Is It Depression or Alzheimer’s?

For many older people, depression and Alzheimer’s go hand in hand. However, the link is largely unclear among the scientific and medical communities. Many people assume that Alzheimer’s causes depression because it brings with it a sense of loss and frustration. While that may be true, depression is far greater than feeling sadness over changes in your mind and body.  Research has suggested that Alzheimer’s affects the brain cells that govern mood and emotions; in short, Alzheimer’s patients often lose the capability to manage their emotions effectively. When coupled with memory loss, this can create a heightened level of anxiety. For example, an Alzheimer’s patient may feel abandoned or neglected, not recalling that a family member visited earlier in the day. However, a study published in the journal Neurology indicated that people with a history of depression have a greater risk of developing Alzheimer’s, but it’s not due to changes in the brain chemistry or brain mass. The study conducted by Erasmus University in the Netherlands followed 503 people between the ages of 60 and 90 who did not have dementia or Alzheimer’s; about 20 percent of the subjects had a history of depression. Upon follow-up six years later, 33 of the subjects had developed dementia — and they were four times as likely to have had a history of depression than the subjects who did not develop Alzheimer’s or dementia. However, because there was no measurable differences in the brain mass of the patients who had depression and Alzheimer’s and those who had Alzheimer’s without a history of depression, scientists are not convinced that depression causes Alzheimer’s. What is also of great concern to doctors, though, is the fact that Alzheimer’s and depression share many symptoms, making it more difficult to make a conclusive diagnosis.

Right Diagnosis, Right Treatment

Experts estimate that as many as 40 to 50 percent of people with Alzheimer’s also suffer from depression. However, what that number doesn’t include is the number of people who are potentially misdiagnosed, at least temporarily, because the symptoms of depression and Alzheimer’s are so similar. This presents a significant challenge when it comes to treatment. Depression can usually be treated effectively with medication and therapy and significantly improve quality of life. While medication for Alzheimer’s can often slow the progression of the associated cognitive decline, there is currently no cure for the disease. Some of the symptoms that are common with both depression and Alzheimer’s include memory problems, loss of interest in once enjoyable activities, withdrawal, sleep disturbances and trouble concentrating. Generally, it takes a full psychological and physical exam to determine whether the root of the problem is depression or Alzheimer’s. However, there are some clues that what appears to be depression may in fact be Alzheimer’s. In general, people with Alzheimer’s with depression do not experience long lasting mood disturbances; most will show signs of depression for a few days or weeks at the most and then appear to be “normal” for some time. The depression symptoms also do not appear as frequently. People with Alzheimer’s also do not have as many suicidal thoughts as those with depression, but they do have a greater likelihood of experiencing delusional thoughts or hallucinations. These symptoms often appear with the typical signs of Alzheimer’s, which include:

• Memory problems that interfere with daily life
• Confusion about time or place
• Challenges when completing normal, simple tasks, such as turning on the television
• Increased poor judgment
• Vision changes related to color or spatial perception
• New difficulties speaking or writing
• Inability to retrace steps

Often, though, it’s the signs and symptoms that mimic depression that show up first, making it challenging for caregivers to get to the real root of the problem. That is why it’s so important to see a doctor as soon as symptoms appear to The earlier one receives treatment, the greater the benefit.

Caring for a Depressed Alzheimer Patient

Because depression symptoms are so common among Alzheimer’s patients, it’s important to learn to recognize and deal with them. Appropriate treatment and interventions can ease depression, even if it can’t address the root causes. A predictable daily routine that includes people, places and things that the patient enjoys can help ease the sadness and despair and create some enjoyment. Regular exercise is also beneficial. It’s also important to provide regular reassurance that the person is loved, cared for and a valuable part of the family; often depression stems from feelings of abandonment or neglect, warranted or not. The link between Alzheimer’s and mental health is well established, but there is still much work to be done to determine how they truly impact each other. In the meantime, pay close attention to your loved ones, particularly their mood and whether they appear depressed. It might be the blues, but it could be something even more serious and life-altering.