Depression and Alzheimer’s disease (AD) are frequent interacting diseases in the elderly with a negative impact on the quality of life of patients and caregivers. Late-life depression may be regarded either as an early symptom of AD or a risk factor for AD, depending on the context. This review was focused on the latest developments in the fields of the neurobiological basis and treatment of depression in AD. We found that some plausible hypotheses are emerging to correlate with depression in AD, such as neuroinflammation and dysimmune regulation. It seems that depression is not related to amyloid deposition, but this issue is not completely resolved. The response to antidepressants is controversial according to the evidence from 10 small double-blind randomized placebo-controlled clinical trials with antidepressants in AD patients with depression: four with sertraline, one with three arms (sertraline, mirtazapine, placebo), one with fluoxetine, one with imipramine, one with clomipramine, one with escitalopram, and one with vortioxetine. The total number of treated patients completing the trials was 638. The main criterion of a positive response was a reduction in the scores of clinical scales for depression of at least 50%. The weighted OR (odds ratio) was calculated with the method of Mantel-Haenszel: 1.29; 95% CI: 0.77–2.16. No significant differences were found compared with placebo. Antidepressants did not have a meaningful negative influence on cognition, which was measured with the mini-mental state examination (MMSE) in 18 clinical trials. Alternatives other than drugs are also discussed. Although there have been important advances in this field, pathophysiology and treatment deserve further research.

抑郁症和阿尔茨海默病 (AD) 是老年人常见的相互作用疾病，对患者和护理人员的生活质量产生负面影响。根据具体情况，晚年抑郁症可能被视为 AD 的早期症状或 AD 的危险因素。本综述重点关注 AD 抑郁症的神经生物学基础和治疗领域的最新进展。我们发现一些看似合理的假设正在出现，与 AD 抑郁症相关，例如神经炎症和免疫调节失调。看来抑郁症与淀粉样蛋白沉积无关，但这个问题还没有完全解决。根据 10 项针对患有抑郁症的 AD 患者使用抗抑郁药物进行的小型双盲随机安慰剂对照临床试验的证据，抗抑郁药物的反应存在争议：其中四项使用舍曲林，一项使用三组（舍曲林、米氮平、安慰剂），一项使用氟西汀，一种是丙咪嗪，一种是氯米帕明，一种是艾司西酞普兰，一种是沃替西汀。完成试验的治疗患者总数为 638 名。阳性反应的主要标准是抑郁症临床量表分数降低至少 50%。采用Mantel-Haenszel方法计算加权OR（优势比）：1.29；95% CI：0.77–2.16。与安慰剂相比，没有发现显着差异。抗抑郁药不会对认知产生有意义的负面影响，这是通过 18 项临床试验中的简易精神状态检查 (MMSE) 来测量的。还讨论了药物以外的替代方案。尽管该领域取得了重要进展，但病理生理学和治疗仍值得进一步研究。