What Are Risk Factors Of Depression
There are many things that may be risk factors of depression. For some people, changes in the brain can affect mood and result in depression. Others may experience depression after a major life event, like a medical diagnosis or a loved ones death. Sometimes, those under a lot of stress especially people who care for loved ones with a serious illness or disability can feel depressed. Others may become depressed for no clear reason.
Research has shown that these factors are related to the risk of depression, but do not necessarily cause depression:
- Medical conditions, such as stroke or cancer
- Genes people who have a family history of depression may be at higher risk
- Functional limitations that make engaging in activities of daily living difficult
- Addiction and/or alcoholism included in Substance-Induced Depressive Disorder
Delirium Risk Factors: Medical Conditions
Heart and lung disease can increase the risk for delirium by affecting the delivery of oxygen to the brain. Congestive heart failure, heart attacks, and arrhythmias all compromise the ability of the heart to pump an adequate supply of oxygen and nutrients to the brain and remove waste and toxins from the brain. Physical shock also decreases the flow of blood to and from the brain. COPD and respiratory failure will impair the exchange of oxygen and carbon dioxide in the lungs, limiting oxygen to the brain and allowing the buildup of carbon dioxide.
Several metabolic conditions can also predispose someone to delirium by disrupting the balance flow of oxygen and nutrients to the brain and waste and toxins away from the brain. Kidney failure and liver failure hinder the bodys ability to metabolize and rid the body of waste and toxins that could be damaging to the brain. Electrolyte or salt imbalance, malnourishment, and vitamin deficiency can hinder brain function and cause delirium. Anemia can also predispose someone to delirium by reducing the bloods capacity to carry oxygen and nutrients to the brain. Lastly, diabetes mellitus, hyperthyroidism, and hypothyroidism can cause hormone imbalances that can lead to delirium.
Because so many medical conditions can contribute to delirium, it is very important to treat and control all medical issues.
Risk Factors For Depression
Some people are more likely to experience depression. According to the National Alliance on Mental Illness, Older women are at a greater risk because women in general are twice as likely as men to become seriously depressed. Biological factors like hormonal changes may make older women more vulnerable. The stresses of maintaining relationships or caring for an ill loved one and children also typically fall more heavily on women, which could contribute to higher rates of depression. Unmarried and widowed individuals as well as those who lack supportive social network also have elevated rates of depression. Conditions such as heart attack, stroke, hip fracture or macular degeneration and procedures such as bypass surgery are known to be associated with the development of depression.
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Questions To Ask Your Doctor
- Do depression and Alzheimer dementia run in families? Am I at risk?
- What types of medicines treat depression and Alzheimer dementia? Are there any side effects?
- Will depression go away?
- Are there any lifestyle changes that help improve the symptoms?
- Can you recommend a support group for people who have these conditions and their caregivers?
Irreversible Dementias: Binswangers Disease
Binswangers disease is a rare form of vascular dementia that involves the white matter of the brain. White matter is the fatty coating that insulates nerve fibers. In Binswangers this coating begins to develop pockets of dead tissue called lacunas, resulting from stenosis or hardening of small blood vessels in the deeper parts of the brain. It progresses in a similar manner as multi-infarct dementia and, in addition to high blood pressure, is often associated with the history of smoking.
This form of dementia is associated with psychiatric symptoms including depression, delusions and hallucinations, as well as losses in memory, speech, self-care skills, and recognition of objects and people.
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Delirium Risk Factors: Drugs
Drug intoxication is responsible for up to 20% of delirium cases, either from side effects, overdose, substance abuse, or substance withdrawal. Medications that are prescribed for depression, hyperactivity, schizophrenia, or other psychiatric illness are considered to be psychoactive drugs. These drugs are sometimes prescribed for behavior problems in dementia treatment. They can have a powerful effect on the brain and, though prescribed for good reasons, can also make the person more vulnerable to delirium.
All medications have side effects some more dangerous than others. When a person is taking several kinds of medication, referred to as polypharmacy, the medications can interact with each other, either to increase or decrease their effect, or to produce a new and possibly extreme reaction. Therefore, people taking many medications should be closely monitored for drug-drug interactions such as delirium.
Withdrawal from drugs can also cause delirium. For example, withdrawal from alcohol dependency can cause delirium tremens . Although rare, DTs usually begin 24 to 72 hours after reducing alcohol intake and can persist for a few hours or up to a few weeks. It can be fatal if not treated and so is a medical emergency.
Depression And Risk Of Dementia
Most previous studies have examined late-life depression or depressive symptoms and risk of dementia, while a few studies have considered earlier-life depression. Given the variable nature of depression onset, the high occurrence of depression in young adulthood and middle age, and the long preclinical period of dementia, studying earlier-life depression may offer an opportunity to determine if depression is a risk factor of dementia, years before the syndrome starts. On the other hand, a significant relationship of late-life depression and dementia may allow for better study of depression as part of the prodromal stage of dementia. As such, studies focusing on both earlier- and late-life depression may provide complementary evidence.
