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Can Depression In The Elderly Mimic Dementia

What Features Are Characteristic Of Pseudodementia Associated With Depression

Medications That Mimic Dementia

Patients with pseudodementia may or may not have a history of depressive or vegetative symptoms. They tend to have flat affect, to give up easily when mental status is examined, or to say that they cannot perform a task without even trying it. They often respond surprisingly well when given extra time and encouragement, but they may deny their success. Results of mental status examination are inconsistent; for example, they may fail a simple task but perform a similar, more difficult one correctly. Or they may have variable strengths and weaknesses over repeated testing sessions.

James B. Brewer, … Allyson C. Rosen, in, 2007

Types Of Depression In Older People

There are different types of depression and most types can affect older people just as easily as they affect anyone else.

Major depressive disorder is perhaps the most common type of depression in older people. Major depression may occur during their younger years and may reappear during their senior years or it may exist continuously throughout their lifetimes. The symptoms of major depression will interfere with their ability to sleep, eat, and enjoy life.

Persistent depressive disorder is also known as PDD. This is a type of depression that lasts for at least two years. A person living with persistent depressive disorder may have times of major depression along with periods of milder symptoms over those two years.

Psychotic depression is a type of major depressive disorder when some form of psychosis is present along with the depression. Psychosis may be in the form of hallucinations, delusions, or some other type of break with reality. Hallucinations may cause them to hear or see things that dont exist. Delusions may manifest as having feelings of worthlessness, failure, or having committed some type of sin.

Still another type of depression that can affect older adults is seasonal affective disorder, or SAD. Seasonal affective disorder typically surfaces when the weather gets cold and gloomy with shorter hours of sunlight. The symptoms are the same as for clinical depression and they may subside when the weather turns warmer.

What Causes Depression in Older Adults?

Risk Factors For Dementia Diseases Like Alzheimers Disease

According to the Alzheimer Society of BC some people have increased risk of being diagnosed with Alzheimers disease. There are some risk factors that one cannot control like age, gender and genetics and there are risk factors one does have some control over. In terms of age, In Canada, 1 in 20 people over the age of 65 is affected by Alzheimers Disease. For people over 85 years, the likelyhood of having dementia increases to approximately 1 in 4 people. . Women are more likely to be diagnosed with Alzheimers disease and if it runs in your family you are even more at risk.

There are risk factors that can be controlled and they include having diabetes, heart problems, and brain injuries. Keeping your body as healthy as possible will reduce the risk of Alzheimers disease. If you or your loved one is experiencing some of the above symptoms of either depression or Alzheimers disease, please see your doctor.

Below are some resources for more information.

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Depression And Older Adults

Feeling down every once in a while is a normal part of life, but if these feelings last a few weeks or months, you may have depression. Read this article to find common signs and symptoms of depression, treatment options, and if you or your loved one may be at risk for depression.

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Infections Of The Body

Medical Conditions That Mimic Dementia

In addition to the infections of the brain, another class of infections must be considered when evaluating a new cognitive change. These other diseases, located outside the central nervous system, are often treatable and sometimes cause great harm before they are discovered. Urinary tract infections or infections of the lungs are very common in older people who show confusion and the rapid change in alertness, attention, memory, and orientation called delirium. Delirium is often reversible once the cause is identified and treated. Simple blood tests and cultures of urine, blood, or sputum are used when clinicians search for these infections and for the antibiotics that will cure them.

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How Does One Differentiate Pseudodementia And Dementia

Depression is commonly associated with cognitive difficulties and many patients in early stages of dementia become depressed. The differentiation of pseudodementia from true dementia can be a clinical challenge. Clues that depression is the cause of cognitive difficulties include decline over weeks to months rather than years and whether the patient has overt concern for their memory loss. Referral for complete neuropsychological testing can be helpful in elucidating the diagnosis in many cases. Treatment with antidepressants will significantly improve cognitive function in patients with pseudodementia, whereas truly demented patients may see improvements in overall function but will continue to have cognitive impairment.

Sarfraz Saeed Khan, … Fred Petty, in, 2007

Differentiating Dementia From Pseudodementia

The term pseudodementia is used to describe the condition in which depression causes cognitive deficits that masquerade as dementia. Patients will often present with difficulties in memory and concentration and deny depressive symptoms. A previous history of depression can be helpful, as can the presence of vegetative symptoms, such as sleep or appetite disturbance, and lack of activity or enthusiasm for previously enjoyed pastimes. The memory disturbance in depressive pseudodementia is traditionally one in which learning is impaired but recall of learned information is relatively preserved, in contrast to early Alzheimer’s disease, in which recall is also severely affected. Performance is often patchy and inconsistent and improves with encouragement. Patients with cognitive impairment secondary to depression may have word-finding difficulty on fluency tasks but do not have impairments in naming or produce paraphasias. A reasonable approach to patients with depressive symptoms and memory impairment in whom even formal neuropsychological testing cannot differentiate depression alone from depression in Alzheimer’s disease is to give a trial of antidepressant therapy for several months before repeating the neuropsychological testing.

