Depression and Dementia

August 4, 2023

Everyone feels down now and then. Sometimes the cause is apparent – a pet passes away, you're diagnosed with a medical condition, you lose a friend – and sometimes there doesn't seem to be a cause. You may even tell yourself, "Snap out of it! You have no reason to be depressed."

Feeling sad occasionally is a normal part of life and nothing to be worried about. However, depression is a different story, and depression in people with Alzheimer's or dementia is particularly complicated and concerning.

What is Depression?

"Depression (also known as major depression, major depressive disorder, or clinical depression) is a common but serious mood disorder. It causes severe symptoms that affect how a person feels, thinks, and handles daily activities, such as sleeping, eating, or working," according to the National Institute of Mental Health. "To be diagnosed with depression, the symptoms must be present for at least two weeks."

"Depression affects an estimated one in 15 adults (6.7%) in any given year," according to the American Psychiatric Association. "And one in six people (16.6%) will experience depression at some time in their life."

Furthermore, according to the National Council on Aging and the National Library of Medicine, estimates for depression in older adults are as follows:

1% - 5% for older adults living in the general community
11.5% of older adults who are hospitalized
13.5% of older adults who require home health care
26.9% of older nursing home residents

Causes of Depression

According to the Cleveland Clinic, experts are unsure of the exact cause of depression. However, the following factors can contribute to the development of depression:

Brain Chemistry
Genetics
Stressful or Traumatic Life Events
Medical Conditions – heart problems, chronic pain, hormonal problems
Side-Effects of Medication – sleeping pills, steroids, beta-blockers
Social Isolation or Lack of Social Support
Not Enough Sleep
Bereavement
Ongoing Stress
Drinking Too Much Alcohol

Depression is more common in people with vascular dementia. Some attribute that to the fact that they are more aware of their condition than those with Alzheimer's, which may cause ongoing stress about their mental capabilities and future.

Symptoms of Depression

The symptoms of depression can vary from person to person. Different levels of depression – mild, moderate, or severe depression – can also create different symptoms. Some symptoms are the same at any age, and some are more common in someone with dementia. And you will notice that many of the symptoms of dementia and depression are the same.

Here are some symptoms of depression to watch for:

Feelings of sadness
Feelings of helplessness, hopelessness, and worthlessness
Lack of energy
Irritability, restlessness, or aggressiveness
Loss of interest in activities once enjoyed
Feelings of guilt
Low self-confidence
Disturbed sleep
Trouble concentrating or thinking clearly
Forgetfulness
Suicidal thoughts
Feeling agitated
Social withdrawal or isolation
Loss of appetite or overeating
Persistent aches and pains

Depression and Dementia

The link between depression and dementia (a general term for a decline in mental ability severe enough to interfere with daily life) or Alzheimer's (a specific brain disease that accounts for 60-80% of dementia cases) is complicated.

Here's why:

Depression is more common in people with dementia, particularly during the early and middle stages of Alzheimer's.
The diseases that cause dementia sometimes cause depression.
Depression can increase the severity of issues with thinking, memory, and behavior in those with dementia.
It can be difficult to diagnose depression in someone with dementia.
Older adults may pass depression off as a normal side effect of aging.
According to the National Library of Medicine, "…earlier-life depression or depressive symptoms consistently have been shown to be associated with a 2-fold or greater increase in risk of dementia."

Experts are still researching to understand the relationship between dementia and depression better. Still, research has shown a relationship, that depression and dementia share common causes, and that depression may be an early sign of dementia.

How to Help an Older Adult with Depression

Depression is serious and should not be ignored. There are things you can do to ease depression and create a better quality of life, but first, it has to be diagnosed. So, it's crucial that you watch for the symptoms of depression in yourself or someone you care for. If you suspect someone may be depressed, they should consult with their doctor or psychiatrist.

A doctor may recommend antidepressant medication (always ask about the risks and benefits), talk therapy, and/or cognitive behavior therapy. Furthermore, there are things you can do for people with both dementia and depression that may help:

Stick to a daily routine
Get regular physical activity
Socialize
Change their environment if it is causing additional stress (loud noises, bright lights, etc.)
Spend more time with them
Reminisce with them – look at scrapbooks and photo albums with them

Need More Help with Home Health Care?

Watching a loved one struggle with depression, dementia, or Alzheimer's disease can be heartbreaking. Comforting Home Care by Phoebe offers compassionate in-home dementia care and Alzheimer's care designed to provide your loved one with the assistance they need to live comfortably and safely at home.