Dementia and depression: What's the connection?

Sunrise Senior Living  |  May 9, 2017

Many older adults experience cognitive changes as they age.

Decreases in memory, energy and mood can happen to anyone, but that doesn't necessarily mean that all these fluctuations are expected or typical. While most older adults will experience some trouble recalling minor details or losing interest in old hobbies, significant alterations to their moods and engagement could signal serious conditions like depression or dementia. 

Research shows that these conditions often coexist, and in their early stages, it may be hard to differentiate between the two. Knowing more about these conditions and how they may affect your loved one is an important part of your role as a caregiver.

Signs of early Alzheimer's 
Alzheimer's progresses in stages. In it's early phase, the Fisher Center for Alzheimer's Research Foundation reports that functional difficulties become more apparent. Tasks like preparing meals or managing finances can become harder to complete, if they can be completed at all. People with early-stage Alzheimer's also tend to struggle with writing down or even remembering the correct date. Signs of significant memory loss also can become more apparent, as they often forget major events that should be easier to recall, like memories tied to major holidays. 

"Symptoms of early dementia mimic the signs for depression."

Mood changes are also prevalent during this phase of the disease. Typically, people will become more withdrawn and have fewer emotional reactions. At this point, those with Alzheimer's are starting to realize the ways their minds are changing, which can have a significant impact on their temperaments. 

How Alzheimer's may look like depression
Many of the physical and emotional symptoms of early dementia mimic the signs of depression. According to the National Institute of Mental Health, older adults experiencing a depressive disorder start to lose energy. They stop performing tasks that they used to because they tire more quickly and they no longer have interest in activities or projects that they once enjoyed. 

This can mirror the ways that people with Alzheimer's start to shy away from their old routines, because tasks have become more challenging for them. From an outsider's perspective, it can be hard to tell if your loved one is withdrawing from activities because they're losing interest, or because they're frustrated by their sudden struggle to complete them.

Emotionally, those with depression are likely to feel hopeless, guilty, helpless, anxious and empty. Similarly, early-stage Alzheimer's makes people feel emotionally withdrawn and subdued. Both conditions can also impact a person's appetite and sleeping patterns. 

The ties between dementia and depression
Alzheimer's, especially in the early to middle stages, is often accompanied by chronic depression, says the Alzheimer's Association. Up to 40 percent of people with Alzheimer's will experience depression as well. As dementia begins to take hold, people may feel sad and hopeless as they realize what is happening to them. Depression may set in, and they are often less likely to talk about these feelings or experiences than people who have depression without dementia. 

While Alzheimer's can lead to depression, depression in turn can impact dementia as well. According to the Mayo Clinic, depression can trigger decreased cognitive function and may impact daily activities even further. 

People with depression and dementia need support and encouragement through treatment.People with depression and dementia need support and encouragement through treatment.

Getting treatment for your loved one
If you are the caregiver for an older loved one who has dementia and you suspect that they may have depression as well, it's important that you consult their doctors for a formal diagnosis and treatment. Look for signs that point more towards depression than just Alzheimer's alone, such as being frequently tearful or sad, more irritable or if they express feelings of unfounded guilt. 

The physician may prescribe an antidepressant to help with these symptoms, depending on your loved one's medical history and the other medications they are currently taking. If medicine doesn't seem like the right option, doctors can also recommend therapy, support groups or social outings to decrease isolation. 

As a caregiver, you can also help your loved one face their depression with activities that can be done around the home. Exercise can help alleviate symptoms, so plan for short walks or other low-impact activities to help your loved one get the endorphins and other feel-good chemicals going that working out can trigger. The Alzheimer's Association also stresses the importance of reassuring and validating your loved one. Let them know that it's okay to have these kind of feelings, but comfort and assure them that they are safe and loved, and that you won't abandon them. Recognize their successes and the ways the contribute to help support them as well. 

Depression and dementia can be challenging to face, but with the right guidance and support you can be a valuable asset for helping your loved one get the treatment they need.

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