What Features Are Characteristic Of Pseudodementia Associated With Depression
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
Pseudodementia: Issues In Diagnosis
“Pseudodementia” needs a third look. Always a “soft” diagnosis, it has never had objective, explicit diagnostic criteria or a spot in an official nomenclature.
“Pseudodementia” needs a third look. Always a “soft” diagnosis, it has never had objective, explicit diagnostic criteria or a spot in an official nomenclature. For most of the past 4 decades, however, pseudodementia-depression masquerading as dementia-has held a firm place in the differential diagnosis of dementia. Now many depression and dementia specialists, armed with new data, have taken a second look and have concluded that this diagnosis has had its day-that is, that the concept of pseudodementia is no longer valid or useful.1,2 The demise of pseudodementia, however, might not be the answer.
Current textbooks still include pseudodementia in the differential diagnosis of dementia, but experts on all sides have been calling for its demise.1,2 Before examining the reasons-and there are some good ones-behind the disenchantment, here I provide a quick look at what the concept has meant up until now.
A question of definition
“Organic” or “Functional”: Evolving View of Depression
In fact, the organic/functional dichotomy remained in the official psychiatric nomenclature until 1994 when, with the advent of the current psychiatric Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, this distinction was dropped.
Depression as a Risk Factor for Dementia
Disclosures:
Dementia Doesn’t Always Mean Alzheimer’s
Dementia is any memory loss or thinking problem caused by changes in your brain. Alzheimer’s is just one type. Your memory also can be harmed by many other health issues, such as a stroke, Parkinson’s disease, or a buildup of fluid on your brain.
If you notice symptoms that have you concerned, see a doctor right away. They’ll give you a thorough exam that may include taking a sample of your blood for testing, brain imaging, and neurological testing to figure out what’s going on with your health and get you help.
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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.
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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Mood Disorders Association of BC www.mdabc.net, 604-873-0103, toll-free 1-855-282-7979
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BC Partners for Mental Health and Substance Use Information, www.heretohelp.bc.ca
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Canadian Coalition for Seniors Mental Health www.ccsmh.ca, 416-785-2500 ext. 6331
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Crisis Centre Seniors Distress Line 604-872-1234, www.crisiscentre.bc.ca
About the author
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Disorders Of The Heart And Lungs
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..
Depressive Symptoms In The Elderlyan Early Symptom Of Dementia A Systematic Review
- 1Department of Neurology, Universitair Ziekenhuis Brussel, Brussels, Belgium
- 2Center for Neurosciences , Vrije Universiteit Brussel, Brussels, Belgium
- 3Department of Psychiatry, Universitair Ziekenhuis Brussel, Brussels, Belgium
- 4Ghent Experimental Psychiatry Lab, Department of Psychiatry and Medical Psychology, Ghent University Hospital, Ghent University, Ghent, Belgium
- 5Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands
- 6Department of Biomedical Sciences and Institute Born-Bunge, University of Antwerp, Antwerp, Belgium
Background: Depression and dementia are common incapacitating diseases in old age. The exact nature of the relationship between these conditions remains unclear, and multiple explanations have been suggested: depressive symptoms may be a risk factor for, a prodromal symptom of, or a coincidental finding in dementia. They may even be unrelated or only connected through common risk factors. Multiple studies so far have provided conflicting results.
Objectives: To determine whether a systematic literature review can clarify the nature of the relation between depressive symptoms and dementia.
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What Are Symptoms Of Severe Dementia
These may include increased agitation, depressive symptoms, anxiety, wandering, aggression, or sometimes hallucinations. bladder incontinence is common in the later stages of dementia, and some people will also experience bowel incontinence. appetite and weight loss problems are both common in advanced dementia.
Depression In People With Dementia
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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When Depression And Dementia Combine
Correctly identifying which or both health condition is taking place isnt easy, which is why professional assistance can help.
The NIH said tiredness, problems sleeping and appetite changes are common symptoms of depression as are confusion and attention problems.
At the same time, these behaviors and symptoms are also common for people dealing with dementia, especially early stages.
People may be tired, unhappy, or confused. They could forget things. They may be unhappy and irritable, but this could be seen as a sign of dementia.
People with depression may become anxious about the possibility of or even a diagnosis of dementia. Likewise, someone with dementia may become depressed with the life-changing diagnosis.
There are other connections as well.
A study in Lancet Psychiatry in 2016 found that people over 55 with depression were more likely to develop dementia. The survey followed 3,325 people over 11 years, some with mild depression, some with severe, and some with changing levels. The patients received regular assessments over the study period. Those whose depression worsened over time were at greatest risk of dementia.
The study concluded those people who have increasing levels of depression later in life may share common causes with early dementia.
