward agomelatne, so we can nly speculate oneestassociated (REEDS:“FAR ominonamonsioc eT ATMNANTERNENEICISEN ALOTATPSINMNCNTERERGMDGVINOSRONCERD DURANT KCN RENAL "serie Antidepressant Drugs With Precognitive Actions the Treatment of Cholce in Alzhelmer's Disease? Eapertsunaninouly coneidned tht the goldtndar aniepresnt dagen AD are the nes tht igre cout fneton a ere depron (Tbe S40). OF ‘eam, dl lew and aegis asl slime ats vrei show a oud ear oly pole 890, S47, and S52). ‘ver eel years amet fh anchor side flats of prose and TCAs has incre they comproie cps (Thi bce name fer Ingotance in ogy mpaied al me patents ee otha, mch tenon as en dave th a of the adress rage peste vortutng ae rom tela i depron ign prove cog ection compare ith duoetin (Ap ober tn AD fod ‘git copie vantages wit ortxetioe a canst ooh endepresats. However, ha ont group ofthe compart am wus ey heterozebnns ad vorinetne'efiaey want delta pneu with prog actions he ann (9), ‘nthe eter aniepresants ane has anit properties nd ea als improve soma symptoms 09). tn depresin an AD snsequnty higher pen compliance than athe sgn mch a aon (00) showshipheroleaiiy ad, ‘Should Non-pharmacological Approaches Be Considered in Deprested and Dementia Patents? pers ekane ht both ys sett and pcg treatise cont, emilee heap, ad copate rebabitoa have enepesat fcc Tle 827 and Se hinay nt be nag aso want hi apliation a an ol apron destin Tl 5 $0) ‘ome ets om pevonsmt-anss suppor exert pion collect this phi questionnaire bt oes pot in dies tions. The ne plished ‘azoxy Foes fund th evidence elf psc activi on depeson rican) Ano one rm 204 eggs it maybe ena peeves of daly (ADL) fle divides, ut depen lees di ot ange (02). Converse, eater ste ee and teats eased he sae ye dl ind a past eet of homes eure on neuropeyciatesmptons of Smet ADL and physi ness fer fa i demeni ving tome wel ar ado in career burden (09) "RL andre dys wrth mentioning tt hcl nce ono erga ax en wl oth ey and sy eet "emg eat ey epain dacepucs ong ies, These plea er pel parang ps mach eminence ery, Wha ‘seat cent spport in AD drpreion (09, Soee CR APXs an NICE ead he alone of uprated olan ‘Bshoons eas men or copie ear sal se naan ote any tion ey (0) catapult ex. sp ot oar tine aby ofso-harmalpal apace ay eter hem fom sing te the en one anther ees roped tha tee pies sal be anaes sees ital les presenting with mer deren Soran rete uh herpes) On the ter ad CHROME cer sae hat here evr en Wy ee rg sdb api othe Amante reins bce pd ops them gpa ist ee ad eerie aes “WHlLcroconnsive Therapy an Acceptable Therapeutic Choice in Dementia? ‘ieee tery PT) coud no be recomend or je a ali ler for npr reactor case (Tables S49 (nttps:ftvCiv artinseosane donegone tonnes eels sa nga eel Seon ine wR AURA DNR omens e cinonBahieiangrmstn mat besremtar wth wits oui empl hearer proportion ferns ne pan Sagrement with itech aan ‘show. Insptea te exer fase agi svete inthe i as pis-CT, mean dats or depres pits demonstrated thst working tod anexopne menoy a wel as procssng ped (among ee ect fncons)impowed ate dys compared wth busine el (07. Conclusions ‘Aa etc ucticasine was desigea to ue opin rom caper gsc working the il of neradegenrave nate, Conse agree cold be ath formos ofthe items ears ik etree parameters, last eters bd vestnent of Gpesion i AD ad other dementia (2) Depression that ate a de dul, wth of witout jet eral compas, was onsiered an eae ig (prodromal) and/or deme preispeon (factor. Therefore, routine chock of depose patents over 50 soul be pertarmed. Convers, a roy agnosed dementia atin experts aged that epreson