The death of Gunter Sachs, iconic playboy of the go-go 1960s, has brought to light how depression often accompanies Alzheimer's and other neurodegenerative diseases such as Parkinson's and Huntington's. The German billionaire and ex-husband of Brigitte Bardot fatally shot himself Saturday at his chalet in Gstaad, Switzerland, at age 78, leaving a suicide note that revealed his struggle with an illness he dubbed "A," thought to stand in for Alzheimer's.
"The loss of mental control over my life was an undignified condition, which I decided to counter decisively," read the signed note, released by Sachs' family to Swiss media Sunday.
Roughly one-third of people with Alzheimer's disease also suffer from a form of depression, according to Dr. Gary Small, director of the Center on Aging at University of California at Los Angeles.
"The realization that you have a disease that has no cure, no treatment, that robs you of your mind, that can be pretty depressing," Small said. "Many people, when they grasp that, they don't want to live anymore. They don't want to face the future."
But the mood disturbance could also result from the same attack on brain cells that causes the memory loss and behavior changes associated with Alzheimer's, Small said. In a 2009 study published in the American Journal of Geriatric Psychiatry, Small and his colleagues found an association between the amount of plaque and tangles -- hallmarks of Alzheimer's disease -- in the brain and symptoms of anxiety or depression.
"It's possible that plaques and tangles not only attack cognitive abilities but also contribute to mood symptoms," Small said.
The recent expansion of Alzheimer's diagnostic criteria to include people yet to develop symptoms such as memory loss could boost the incidence of depression even more, said Small.
"We have new tools for making diagnoses earlier and earlier, which is good -- it helps us with research and it helps people with planning -- but it also brings up the issue that there may be more people who are diagnosed at a time when they appreciate the disease's impact, rather than being demented."
Despite the dearth of effective treatments for Alzheimer's disease, depression can be treated through drugs or therapy. But barriers, such as Alzheimer's symptoms and the stigma of mental illness, can stand in the way of people seeking the proper care, Small said. Depression can also take a toll on caregivers, who play a crucial role in the lives of people living with Alzheimer's disease.
"One thing about depression, or any kind of mood disturbance, is it tends to be, I guess maybe contagious? Not like a common cold, but if you have any capacity for empathy and you're around somebody who's depressed, you're going to feel that too," Small said.
More than half of caregivers also experience depression, Small said.
"It becomes a real challenge for caregivers and for patients," he said.
It is unclear whether Sachs had been diagnosed with Alzheimer's disease or depression. Sachs' father, Willy Sachs, shot and killed himself in 1958.
Despite training as a mathematician and economist, Sachs made history as the 1958 European bobsled champion, a photographer, documentary filmmaker and author of the 1997's "The Astrology File: Scientific Proof of the Link Between Star Signs and Human Behavior."
Nicknamed "Sexy Sachs" in his bare-chested heyday, the doe-eyed romantic once ordered a helicopter to shower Bardot's Riviera home with thousands of red roses. Bardot is said to be devastated by the news of Sachs' death, according to AFP.
Sachs is survived by his third wife, former model Mirja Larsson, and their two sons, as well as a son by his first wife, Anne-Marie Faure, who died the same year as Sachs' father.