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Alternative Dementia Treatments And Research
In addition to the FDA-approved drugs, alternative treatments for Alzheimers disease are also available, including dietary supplements. Most of these are not regulated by the FDA or quality controlled. There may be limited research on their effectiveness and side effects. Please consult a physician before starting an alternative treatments, as there may be serious side effects or drug-drug interactions.
A popular supplement for Alzheimers disease treatments that is currently not FDA approved is ginkgo biloba. Research has been inconsistent regarding its efficacy. Some studies report that ginkgo biloba is safe and may improve or stabilize mental and social functioning in those with dementia. One study found that it was as effective as donepezil in treating Alzheimers disease. The American Academy of Neurology has stated that vitamin E supplements, also known as alpha-tocopherol, may delay symptom progression in some people with Alzheimers disease. One should consult a physician prior to taking vitamin E due to possible side effects including increased risk of bleeding. Research is ongoing to evaluate the benefits of vitamin E and other antioxidants, aspirin and other nonsteroidal anti-inflammatory drugs , estrogen, progesterone, and selegiline, an MAO inhibitor, at slowing the progression or reducing the risk of developing Alzheimers.
What To Do If You’re Blue
If you have any signs of depression , the first step should be to see your doctor or a psychiatrist. Yet many people avoid getting diagnosed because of the stigma depression still holds for older adults. “Older people still have the idea that, I’m not crazy. I don’t want people to think I’m crazy,'” Dr. Cremens says.
“If somebody appears to have the beginnings of dementia and they are depressed, it’s very important to treat their depression, and to treat it as aggressively as possible,” she adds.
The treatment for depression at any age usually involves a combination of antidepressant medicines, talk therapy, and cognitive behavioral therapy .
“I think older women who are depressed should also be evaluated for dementia,” Dr. Cremens says. Screening tests such as the Mini-Mental State Exam and the Montreal Cognitive Assessment are short questionnaires your doctor can use to pick up on cognitive impairment early.
Although there isn’t any real method to prevent dementia, you may be able to reduce your risk by not only treating depression, but by also following healthy lifestyle habits such as exercising, eating a healthy diet, and keeping your mind active with social outings and games. Knowing you’re at high risk for dementia can also help you and your family prepare for it, so it won’t be as much of a shock down the road.
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Health Conditions With Symptoms Similar To Dementia
These 7 health conditions often cause symptoms similar to dementia in older adults.
Once these conditions are diagnosed and properly treated, the troubling symptoms are usually eliminated.
1. Urinary tract infection Seniors are the most likely group of people to develop a urinary tract infection , something easily treated with antibiotics.
Theyre also the least likely to have typical symptoms like pain during urination, fever, or a frequent urge to go.
Instead, UTI symptoms often show up as a sudden change in behavior. Someone who suddenly cant remember a significant event from last week might have a UTI.
Other signs of an infection include:
- Becoming unusually sleepy or withdrawn
2. Medication side effectsMedications called anticholinergics are commonly used by older adults .
These drugs and their side effects can cause dementia-like symptoms in people without previous cognitive issues.
Thats because anticholinergic drugs block brain chemicals used for learning, memory, and muscle functions.
Older adults already have less of these key brain chemicals because our bodies produce less as we age. And blocking them with drugs makes it even harder for the brain to function properly.
Ask the doctor to do a complete review of all medications and supplements. But DONT start, stop, or change dosage for any medications without first talking with the doctor.
Dementia develops slowly, but delirium starts suddenly.
Distinguishing Between Types Of Dementia
For physicians and families intent on pinning down a diagnosis, one major complicating factor is the existence of so many kinds of dementia. More than 50 conditions can mimic or cause dementia.
Alzheimers disease is by far the most common intractable condition. But other causes of irreversible dementia include blood vessel diseasevascular dementia), other degenerative disorders , slow-growing brain tumors, or infections of the central nervous system .
In some types of dementia, treatment will improve mental functioning, and in a small percentage, the dementia is completely reversible if treatment begins before permanent brain damage occurs. Thats why it is important to report to a doctor any signs of dementia as early as possible.
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Delirium Risk Factors: Brain Conditions
Brain conditions can increase susceptibility to delirium through direct damage to the brain or compromise of its function. Head trauma, bleeding in the brain or head, brain infections , seizures, strokes, hypoxemia , hypercapnia , and dementia can predispose someone to delirium. Sleep deprivation can also lead to delirium through a complex mechanism.
Having a diagnosis of Alzheimers disease or other form of dementia can make a person more vulnerable to delirium. People with dementia are less able to interpret and understand their environment, which can result in fear and frustration. They may also have poor communication and functional abilities, which limits their ability to meet their needs and express their thoughts. The brain of someone with dementia is in a precarious state at baseline so the addition of pain, a stressful experience, high fever, or toxin to the brain can tip the balance towards delirium.
Many older people including those with dementia have poor vision and hearing. These sensory losses limit peoples ability to understand their environments and the activities occurring around them, causing them to be more easily frightened by a change in routine or the environment, or an unfamiliar person or noise. All these factors can increase the risk of developing delirium.