woulda oly bean emtionally eave ental datutence ested othe experinete rpaiment,lbogh teiadaense fc eironment om cast capo! bedriased- Inte, ther neurbilgeal acs cha vse damage woul ply’ more pried ole, Once detest sale ws ‘sgt tat depressive episodes woul alert deme progression wees aniepresants woul have te oppaste ee ‘According exper opio, the existence of og symptons spel elated to epson undermines eurpaycoga assent in eeady mented eet Al, eatin seal be tke when on Sing te Sing of ement,which soe pone tl waste with aniepreas has bon ite ta both deprive coaitvesymptims hve ben alawel for areca eid tine {naar deena patents rearing fympoms of Epresin” seemed more appropriate an the em epson or "depressive snd ees there aren forma digostiectea for deresion a ltestage dementia. Acherved in cna pact, ees reared tht spon in such tae of eet inde revs flepake es, geese bebar, and pation In ants depression in ey dementias haar by somate symptoms ain te goer ade opuaton: Day ood acuations, enrvmeringwalerng ppchomalrsaratn or snore wih wept os Ala eck ating prs hash ad Ag upenee the crning wre found tobe ugg depen and ot py, To ai digi of depen dent eres, CSOD ale ated nGrmatio fom relatives were found we bern srl earimaging ost were iar “Solio onseasis could be reached on be ofeny antidepressant tough it ay be owe the io xg helthy patie. lo ner the dose ete "iE prod hoi be neces iferentn dementia pains, An-demeta Ci may havea pone cf on Gepesve symptoms an a syeriic eect esa is eticpromants Howe hele recommended oreo adnan rene uot "BR, amideresantof choice were shove tht inprave age faction and/or havea dual or mimo made of ron, namely dle, eens, anepe vortentne, and mirtazapine. SSRIs way lo be used i AD pallens TCAs were nol garde a sale aent ors inden ‘leat 00-pharmesoga approach uses af exer and peo interventions bse o soil conc Feinsence therapy, a eogitve “mbbiiatign war cts, tough their stn lone se wast csr appropri a nia tates. "RE pions sma above mark a ep forward nd conte to he el eres in the conte of aman. They pone knowlege an nc doe ‘joe ERLE resnnendtion nao printf auch pits, Tey sage dary earings troversial diel pects -depesion and demetin. Home, ture endear shoul atic adress seer net ce neds, spec ciagestieteoa or epson and icrorpra rd herpes in dementia patina contrat younger rcpt Beal ate Aetna (nttps:ftvPpetewBateduailabitity “The rw data suppertig the conasins ofthis atc willbe made eae by the author, hou undue eseration ‘Author Contributions 14.0, RG, FO, 2M, 70,30, CP, a PE conte guy to the ay desig andthe development ofthe Delph guetonar. 31 prepared an etnsve logy and aplaed and inerrted the ress uf the survey based ot i LAD cordate Ue group of experts. Al utr contrat egal othe al ranserit Funding nani suport tocary ol his sty wa recive from aes Pract Holding S28 Manel ombo Angas, ie, Made 26050, wot Interfering withthe st desiy dt clletion,analss an interprettion of ats, he rear ftir or he esison tbe it for pasion. Open acces pba foe weeded by Bai Conflict of Interest |LXOhas civ grants fom and served as eonsant aor, or CMB speak Janse, Eats Lande, Pier, Nesraxpar,SaoHvets nd Serie {0 be rend nore a patie coure etre, congress nscale vin baa ever perma crmpaie ncn xine, apd, Angas, Pin, Osa, bd Hee J-A as peparl a monographs Dephcosesus ih the nani ep of Belts Pharraceuteals Holling, SI. iss events fn wi served as ont dso, CME speak or Alma Angeli, Arena, Britl-et Sq, Hh Lily, Fer, “Gln, Janse Cla, Landbeck, Oka, Per, Qelgr, Roda, Snort, Servi, and he pai Mey of Selene ad asain ifdnsaan, ce