People with Alzheimer’s disease (particularly in the early and middle stages) are at a much higher risk of suffering from depression than the general population. In fact, according to The Alzheimer’s Association, experts estimate that up to 40 percent of people with Alzheimer’s disease (AD) suffer from significant depression.
Depression affects more than 2 million people over 65 in the U.S. The National Mental Health Association conducted a survey and found that as many as 68 percent of seniors knew very little about depression. If you are a senior citizen with Alzheimer’s disease (AD), or an Alzheimer’s caregiver, it’s vital to know how to identify the early signs of depression and know where to go to get help if necessary.
Alzheimer’s Disease and Symptoms of Depression
There are many reasons that diagnosing depression in people with AD can be complicated. For example, side effects of medications and certain medical conditions can cause the same symptoms as depression. Another major reason it’s difficult to identify depression in people with AD is because many Alzheimer’s symptoms (including cognitive impairment) mimic those of depression. In fact, one small 2004 study found that more than half of the participants suffering from late-life depression had significant problems with processing information and executive function (decision making, and reasoning). In addition, cognitive impairment may interfere with a person’s ability to express emotions, masking feelings that oftentimes accompany depression (such as sadness).
Symptoms that are common to both AD and depression include:
-Apathy (loss of interest)
-Problems with memory and focus
-Lack of attentiveness
-Social withdrawal
-Isolation
-Difficulty concentrating
-Impaired thinking
-Slow speech or movement
Depression in people with AD doesn’t always manifest the same as it does in those without Alzheimer’s disease (AD). Here are some ways (according to The Alzheimer’s Association) that depression may look different in those with AD:
-Depression may be less severe in AD.
-Depression may not last as long in people with AD.
-Symptoms of depression may come and go with co-occurring AD.
-A person with AD who has depression is less likely to talk about (or attempt) suicide.
Diagnosing Depression in People with AD
In order to be diagnosed with depression, a person with AD who is diagnosed with depression must have either a depressed mood or decrease in pleasure in normal activities, as well as 2 or more of the following symptoms (for at least 2 weeks):
-Social isolation or withdrawal
-Disruption in appetite that is not related to another medical condition
-Disruption in sleep
-Agitation or slowed behavior
-Irritability
-Fatigue or loss of energy
-Feelings of worthlessness, hopelessness, or inappropriate or excessive guilt
-Recurrent thoughts of death, suicide plans, or a suicide attempt
“Often in older adults, when they’re depressed, you don’t see high levels of crying and sadness you might see in a younger adult,” says Dr. Sarah Yarry, Ph.D., a Licensed Clinical Psychologist specializing in gerontology. “You see it more often as withdrawal. It’s apathy, hopelessness, loss of appetite and interest.” Seniors commonly demonstrate physical symptoms as a result of depression-such as aches and pains, says Dr. Yarry.
A professional evaluation for depression will include, a review of the medical history, a physical and mental examination, and an interview with family members to get a clear and accurate picture of symptoms. The attending physician may make a referral to a psychiatrist or other mental health professional to make a diagnosis. Because there are so many factors involved in diagnosing depression in people with AD, a consultation with a geriatric psychiatrist (who specializes in treating depression in seniors) may be indicated. Your attending physician can make the referral.
If you suspect depression in a loved one with AD, it’s vital to seek immediate medical advice from the attending physician.
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