Neill H Anderson, Kirstie Woodburn, in, 2010

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How Is Depression Treated

Depression, even severe depression, can be treated. Its important to seek treatment as soon as you begin noticing signs. If you think you may have depression, start by making an appointment to see your doctor or health care provider.

Certain medications or medical conditions can sometimes cause the same symptoms as depression. A doctor can rule out these possibilities through a physical exam, learning about your health and personal history, and lab tests. If a doctor finds there is no medical condition that is causing the depression, he or she may suggest a psychological evaluation and refer you to a mental health professional such as a psychologist to perform this test. This evaluation will help determine a diagnosis and a treatment plan.

Common forms of treatment for depression include:

Disorders Of The Heart And Lungs

Diagnosing Depression in the Elderly

The heart and lungs provide the brain with oxygen and nutrients that are necessary for proper functioning. Age is often accompanied by vascular disease that interferes with cardiac output or lung disease that interferes with the delivery of oxygen to the brain. These underlying diseases can cause MaND as well as whats commonly known as vascular dementia . They can also affect alertness, memory, and executive function..

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Recognizing Depression Or Normal Memory Loss Vs Dementia And How To Tell The Difference

May 23, 2017

As we age, we sometimes get a little more forgetful.

As we age, we sometimes get a little more forgetful. While most people understand that this is just a normal part of getting older, there are some who fear that forgetfulness is the first sign of Alzheimers disease or some other form of dementia. There has been a lot of research focused around aging and memory loss recently, and researchers have learned a lot about what is normal versus a more serious problem.

Aging is not the only factor that contributes to memory loss, however. Many older adults develop memory problems as a result of health issues that may be treatable. These can include: side effects due to medications, vitamin deficiencies, substance abuse or possibly even reduced organ function due to thyroid, kidney or living disorders. These can be serious medical conditions and should be treated as soon as possible.

In addition to the aforementioned medical issues which can precipitate memory loss or impairment, there is what seems to be the most common reason: depression. Depression in older adults has been as steadily growing problem, and emotional problems such as stress, anxiety or depression can and quite often do lead to forgetfulness, confusion and other symptoms that are similar to those of dementia.

What is Dementia?

How to Tell the Difference

Alzheimers Association

Seniors And Depression: The Difference Between Depression And Dementia

Depression is a mood disorder; dementias like Alzheimers disease, can have similar symptoms but they are different illnesses and have different treatment plans.

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Its important to know what to look for to help determine what illness you might be dealing with. Only a doctor can make a diagnosis however so if you experience any of the symptoms of either illness see your doctor right away.

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Problems With Vision And Hearing

Sensory limitations, too, can create a picture like cognitive impairment that worsens as the affected person becomes increasingly isolated as a result of hearing or vision problems. Recent research has emphasized that there is a relationship between hearing loss and the risk for development of cognitive impairment.

Supporting Friends And Family With Depression

Medication fog can mimic or worsen dementia in the elderly

Depression is a medical condition that requires treatment from a doctor. While family and friends can help by offering support in finding treatment, they cannot treat a persons depression.

As a friend or family member of a person with depression, here are a few things you can do:

  • Encourage the person to seek medical treatment and stick with the treatment plan the doctor prescribes.
  • Help set up medical appointments or accompany the person to the doctors office or a support group.
  • Participate in activities the person likes to do.
  • Ask if the person wants to go for a walk or a bike ride. Physical activity can be great for boosting mood.

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The Truth About Aging And Dementia

As we age, our brains change, but Alzheimers disease and related dementias are not an inevitable part of aging. In fact, up to 40% of dementia cases may be prevented or delayed. It helps to understand whats normal and whats not when it comes to brain health.

Normal brain aging may mean slower processing speeds and more trouble multitasking, but routine memory, skills, and knowledge are stable and may even improve with age. Its normal to occasionally forget recent events such as where you put your keys or the name of the person you just met.

In the United States, 6.2 million people age 65 and older have Alzheimers disease, the most common type of dementia. People with dementia have symptoms of cognitive decline that interfere with daily lifeincluding disruptions in language, memory, attention, recognition, problem solving, and decision-making. Signs to watch for include:

Alzheimer’s disease or related dementias are not an inevitable part of aging. There are 7 ways to help maintain your brain health.

  • Not being able to complete tasks without help.
  • Trouble naming items or close family members.
  • Forgetting the function of items.
  • Repeating questions.
  • Taking much longer to complete normal tasks.
  • Misplacing items often.
  • Being unable to retrace steps and getting lost.

If you have one or more of the 10 warning signs, please see your health care provider. Early diagnosis gives you the best chance to seek treatment and time to plan for the future.