ha received honoraria pricpte in cores and lecture od has ben invied one td cet advisory bot from severe "itr ompaisineig aes, Janse, Landes, Angin, Pat and Cae. "ACRE asda thatthe esearch mas condctel athe absence fay commer or Baal eatiasp cal be const as apotel eae, “pie ‘KéiSwiedgments Steel writing services were provided by Nes Cantrio, M,rm Tela SCL Spi). The thr als thank the pei wh parted the Delph swears References t ga stn gn pine De a ‘tr hence cp isnt > Nig cama SPebuigreretnn pineeponir sie aah Sn sate ene ona tnta-t ee tp ng eh tema pis eo ann em geet? ow eA te De erga Ey ake mm gn ment snc denne ea ee A SeitEipatin owinestce ecinsrternpsos me ao Se ca ant t-Bu so eu ry ranger Seana recess heey felons ree adh ie, Man, estan pap na Mandap ne SMR ine ie (permas mada ts el i Dan tae cs a Dama? ‘os antacaaucc aie oo eo Se een acuan as ecient ‘hae Ast rn ai ah i lng ia an pi igo pre se Anns phat pf re ot ge naan |G ne gon gt etc ease sri ome ‘ao emer a ter ssi iit ah "nh tani em man eam od hb ay caer alc Dy So ‘itis iri ppm ‘Snr ts her heuer’ hata 9 paar ea “nese nid ccpnnenpsme throngs a) oan iene i Os ig ime cdi Sra er eee er rine: nee nite ese Onna tpl parla Abeta marlon Aft oad nih nawsnuese ci hs genta pie |g engi | ee pm? nsec as fat er ata ae spe pancetta nap pete i ge) oth a ch Senge meee shea Sm th Gr yar uast-int a hei ee enters eke mse Beeman aur ty asa ord iiss sao mi Ara, 4 Hon De mats he A. ea ig gegen Neyo me a es sing sno er sn bamnsann nae necadncrs nt Beccse’ reac coast ep a "an sau Lp WD, Ae eae tn ah pe gm ay tin aay he Pa ss) comettergeticnteapnssass cvocarats (nttps:i/vths mea gn Ce aoa ed pecan a ‘os i anc lassen aa : he Saas eestor ‘na ie a A nn Bi La Senin iit ep be Ann tp phat pip |r gels AN enn | np il gp omen ‘seat tt eb cae a pe 10 se nd ewer tn daring a nor os “ana nt st ener grea sy hee ‘Sic Gatiotscurc hater Reusabstrc datesbar ka kp, ata ratte epannagie Seat pnw stn Poni eh ete A Da 0 =m se Mesa soe ip itasmaeamen | eco a? ences ‘Auge en gt Vn Se tl Pd etc soem fin ed Ni ea oma sedentary yee Lanegan ai toe el caackag entreaties i tua oie spenie enn Sete atm sein rit ane mete tan tg Ran overhang at mci inven yarns hepa ng (EEStor ire in npn min un har et et “rains atta onto yar sneaking emir seeodtepngon casa ansehen tas Pegrtaene (nttps:i/v"rion gas na sa erm a ne drama a det ape oa a iP ceo aR Le ee im oR pater iC ap ay a |g Sp inl ag? i Str tsttre ani-nek oe ‘toni phn angrier een helt mn aii ete a msn pig ee eect nage be msg asa “sos puma [ge yah ee ‘emer emacs Arrears een ein ‘sam nme seat nr ei satan in prasinenmtn An or rrr d'emploi ee | “ * ™ sae pe rsa seaeasnen et eke? ‘st ae ane dp, pana Do tactic a Radtntamrsttmt) ‘nhc get ee laren inhale et An tp pati sip) Gna le aero nsGador n thgne turin ny 06 Cnn on Dns dn hin NAY ac Bl ve Sm) Ane Hieron sncccesancincn hep forage ansomsesa noire ya "mses re mnogo oot Cue egies) artnet Meer Sa Bee tl Pn a deri ee Aa i ns a i Sep ea area eae ede! en papitata pera [MT Onsen hp ecm op amt timate elie ti Aer nh. eo yn dn erin at ing ror aan " (nttps:ftveen ea eae ee esta itacxtcenarcagey cc WTPSiWMNROER GNU SOFEN URAHARA Dongs prrmenn tay yas Som A tt Sch i ua mien hy ge? ‘Sieweroapanc neteraascbinena ie sine scepeietiesonnerae) ‘Seana uote Psat Sopa epi apa plan ae ps ent tt emp inh rh ma ‘ee ssn Latina cabbage, fs oss epee Rovraicatjer meer 8 ‘anh me aio ew rani i Prt An pana neg io apa nn | i i gt ees cre ie ecules pt vin dnt cepa 9 ‘WS PEGE nds pvp nso ip asm nn eh con syncing ona asa ‘tat met ea a data "Res