Mental health and dementia - risk factors

An elderly person with severe depression can sometimes be misdiagnosed as having dementia.
Depression is defined as feeling sad or miserable for a projected period of time, although there
is no specific time limit. The feelings of depression can include hopelessness and can impact
the way in which a person would normally live their lives. It can impact their routine and their
ability to do things. They may lose their appetite or stop eating altogether. In severe cases of
depression, people may start to reduce communication, stop washing, stop caring about things
they used to be interested in. Because of the similarity in symptoms and age factor, sometimes
the symptoms can be misdiagnosed as dementia, without completing the full range of tests.
 

Depression in dementia

While someone with dementia can become significantly depressed by the changes that are
happening to them, or about the environment that they are in. If they live alone and don’t have
many friends or much contact, they can feel isolated and locked into the symptoms that they are
experiencing. This may encourage them to withdraw from social engagement and they may take
little enjoyment from the activities that they do take part in. This is a difficult situation for them as
by choosing to lock themselves away, they can precipitate the rate of dementia decline.
Depression can impact the patient’s mood, their self esteem, they may be more irritable,
become overly tired, or experience significant interruptions to their sleeping pattern. This will
also impact their mood. In more serious cases of dementia, the patient may experience feelings
of hopelessness and have thoughts of death or suicide.

As with any case of depression, the patient needs access to support and medication where
appropriate to help manage the symptoms. Given that the brain is already under attack from the
dementia disease, the symptoms of depression may be worse in dementia patients than other
people. If left unsupported and untreated it can get worse too.
 

Anxiety in dementia

Similarly patients with dementia can experience high anxiety as a result of their dementia
progression. It can manifest itself as a phobia or a panic disorder and can impact a dementia
patient’s everyday activities. Anxiety is a common symptom of dementia and can encourage
some of the more disturbing behaviours in dementia patients from wandering to sundowning
and can be responsible for aggressive outbursts.
Anxiety can also impact sleep patterns and lead the dementia patient to not get enough sleep,
which can then lead to more issues for the patient and have a bigger impact overall.

Treatments

Depending on the level of diagnosed depression, the GP will decide if it is appropriate to
prescribe antidepressants. If mild to moderate depression is diagnosed, it might be treatable
without the need for medication and instead through self help and support groups. If the
dementia patient lives alone, they should be encouraged to get involved in a local dementia
community group. This might help to alleviate some of the feelings of loneliness. Maybe it is
time to consider having a carer who visits them on a regular basis, to check on their well being.

Therapy such as cognitive based therapy might be prescribed as well, or access to a therapist
to support the patient while they need it. It can take time to recover from depression, so the
earlier it is picked up and supported, the better. As with other therapies for dementia, music
therapy is thought to be beneficial in tackling depression in dementia also.
Exercise or taking part in activities which the patient used to enjoy might help to boost their
mood and self esteem. However it is important to also try and understand what is causing the
depression, whether it is something in their environment that they are living in. See if any
changes can be made to support and improve the dementia patient’s outlook.

Take a look at our knowledge base to see more content about dementia.