Does Depression Contribute To Dementia
A large body of research has linked late-life depression to social isolation, poorer health and an increased risk of death. Now, a new study finds that depression is associated with subsequent vascular dementia and Alzheimers disease, conditions poised to expand dramatically with the aging population.
The report, published on Wednesday in the British Journal of Psychiatry, is a meta-analysis of 23 previous studies that followed nearly 50,000 older adults over a median of five years. The researchers found that depressed older adults were more than twice as likely to develop vascular dementia and 65 percent more likely to develop Alzheimers disease than similarly aged people who werent depressed.
We cant say that late-life depression causes dementia, but we can say it likely contributes to it, said Meryl Butters, an associate professor of psychiatry at the University of Pittsburgh School of Medicine and a co-author of the paper. We think depression is toxic to the brain, and if youre walking around with some mild brain damage, it will add to the degenerative process.
In terms of absolute risk, she said, the data suggest that 36 of every 50 older adults with late-life depression may go on to develop vascular dementia, while 31 of every 50 seniors with a history of depression may eventually be diagnosed with Alzheimers.
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What Are Signs And Symptoms Of Depression
How do you know if you or your loved one may have depression? Does depression look different as you age? Depression in older adults may be difficult to recognize because older people may have different symptoms than younger people. For some older adults with depression, sadness is not their main symptom. They could instead be feeling more of a numbness or a lack of interest in activities. They may not be as willing to talk about their feelings.
The following is a list of common symptoms. Still, because people experience depression differently, there may be symptoms that are not on this list.
- Persistent sad, anxious, or “empty” mood
- Feelings of hopelessness, guilt, worthlessness, or helplessness
- Irritability, restlessness, or having trouble sitting still
- Loss of interest in once pleasurable activities, including sex
- Decreased energy or fatigue
- Moving or talking more slowly
- Difficulty concentrating, remembering, or making decisions
- Difficulty sleeping, waking up too early in the morning, or oversleeping
- Eating more or less than usual, usually with unplanned weight gain or loss
- Thoughts of death or suicide, or suicide attempts
If you have several of these signs and symptoms and they last for more than two weeks, talk with your doctor. These could be signs of depression or another health condition. Dont ignore the warning signs. If left untreated, serious depression may lead to death by suicide.
Medication And Older Adults
As you get older, body changes can affect the way medicines are absorbed and used. Because of these changes, there can be a larger risk of drug interactions among older adults. Share information about all medications and supplements youre taking with your doctor or pharmacist.
Use this worksheet to help track your medications.
Treatment, particularly a combination of psychotherapy and medications, has been shown to be effective for older adults. However, not all medications or therapies will be right for everyone. Treatment choices differ for each person, and sometimes multiple treatments must be tried in order to find one that works. It is important to tell your doctor if your current treatment plan isnt working and to keep trying to find something that does.
Some people may try complementary health approaches, like yoga, to improve well-being and cope with stress. However, there is little evidence to suggest that these approaches, on their own, can successfully treat depression. While they can be used in combination with other treatments prescribed by a persons doctor, they should not replace medical treatment. Talk with your doctor about what treatment might be good to try.
Dont avoid getting help because you dont know how much treatment will cost. Treatment for depression is usually covered by private insurance and Medicare. Also, some community mental health centers may offer treatment based on a persons ability to pay.
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Light Shed On Link Between Depression Dementia
Researchers deem depression an independent risk factor for dementia
HealthDay Reporter
WEDNESDAY, July 30, 2014 — Older people with depression are more likely to develop dementia, but researchers have been unable to explain the exact nature of the relationship between the two.
Specifically, they haven’t been able to figure out the direction in which the relationship works — does depression help bring on dementia, or does dementia cause people to become depressed?
A new study published online July 30 in the journal Neurology sheds more light on the mystery.
Depression is a risk factor for dementia, researchers report, and people with more symptoms of depression tend to suffer a more rapid decline in thinking and memory skills. While the study found an association between the two, it did not prove a cause-and-effect relationship.
Depression accounted for about 4.4 percent of the difference in mental decline that could not be attributed to dementia-related damage found in the brain, the researchers said.
“This is a risk factor we should take seriously,” said lead author Robert Wilson, senior neuropsychologist at the Rush Alzheimer’s Disease Center at Rush University. “Treating depression can reduce the risk of dementia in older people.”
The study involved over 1,700 people, with an average age of 77, who had no thinking or memory problems at the start of the study.
However, the researchers found no relationship between depression and dementia-related damage in the brain.
Differences Between Depression And Dementia
- Depression tends to develop much more quickly than most types of dementia over weeks or a few months.
- It is common for people with dementia to have problems with their speech and awareness of where they are and what time it is. This is unusual in depression.
- A person with depression may sometimes say they cant remember something but then remember when they are prompted. However, a person with dementia is likely not to remember recent events. They may also try to cover up their memory loss.
- A person with severe depression may have problems with their reasoning or memory. However, this is likely to be because they have poor concentration. Their problems with reasoning or memory should get better with treatment or when the depression lifts. This does not happen with dementia.
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