How can you tell whether an elderly person is suffering from depression or dementia? Is it possible for someone to have both conditions? Why is it so difficult to differentiate between the two ailments?
Depression mirrors a range of biological and social features, which may be difficult to diagnose in older people as its presentation may differ from that of younger people.
Older people tend to under-report depressive symptoms and may not acknowledge being sad or depressed. Instead they report symptoms such as a loss of interest in life, lack of enjoyment in normal activities, apprehension and poor sleep. Other symptoms are persistent thoughts of death, chronic unexplained pain, and poor concentration.
Depression in old age is often accompanied by memory changes which is usually the main focus for medical intervention rather than the depressive illness.
Family, friends and doctors frequently attribute those symptoms to old age or dementia. The result is that the depression may go undiagnosed and untreated for a long time.
Symptoms of depression often become apparent on close questioning. However, the older person may deny that depression could be the problem. In extreme cases, the older person may believe they have an incurable disease which can put them at risk of suicide.
Treatment of the underlying depression usually improves memory if there is no corresponding dementing process going on as well.
Dementia on the other hand, describes a set of symptoms that may include memory loss and difficulties with thinking, problem-solving or language.
A person diagnosed with Alzheimer’s disease, which is the most common form of dementia, may also experience changes in their mood or behavior.
Early Alzheimer's disease and depression share many symptoms, so it can be difficult even for doctors to distinguish between the disorders. Plus, many people with Alzheimer's disease are also depressed.
The discrepancy between the two conditions can be found in cognitive abilities, behavior, language and motor skills. In depression, mental decline is relatively rapid, while in dementia it happens slowly.