Is it Dementia or Depression – Seniors in Arizona

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For Information or Home Care in Phoenix, Scottsdale, Fountain Hills, Carefree, Cave Creek, Paradise Valley, Arizona, please click Right at Home or call 602-569-7240

Are you confused about whether or not your loved one has depression, dementia or maybe both? With many similar symptoms, it can be hard for family members to distinguish between the two illnesses. As much as 50 percent of people with Alzheimer’s (the most well-known form of dementia) also suffer from depression, so it’s natural to be concerned.  Fortunately, there are survey questions and treatment options that may be able to identify and help ease your loved one’s symptoms.

Diagnosis

There are many shared symptoms between dementia and depression, including anxiety, agitation, apathy, irritability, poor sleep, restlessness, memory loss and difficulty concentrating. Anton P. Porsteinsson, director of the Alzheimer’s Disease Care, Research, and Education Program, points out the difference: depression affects emotions while dementia affects cognitive ability. “Someone who’s depressed may not care to drive, pay bills or pay attention to the details of events; someone with Alzheimer’s can’t do these things,” he said.

Nina Laurencot, a geriatric social worker, added that other conditions, such as urinary tract infections, may also cause memory loss and can make diagnosis even more difficult. In addition, the lines between the two conditions are blurred because many people with dementia “feel anxiety about early memory losses, they acknowledge the loss of vocabulary and short-term events, all of which can catapult them into depression,” said Laurencot. So a person’s awareness of his or her dementia can actually cause depression.

There are several surveys or questions you can ask your loved one to determine whether a doctor’s visit is necessary. Watch for tell-tale signs specific to depression, which include sad feelings, feelings of hopelessness, frequent crying episodes, fatigue, sleeping too much or not enough, poor appetite or overeating, expressing thoughts of dying or suicide, or persistent aches and pains.  If these symptoms persist for at least two weeks, it is time to start asking your loved one some important questions.

According geriatrician Leslie Kernisan, M.D., for someone with mild or moderate dementia, there are five questions you should ask to assess whether or not your loved one suffers from depression:

• Are you basically satisfied with your life?
• Do you often get bored?
• Do you often feel helpless?
• Do you prefer to stay at home rather than go out and do things?
• Do you feel worthless the way you are now?

For people with more severe cases of dementia, there are two different surveys you can use. The first is Stanford University’s Geriatric Depression Scale.  This scale consists of 15 questions to ask your loved one. A five-point score or more indicates depression and you should schedule a doctor’s visit. The other is The Cornell Scale for Depression in Dementia, which is a 19-question survey; a score of eight indicates depression. A high score on each necessitates a visit to the loved one’s doctor or a specialist.  Both surveys are available for free online.

Approaching Your Loved One

Bringing up the topic of depression and seeking help with your loved one can be difficult. Laurencot recommends “empathy, active listening, and recognizing that losing friends, health, and independence can be difficult and sometimes a little medical help can get us through it.” Many elderly people do not want to talk about their depression because they are embarrassed, so it is important to make it clear that what your loved one is going through is normal and that there is nothing to fear. Let your loved one tell you how he or she is feeling by asking questions, such as, “You seem to be more tired and down than usual lately, are you okay?”

Steps to Treatment

Laurencot suggests the first step after administering either the Geriatric Depression Scale or The Cornell Scale for Depression in Dementia is to schedule a geriatric assessment.  Your loved one’s General Practitioner (G.P.) can use this to rule out other medical conditions that may cause similar symptoms to depression or dementia.

Once a medical doctor has confirmed a diagnosis of depression, whether your loved one also has dementia or not, you have several options for helping your loved one that don’t require medication or professional assistance. One of the most important and effective options is physical exercise. Keep your loved one active by going for daily walks or doing other activities that are approved by the G.P. Exposure to fresh air and sunlight are also effective. You should try to plan daily activities based on your loved one’s interests. A visit to a museum, shopping, or a social get together are all things that can help alleviate your loved one’s feelings of depression. Joining a support group together is another idea you may consider to let your loved know there are others going through the same thing.

If these less-structured methods are not helping, there are other options. Many doctors will prescribe antidepressants or suggest psychotherapy, also referred to as counseling or intensive talk-based therapy. Be sure to tell the doctor about any medications your loved one may already be taking. Studies have proven psychotherapy to be very effective in treating elderly depression, and research has also shown that psychotherapy and antidepressants together is the most effective medical treatment. You may want to continue the psychotherapy and antidepressants even after the depression has been treated. A study in 2006 in the New England Journal of Medicine found that when treatment was continued, the elderly patients were less likely to relapse.

Suggestions for Further Research

According to Laurencot, most hospitals offer neuropsychiatry evaluations for diagnosis of dementia and elder services for home care support and social programs. She stresses the importance of seeking help and gaining an accurate diagnosis because she often sees delirium and depression mistaken for dementia. Be sure to ask your loved one’s G.P. any questions you may have and offer your support.

For More Information, In Arizona, Right at Home is standing by to assist you with your Senior In-Home Caregiving Needs.  Our trained, experienced, background-checked, caring, bonded and insured caregivers are waiting to assist you with everything from things like companionship, housekeeping and transportation all the way to helping with personal care items such as bathing, continence control and much more.

For Information or Home Care in Phoenix, Scottsdale, Fountain Hills, Carefree, Cave Creek, Paradise Valley, Arizona, please click Right at Home or call 602-569-7240