Heres what you can do:

Talking With Friends And Family About Suicide

Its important to watch for signs and symptoms of depression or suicide. Dont shy away from asking if a family member or friend is feeling depressed or suicidal. It may be an uncomfortable conversation, but it is important. Asking if someone is having thoughts of suicide will not make them more likely to act on those thoughts. Your questions may help the person open up about how theyve been feeling and encourage them to seek treatment.

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Depression Can Look Different Depending On A Persons Cultural Background

Signs and symptoms of depression can look different depending on the person and their cultural background. People from different cultures may express emotions, moods, and mood disorders including depression in different ways. In some cultures, depression may be displayed as physical symptoms, such as aches or pains, headaches, cramps, or digestive problems.

Depression In People With Dementia

Depression in older people

Depression is common in people with Alzheimers and related dementias. Dementia can cause some of the same symptoms as depression, and depression can be an early warning sign of possible dementia. Suicide attempts may also increase in people recently diagnosed with dementia. It is important to have support systems in place to help cope with a dementia diagnosis and possible depression symptoms that follow. More research is needed to determine effective depression treatment options for people with dementia.

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Differentiating Among Depression Delirium And Dementia In Elderly Patients

Virtual Mentor.

Elderly patients are at high risk for depression and cognitive disorders, the latter of which can be chronic or acute . Some patients have both affective and cognitive disorders. Clarifying the diagnosis is the first step to effective treatment, but this can be particularly difficult because elderly patients often have medical comorbidities that can contribute to cognitive and affective changes.

When evaluating elderly patients, it is important to assess cognitive status and determine their baseline ability to function and perform activities of daily living . ADLs relate to personal care including bathing or showering, dressing, getting in or out of bed or a chair, using the toilet, and eating . Instrumental activities of daily living include the individuals ability to prepare food, manage finances, shop for groceries, do housework, and use the telephone . Having a baseline for a patients ADLs and IADLs allows the physician to recognize and act upon changes. Though it is tempting to make assumptions based on a patients appearance, contacting family members or staff at the facility where a patient resides can provide valuable information about his or her cognitive and functional status that may otherwise be missed.

Practical Advice For Differentiating Depression Delirium And Dementia

Generally speaking, an acute behavioral or mood change is suggestive of delirium. Once medical contributors have been ruled out, depression, characterized by a more pervasive or chronic low-mood state with or without cognitive impairment should be considered. Patients with dementia are less likely to self-report their cognitive problems than are patients with depression .

Table 1. Characteristics of depression, delirium and dementia


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Brain Fog Vs Dementia

We all forget things. Even in our twenties we might lose our keys or forget the name of someone we just met. And as we age, these moments of forgetfulness happen more often.

For women in their late forties and early fifties, the onset of menopause can bring even more brain fog and memory lapses for many women.

But the big question is: when should you worry that something is wrong? Is it just menopause, or might it be early warning signs of Alzheimers disease or dementia?

Its important to remember that there are lots of causes for brain fog, says Lynne Shinto, N.D., M.P.H., a naturopath with expertise in neurology and womens health at the OHSU Center for Womens Health.

Most of them are far less scary than Alzheimers disease. Here are a few of the most common causes:

  • Hormone changes during the transition to menopause
  • Other hormone changes
  • Depression
  • Lack of sleep
  • Vitamin and mineral deficiencies

Many of these causes come in pairs, or even trios. Stress can lead to lack of sleep or depression. The transition to menopause can lead to hot flashes that impact sleep, or to depression. Depression can lead to stress.

Poor thinking ability and memory problems are a very common symptom of depression.

For many people, treating their depression clears up symptoms of brain fog and cloudy thinking. For this reason, everyone with these symptoms, even people in their seventies and beyond, should be screened for depression.

Brain fog and dementia are different

Healthy brain aging

Depression Common With Age

Scientists identify another form of dementia that mimics ...

The link between depression and dementia is even more significant considering that depression becomes more common with age. All of the following may put you at risk for depression as you get older:

  • the death of a spouse, friends, or family members

  • having to move out of your home and into an assisted living facility

  • side effects of medicines you’re taking for health conditions.

You’re also more likely to develop illnesses such as diabetes, heart disease, and cancer as you get older. These conditions can increase your risk for depression, and vice versa. Depression can make a chronic illness worse, says Dr. Cremens.

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Relationships Of Depression With Cognitive Impairment Decline And Dementia

Depression and cognitive impairment: A profusion of studies have demonstrated that the presence of depression is associated with worse performance on cognitive tests, both in clinical samples of patients with depressive illnesses and in population-based samples of older adults drawn from the community. Many older patients with depression complain of difficulty in concentrating and remembering, and this subjective phenomenon is borne out by objective studies showing that cognitive deficits in depression are mediated almost entirely by slowed processing speed and working memory . There is some variation in results as to which cognitive domains are associated with depression, related in part to the nature of the study population.


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