Dementia and Depression in Seniors


Healthy Living - June 14, 2016
David Prescott, PhD - Acadia Hospital

Defining Dementia and Depression:  Two common health concerns for seniors are dementia and depression.  The relationship between these two conditions is complex and usually requires a careful assessment by a health or mental health professional.  However, knowing some of the common similarities and differences can help seniors and their family members know when to ask for help. 

Dementia refers to significant problems with memory and at least one other cognitive ability such as language or reasoning.  As noted by the American Psychological Association‘s Help Center, dementia can be caused by Alzheimer’s disease or other age-related problems such as stroke or Parkinson’s disease.  Dementia is not an inevitable consequence of aging, although it is age-related and doubles in prevalence from a low rate in 60-64 age group to 40-50% of those older than 85.
Depression is primarily a mood disorder, but depression is also marked by difficulties with concentration and short term memory.  In fact, concentration and memory difficulties are often the most treatment resistant symptoms of depression in the elderly.   In addition to problems with memory or concentration, elderly people often first report signs of depression as physical complaints, such as lack of energy, poor sleep, or increase in minor pain and discomfort. 

How are Depression and Dementia Related?  Experts are still trying to sort out the nature of the relationship between depression and dementia.  It is possible that the body’s biochemistry changes with age in a way that increases risk for depression.  There is also some preliminary evidence that for some people, depression may be a precursor to dementia.  Even though these findings are in their early stages, they highlight the importance of seeking treatment early for possible depression or dementia.  

How to Differentiate Dementia from Depression:  As mentioned previously, sorting out whether changes in mood and memory are due to depression, dementia, or both usually requires a health or mental health professional.   However, certain situations are commonly associated with depression.  The following are questions which may help you identify whether or not depression is the underlying factor. 
1.    Are memory problems brief and variable?  Occasional lapses in attention and short term memory, such as forgetting where you put something or forgetting someone’s name, are common and not usually cause for concern about dementia.  These types of problems may become more common when a person is depressed. 
2.    Was the onset of memory problems associated with a loss or other difficult event?  Depression is often associated with a loss of a loved one, a job, or loss of physical functioning.  Sometimes the losses are gradual, sometimes sudden.  In many cases, if memory problems are associated with some type of loss, they are symptoms of depression rather than dementia. 
3.    Does the person have persistent hopelessness, discouragement, or sadness?  Persistent hopelessness or sadness is a hallmark of depression.  If these mood symptoms are present, there is a strong chance of a mood disorder like depression. 

What Can I Do? Perhaps the biggest common misconception about either depression or memory problems is that there is nothing you can do about it.  While there are certainly limitations to treatment, particularly with severe forms of dementia, there are many ways that you can help both your memory and your mood. 
1.    Engage in mentally stimulating activities:  While the exact impact of keeping your mind active is still being researched, there is widespread agreement that staying mentally active helps both your mood and your memory.  
2.    Find ways to be independent:  Independence in the elderly may be different than independence of younger adults, due to physical limitations or general life circumstances. But, finding ways to respect the preferences and self-worth of our senior citizens is a good way to combat depression, and to keep their mind active. 
3.    Get professional assessment and treatment: Both medication and psychotherapy have been shown to be effective for the treatment of depression in seniors.  Also, while there is no cure for dementia, both medication and training in memory improvement techniques can help slow the progression of dementia.  In either case, the sooner an accurate diagnosis is made, the better the outcome is likely to be. 
4.    Don’t keep it all to yourself:  Neither depression or dementia are inevitable consequences of aging.  There are things you can do to cope with depressed mood or mile memory loss.  Don’t think you have to go it alone!
Additional Resources:  
    American Psychological Association Psychology Topics:
    National Institute of Mental Health:  www.nih/