An entirely predictable conclusion, but a few important details are missing!
A report, by Eric W. Dolan, June 24, 2024, in “Depression“
(Photo credit: Adobe Stock – copied from E.W. Dolan’s article)
A recent study published in JAMA Network Open, was recently reported by by Eric W. Dolan, in the Journal “Depression”, of June 24, 2024.
This study was undertaken to satisfy a query: “It is known that depression and poor memory often occur together in older people, but what comes first has been unclear”.
The researchers studied 8,268, out of 11,391 original participants, who had complete data for cognitive function and depressive symptom assessments and who had been examined every other year from 2002 and 2003 until 2018 and 2019, resulting in a follow-up period of up to 16 years. They came to the unsurprising, inevitable conclusion that there is a bidirectional relationship.
The original article
I read the original article: to give the authors their due, this was a careful and well-thought-out study which, as senior author Dorina Cadar of University College, London, averred, ”shows that the relationship between depression and poor memory cuts both ways, with depressive symptoms preceding memory decline and memory decline linked to subsequent depressive symptoms. It also suggests that interventions to reduce depressive symptoms may help to slow down memory decline.”
Wonderful information!
I am disappointed
However I found it disappointing that, having gone to the trouble of studying 8,268 elders who were known to have some combination of cognitive loss and depression, the authors commented on educational level, financial viability, lifestyle, alcohol/tobacco habits and “allostatic load”, but made no attempt to evaluate the metabolic, vitamin and hormonal milieu in which those carefully documented elders’ brains were functioning.
It would have been nice to know, among other things, what proportion were subject to childhood (or adult) PTSD, what their levels of DHEA, testosterone, progesterone, estradiol and vitamin D were and whether their thyroid balance, glucose and cholesterol management, BMI, kidney and heart function were.
An excellent opportunity was missed!
Why am I wasting your time?
So why am I wasting your time, by reporting a foregone conclusion to which any reasonable adult would apply a huge “So What?” Factor”?
The point here is to encourage you to examine all reports you read, for evidence of attention to metabolic conditions: metabolic aberrations can markedly affect the conclusions reached and ultimately, the value (or the lack of value) of researchers’ opinions.
COMMENT
Any (medical) scientific conclusion is liable to error if the metabolic/hormonal status (especially, the thyroid balance) of the study population is unknown.
No physical or cognitive function can be adequately assessed in the absence of information as to the physical and metabolic conditions under which that function was exercised: as an example, imagine assessing the physical ability of a group of men, based on a 200-metre race, without taking into account the information that 37% of the runners had had both great toes amputated!
Ergo, here’s my advice
I would advise my young colleagues to add a “hormone profile”, including assessment of DHEA, Testosterone, Estradiol, Progesterone, T3/rT3 ratio, HS CRP and serum Vitamin D (Vitamin D IS a hormone), to the test requisition for all patients who qualify for a lab-test “checkup”. Also, pay close attention to the results and correct any aberrations you find, as part of therapy for whatever condition is diagnosed – your patients will thank you.
CAVEAT
This comment is important in and of itself, but is merely a prelude to a discussion of the more important question: ‘why do we age’, and the most important, ‘is there anything that w can do, to postpone, or ameliorate, aging?