The Prevalence of Depression in Dementia
Depression is a fairly common experience for people with dementia. The Alzheimer's Association estimates that approximately 40% of people with Alzheimer's and related disorders suffer from depression. However, while common, it is not normal, nor is it inevitable. Although it’s appropriate to grieve a diagnosis of dementia and the losses associated with the disease, it shouldn’t be an all-encompassing feeling that removes joy from your entire life.
How to Identify Depression in Dementia
Recognizing depression in someone who has dementia can be challenging because there are several symptoms that are common in both disorders.
So, how can you tell if you or someone you love is experiencing depression in dementia? Often, the biggest clue that someone is depressed is that they demonstrate a change in their emotions or behaviors when compared to their usual mood and behavior.
It is also important to note that symptoms of depression in dementia may not appear as severe as in someone without dementia. For example, someone with depression and word-finding difficulties may not be as vocal about their feelings. It can become difficult to express feelings and so someone may simply withdraw or appear listless.
Remember, too, that a person who has a personal or family history of depression or anxiety prior to being diagnosed with dementia may be more prone to experiencing a mood disorder such as depression.
Symptoms of Depression in Dementia
- Apathy and Loss of Interest
While a decreased desire to interact and participate in the activities occurring around you can be a sign of dementia, it can also point to depression. One way to tell the difference is to choose an activity that normally is enjoyable and notice your loved one’s reactions. For example, if your wife has always loved seeing the grandchildren but now no longer pays much attention to them, this may be because she’s feeling depressed. Likewise, if your dad has a favorite sports team but doesn't notice even when you turn the channel to the game, it’s possible that his lack of interest is indicating feelings of depression.
Increased tearfulness and prolonged periods of crying can indicate depression.
- Decreased Appetite and Weight Loss
Depression in dementia can manifest itself in your family member’s eating habits. Your loved one might say that nothing tastes good anymore. Even if you bring him his favorite pastry, he might take one bite and push it away. A decreased appetite can, of course, be due to other medical diagnoses, so be sure to report this symptom to the physician.
- Change in Sleep Habits
Excessive sleep and difficulty getting to or remaining sleeping can be signs of depression.
- Agitation and Irritation
Some people with dementia who are depressed display agitation and restlessness, and are more easily irritated with other people or their surroundings.
- Multiple Physical Complaints
Complaints and concerns about several physical ailments can be a sign of depression. Clearly, there may also be medical explanations for those physical complaints, but in absence of a specific cause, it's possible that depression may be present.
Some people tire more easily when struggling with depression. They may complain of having no energy anymore.
Tests to Evaluate Depression in Dementia
- Cornell Screen for Depression in Dementia
This screen consists of several questions to ask the person to answer, as well as to have an informant answer. The informant can be anyone who knows the person in question well, such as a relative or consistent caregiver. The Cornell Screen includes questions about appetite, weight loss, mood, sleep, physical complaints and behavior. A score of above 18 signifies a major depression and a score above 10 indicates a probable depression.
- Geriatric Depression Scale
This test is not specifically designed for those with dementia, but it can help screen for depression if your loved one is in the earlier stages of Alzheimer’s or a related dementia. It consists of several questions that are asked of the person and then scored. A score of above 10 in the short form indicates probable depression.
Seek an Evaluation
If you or your loved one demonstrates some of the symptoms identified above, don't hesitate to ask a professional for help. Treatment of depression is generally quite effective, and can lead to an improved quality of life.
Alzheimer's Association. Depression and Alzheimer's. http://www.alz.org/care/alzheimers-dementia-depression.asp
Cornell University. The Cornell Scale for Depression in Dementia. Administration and Guidelines. Accessed December 28, 2012. www.scalesandmeasures.net/files/files/The%20Cornell%20...
Cornell University. The Cornell Scale for Depression in Dementia: Administration & Scoring Guidelines. Accessed December 28, 2012. www.scalesandmeasures.net/files/files/The%20Cornell%20
Johns Hopkins Medicine. Depression in Patient with Dementia. Accessed December 28, 2012. http://www.hopkinsmedicine.org/gec/studies/depression_dementia.html
Stanford University. Geriatric Depression Scale. Accessed December 29, 2012. http://www.stanford.edu/~yesavage/GDS.html