Anxiety And Insomnia Medications
Benzodiazepines, a class of medications used to treat anxiety or insomnia, comprise another group that has been linked with cognitive difficulties. Although these medications are truly a blessing for some individuals immobilized by anxiety, their use can be accompanied by sedation and mental slowing. A recent study even suggested that prolonged use of benzodiazepines might be a risk factor for later dementia, although experts have questioned the significance of this finding and clinicians continue to prescribe anti-anxiety medications such as lorazepam or sleeping pills such as temazepam and consider them very beneficial when used properly.
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Dementia As A Major Neurocognitive Disorder
Dementia is a neurological disorder which is very easily misdiagnosed as several other disorders by many doctors during the diagnosis. An acute organic brain syndrome or delirium is responsible for altering mental state causing confusion, memory impairment, disorientation, and behavioral changes, etc. These symptoms appear in dementia as well and hence can easily mimic the condition or cause misdiagnosis. Delirium is very different from dementia since it involves rapid onset after any surgical treatment or some medical ailment or even due to the toxic effects of some medications. In delirium, there is an alertness drift, changes in sleep patterns causing agitation, visual hallucinations, and psychotic delusions etc. which makes it entirely different from dementia.
Dementia slowly onsets and can be really a challenging problem. A proper diagnosis should be made through detailed understanding of the signs and symptoms, the past medical and family history and a thorough understanding of the patients condition. There are a number of medical conditions which mimic dementia and hence a thorough evaluation is necessary.
Medical Conditions Often Mistaken For Alzheimers
Before you assume the worst, take a few minutes to learn about other medical conditions your senior loved ones physician is likely to consider before arriving at a diagnosis of Alzheimers disease.
Common Health Conditions That Mimic Alzheimers Disease
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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 Alzheimers 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 Alzheimers 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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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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Depression Common With Age
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:
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the death of a spouse, friends, or family members
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having to move out of your home and into an assisted living facility
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side effects of medicines youre taking for health conditions.
Youre 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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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.
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Two Liters Of Water A Day May Cure What Ails You
The key here is SUPPORT. Lets make it a simple goal to drink 2 liters of water a day. Keep a 2 liter jug of water in the fridge and make sure that your parent or client drinks the whole 2 liters. There may be some fussing at first. Change is not always welcomed. But the results are guaranteed! Lets continuously ask our friends, family members, patients, How much water have you had today?
Once a senior or average adult has been properly hydrated, then lets see what symptoms there are to be able to properly diagnose them. Weve been relying largely on medication and the health of our society is still declining. Isnt this a key sign that our current system is not working?
Conditions That May Be Mistaken For Dementia
By Ben Isaac 9 am on January 17, 2019
Memory loss, confusion, changes in personalitywhen an older loved one exhibits these signs, your first thought may be that he or she has dementia. However, the truth is that a person can show these and other dementia signs and symptoms but actually have another health issueone that, in many cases, is treatable, so its important to see a doctor right away. Here are some common conditions that may at first appear to be dementia.
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Depression: Early Warning Of Dementia
Persistent sadness might be more than just a mood problemit could be a warning sign of memory impairment.
You can’t sleep. You feel irritable and restless. Foods you once loved look unappetizing. These are signs that you may be depressed, but they might also warn that you’re at greater risk for dementia.
A study published in the May issue of the Archives of General Psychiatry found that people who became depressed late in life had a 70% increased risk of dementia, and those who’d been depressed since middle age were at 80% greater risk.
Researchers have long known that depression and dementia go hand in hand. Yet they’ve debated over whether the two conditions simply share common causes, or whether depression is an early sign of dementia. Both theories appear to be true. The authors of the study also say depression late in life may indicate that changes have occurred in the brain that can make us more prone to developing dementia.
Depression As A Risk Factor
It is well established that depression is a risk factor for dementia, but speculation still exists that the cognitive dysfunction occurring with depression leads to the decline and impairment recognized as dementia. More research has been done to establish what type of depression predicts the development of dementia results show that early-onset or late-onset , are the most likely to lead to dementia later in life.
A study done in Nature Review Neurology affirmed the correlation between depressive symptoms early in life, and the magnified increase in dementia risk.
For older people already suffering from dementia, depression may manifest itself as physical symptoms, rather than its commonly known cognitive symptoms. These symptoms can include a loss of appetite or energy. This does not discount the many cognitive symptoms that can appear as a result of depression the Alzheimer’s Society provides a comprehensive list of these symptoms on their website.
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One Issue I See At The Hospital
Nurses are following protocolthose that need IVs receive them for hydration. However, it is a rare occasion that a patient is encouraged to drink a lot of water and given an explanation as to why this is important. Instead, the aides are serving sugary drinks and soda pop, which dehydrates the body. Where is the education on proper hydration?
What if seniors actually started to drink the required amount of water everyday? Would many of their symptoms go away? We have witnessed a massive improvement with our clients because we support them to drink lots of water.