As if the changes brought about by dementia aren’t devastating enough, many of the more than 5 million people living with the disease in the U.S. also face depression. In fact, according to the American Psychological Association[APA], it’s common for people with dementia to experience not only depression but also anxiety and paranoia.
Those with Alzheimer’s Disease — the most common form of dementia, affecting about 1 in 10 U.S. adults over 65 — often experience depression in the early and middle stages of the illness. Since dementia and depression share similar symptoms, it can be difficult for doctors to know whether someone has dementia, depression or both.
If your loved one has symptoms of either condition, he or she will need a full physical and mental health examination to get an accurate diagnosis. As with dementia by itself, it’s best to see a doctor about depression in dementia sooner than later, since treatment can make a big difference in quality of life and give family members important tools to help their loved ones cope.
Sometimes it can be hard to know whether a loved one with dementia is depressed or is only showing dementia-related symptoms that don’t necessarily indicate depression. However, research shows that people with Alzheimer’s disease tend to experience depression differently from those without Alzheimer’s.
Depression symptoms in people with Alzheimer’s tend to be less severe than in those who are depressed but don’t have dementia, according to research conducted at Duke University Medical Center. Individuals with both Alzheimer’s Disease and depression may have noticeable irritability and social withdrawal, but they may not show many of the other symptoms typically associated with depression.
Some signs that a person with dementia may also be depressed include:
- Social withdrawal
- Apathy or lack of interest in previously enjoyed activities
- Irritability
- Crying
- Not eating
- Lethargy
Many times, the isolation is one of the big signs that you have some dementia going on, and isolating yourself in your room and not being interested in life is a sign of depression. Also notable is that, while social withdrawal is a key symptom of depression in dementia, this behavior can also occur because the person with dementia is hearing impaired.
Even doctors have difficulty determining whether an older adult has depression or dementia, since the two conditions share so many overlapping symptoms. In older adults experiencing depression for the first time, signs of cognitive decline are also common.
If your loved one has any of the above symptoms, it is important to see a doctor as soon as possible for diagnosis and treatment. Doctors rely on various tests to help them detect whether an older person has dementia. There is the Cornell Scale for Depression in Dementia, which relies on interviews with patients and nursing staff to evaluate symptoms.
Another is the Geriatric Depression Scale, a 15 item yes/no questionnaire, useful in the earlier stages of dementia. Also the Minimum Data Set 3.0 Cognitive Function Scale is useful as a performance-based diagnostic in skilled nursing facilities. For those who have both Dementia and Depression, a combination of treatments is used through support groups working to establish daily routines along with anti-depressants, if necessary.
Important for loved ones and caregivers at home, is to keep your loved ones engaged in the world around them. A big part of that engagement is to make sure your loved one is socially stimulated. They need purpose and purposeful activities. When we lose our sense of purpose, we tend to withdraw and decline. Actively engaged, we find little time to be consumed in depressive thinking and behaviors.
So, keep your loved one busy and give them meaningful activities- a reason to get up every day. Sometimes the simplest activities and tasks will do wonders for an older adult. Occupy people with dementia with a continuous stream of activities. When you have an activity that stops — that’s when you have the depression signs, that’s when you have apathy, that’s when they fall asleep and when they start to wander.
Stimulate them, and give personal attention by looking them in the eye, giving compliments and helping them feel valued. Keep them smiling, make them laugh, lightly touch their hair or cheek. Go for walks -guided walks-regularly scheduled. This can also reduce the wandering and getting lost incidents that happen with adults with Dementia.
The most important takeaway for loved ones and family members of a person with Dementia, Depression or both is: keep your loved one feel that they are loved, valued, and part of the family, with purposefulness reinforced by you. Surround them with love-as much love as before their diagnosis, but more targeted love communicated by all. So, go home, brush your loved one’s hair, splash on that familiar scent, make that person feel special and spend the day playing BINGO!!!
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