Psychiatric Symptoms in Alzheimer’s Disease: Depression, Anxiety, and Stress as Overlooked Dimensions

The majority of current research on Alzheimer’s disease (AD) is based on a medical model that emphasizes neuropathology, cognitive deterioration, and pharmacological intervention. Although these methods are crucial, they frequently neglect the psychosocial and mental aspects of the illness. Depression, anxiety, and chronic stress are often regarded as secondary comorbidities, despite increasing evidence that they significantly influence the risk, development, and progression of Alzheimer’s disease. This review directly confronts this disparity by employing a psychological and biopsychosocial framework. This review illustrates, through an integrative synthesis of clinical, epidemiological, and mechanistic data, that depression may serve as both a prodromal expression and a modifiable risk factor for Alzheimer's disease, rather than simply a response to cognitive loss. Anxiety is recognized as a distinct factor in disease progression, affecting cognitive development through neurobiological pathways such hippocampus susceptibility and HPA-axis dysregulation, along with psychosocial processes such as avoidance and social isolation. Chronic stress exacerbates these processes by hastening neurodegeneration via prolonged glucocorticoid exposure, neuroinflammation, synaptic dysfunction, and dysregulation of the gut–brain axis. This study emphasizes the therapeutic and preventive significance of early mental health evaluation by redirecting focus from a solely medical interpretation of Alzheimer’s disease to its psychological underpinnings. Incorporating psychological elements into Alzheimer’s research and care could facilitate early intervention, risk mitigation, and a more comprehensive approach to disease management.

کلیدواژه ها:

Depression ، Anxiety ، Stress ، Alzheimer’s Disease ، Psychology