ota nn Raden deen Ae enema JAbhnr a a eB ores ‘secundaria pee ” “— “— ov ine oar Wi Ao ee et ne et en oii rm rss up path [sa i el aga soma he ih nh okt Sates tr tego apeais deer i hes pina, hopped it ae senses oe pera aces ea cham yi etka in dp penn Concert tg tenn etn hse st nen? eo une taete ealnaer nesa emtearane neioe Saaane https cc RE ei tse neat od ctign en eb ahvope or dgen iia Naja oe pepsin"nena cay eae ie tu te nem de mi aa oven, a re a SEE an ee er ee Te Se SE Bt nenaron cons (phe oS air | a ip naa Vn i a fala? se pea cai ipa ae he ‘e.oeann on Dn, Sd dal gl inp en dpi aia eid SI ans tar py ent alias 8 hen ih pyr Somat eg am 8 hs i me SoS ier ec ene th en ge OL Te Sn Sar Re ned ae ab ge mpi nent pet dao ‘Seems hoary nt aoe kaa Snider mn eea= ™ ° ‘myenteric io ‘ips eid tt oe an nan iii om? nn A pdt phn st gins Jo mmc dn hs np ag? ‘a Gamma hang yan bn a annapolis ceon e jaar aaa Sp ca ca, mc ag oti pth een Apr et pie ny. sanadienbnge™ Devt bosses da mnraeabcorwo tee sanracnnorcqainentnes¥ninaot F< Akan user-agent esate Range pateses epee Pee etenotmmeribnetmescemetpeertn nurs tbe) ‘magn mapa vughey A.C near peal ett ena ae Ma AR. ESE ht pone nt sense Srp Tne 4a, rant ete ned integrin orien tnae ott onte tm atrintent orr crn treme me ir nt rer et Cee ee meme Seca skein tame “et ee, maser Hee BF. Ynae Cr et Aran oid plac ctl a fc eeu ed mma sh at a See ee nee eT ae cancels lpe oe tenatae treba earn annaeoenayngnsiara. Gehan swame-emyegat= (MERRY a"THEY nur unt a ad nl ens era Sn nna ana rn nad a a EE aR aaa ea ere eee a tn noas (ie oS ana Ca pc Apa) [Cg Sr hr ‘er on rn ahi Ong nt wii tin i ei hin ‘esheets Satta Sonate A spin ora Sra rie a agement agenda pan opp area iors teens erm een, fee rn, mpalnsom-acanopn rapes ston nn Pn Seek. Peg et ws dg emerges rea neat renee tern amr maar a) — revs sige orb pip ksh iy pe eZ. Ae gina, ina Ln Mn, SnD al ep ame ep a, antarctic OMSabt yar van a t- at aninoaes lt fi nr gran een team thr srs rns pein encontrar Ciera che et 0 ee tg oe to rg rei ergo CAA ei ee Ad he iin phat poy Sunt Peon sam ws eg sh ec conn? lame eon nent’ etn amas a, eres ere inn eH nish ington otra sa denntiniay Sena EERE Agnes marin bod mab ne actin a ntegeboatn-tmn ‘sua omen rng nn omnnmp anmmm nOhr) aon Oy asin nae,jhap aa) Rg rent tn Peffeninaetrameetmi tnmthiet —ty pews pen asoSeitensneneeseyntiscnnesantnetotneetintatearansr! og an i a thin . patcauemnacayamanesie|eum oes ‘at pan inet dnt enn oa iin 2. De seein nen is nh ain aan shoe rat iy te Ant Ohana psty unt Pe te eye hey ik gam? se ecient heen xp ee cir pa te 6 Aino Gea? ionamin alpina sn esr oa i tweens) "ph inant ese het ‘anor en jason ech deter Pg ar menage nh pl hat nip el a eran hoi Di hha piace? os pane CBee) [Ou oben i? ‘Sida tps cg Se Mange AP td py en ti ia in ami ‘WS PEEEETptmndchntphSon hpensne e liglpaeaet nua Sinner Meteo genase ese Spey ppt pf ca panto oore Sanpete dane pind) "Pens Tone heater gee din ty en Asn: bmn a er 9) eae eeu in nna Teme eran ftir. sin emt andi aln Seana ge) 888g non ene Zn Gre og ane Se arin eo ipa ai On nl ip nde game Seon apn, ran bse Gsm) anette, yr, M ire tai Ce CDM pn arin ti eo ny pe paced psec soa inc opr Foes tae Fos hb gel okra eerie irene oo re secede ston soutien Rcd enna nena (nttps:i/vya S049 cused tecpen nA DmmandDepaon aint SOR AATINND ifn nnn ae ry mea Pn Coe ann pene apes neers metres Dee temoonensmnncerinees “Ei lot mace Sres Resontn phony Vr! 389/ns 209 80:56) ; aia inn neta aneatred (nts:i ented srt Medes Appin i 2 “tee mech se tines epeediscoverability O)MelU maoiar-] celal