Is Depression Associated With Dementia

Can Depression Be A Precursor To Dementia

Its important to note that depression does not directly cause dementiarather, depression may contribute to other risk factors known to increase the risk of developing dementia. In other words, depression can be a precursor to dementia, but not in the way you may think. It appears that depression and its associated lifestyle impacts may be a modifiable risk factor for Alzheimers disease and other forms of dementia.

Research studies continue to demonstrate the significant association between depression symptoms and dementia. One study suggests that depression symptoms before the onset of Alzheimers disease are associated with the pathogenesis of Alzheimers, even when the first depression symptoms occurred more than 25 years before the onset of Alzheimers. This indicates that depression symptoms are a risk factor for the future development of Alzheimers.

There is a clear link between depression and dementia, but the main connection lies between the symptoms of depression and dementia. Depression symptoms, such as social isolation and lack of stimulation, have been recognized as modifiable risk factors for dementia.

Questions To Ask Your Doctor

• Do depression and Alzheimer dementia run in families? Am I at risk?
• What types of medicines treat depression and Alzheimer dementia? Are there any side effects?
• Will depression go away?
• Are there any lifestyle changes that help improve the symptoms?
• Can you recommend a support group for people who have these conditions and their caregivers?

Depression As A Disorder

A depressive disorder usually includes a depressed mood or loss of interest in previously enjoyed activities, together with other symptoms. These may include a lack of energy, changes in appetite, sleeping too much or too little and feelings of guilt or worthlessness.

Depression is not a normal part of ageing.

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Understanding The Obstacles: Diminished Insight

A further obstacle to recognizing depression in a person with dementia occurs when diminished insight interferes with a persons ability to recognize or describe their emotions. A person with dementia and depression may feel desperate and yet be unable to express sadness in words. Delusional fears, agitation or withdrawal, or aggressive or suicidal behavior may be the most noticeable signs of depression in that person.

Strengths And Limitations Of This Study

• Data were obtained from the National Health Insurance Service-National Sample Cohort , a representative sample of Korea, and our findings on the relationship between dementia and depression is therefore reliable.

• Patients were included in the case group based on usage of International Statistical Classification of Diseases and Related Health Problems, 10th revision diagnostic codes, resulting in accurate results that reflect the actual medical environment.

• Our use of NHIS-NSC data rather than medical records, enabled us to control the association of various covariates with dementia, although diagnostic accuracy may be limited.

• It was not possible to confirm if the clinical intervention for depression was protective against the development of dementia.

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Tips To Provide Ongoing Support

• Keep to a daily routine.
• Encourage regular exercise.
• Reduce noise and activity in the environment. This will help avoid overstimulation.
• Organise activities they previously enjoyed. If possible, include family and friends.
• Have realistic expectations. Expecting too much can lead to frustration and disappointment.
• Get important tasks done at the time of day when they have the most energy.
• Be positive. Optimistic and supportive words will help everyone.
• Include the person in as much conversation as they feel comfortable with.

Depression Increases The Risk Of Alzheimers Disease

Being depressed increases the risk of developing Alzheimers disease and other forms of dementia, a new study reports. The study found that men and women with a diagnosis of depression were at increased risk of getting a dementia diagnosis, and the risk persisted even more than 20 years later.

The study, in PLOS Medicine, consisted of two parts. In one, researchers in Sweden tracked nearly 120,000 men and women over 50 who had been diagnosed with depression, comparing them with peers who were not depressed. They followed them for up to 35 years, with an average follow-up time of more than 10 years.

They found that Alzheimers disease or other forms of dementia developed in 5.7 percent of those who had depression, compared to just 2.6 percent of those who were not depressed. Dementia was particularly prevalent in the first year after a depression diagnosis: those with a depression diagnosis were more than 15 times as likely to develop dementia than their peers without depression. But even 20 years later, the risk of dementia remained elevated in those who had depression.

For the second part of the study, the researchers studied more than 25,000 pairs of brothers or sisters, in which one sibling had depression and the other did not. They found that a sibling with depression was more than 20 times as likely to develop dementia than their brother or sister who was not depressed. Again, the risk remained elevated more than two decades later.

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Tests To Evaluate Depression

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.

Enhancing Healthcare Team Outcomes

Depressive cognitive disorder continually poses a diagnostic difficulty. These cases demonstrate symptoms of a major depressive disorder associated with cognitive impairment. It may be due to numerous causes with several etiologies. While the record may illustrate that the person has pseudodementia, the reason is complicated to know without a comprehensive examination, assessing cognition, and ordering laboratory tests.

For the early diagnosis and treatment of depressive cognitive disorders, collective interprofessional activity is meaningful. For example, if an aged person complains of memory problems along with behavioral disturbances, the clinician should contemplate the differential of depressive cognitive disorders. An additional difficulty in old-age is polypharmacy and medication interactions. The pharmacist should frequently monitor the drug dispensing and discuss with the physician if there are any potentially lethal prescriptions. Eventually, a psychiatric nurse and a social worker should be involved in the supervision of these cases as they want assistance services, a stable living atmosphere, and appreciating caretakers. An interprofessional squad strategy is crucial if one wishes to enhance outcomes and decrease undesirable circumstances related to depressive cognitive disorders.

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Path To Improved Health

From the outside looking in, it may be difficult to know if your family member is depressed. You can look for some of the typical signs of depression. Your loved one may become angry and agitated or lost and confused. They may refuse help with personal care, such as getting dressed or taking medicines.

Alzheimer dementia and depression have many symptoms that are alike. It can be hard to tell the difference between them. If you think that depression is a problem for your loved one who has Alzheimer dementia, talk to their doctor.

Caring For The Caregivers

A final consideration regarding dementia and depression concerns care partners of people with dementia. Caregiving is a stressful responsibility and increases the risk of depression for the caregiver. One recent report found that more than two of every three caregivers scored high on a test of depression. The risk for depression was greater among caregivers who were older, or had attained a lower educational level, or had less support from other family members.

Depression risk was also increased when the severity of dementia was greater in the care recipient. A healthier care partner will enjoy a better quality of life and will also have more to offer the care recipient.

Owens evaluation suggested that depression was indeed present along with dementia, but found no treatable medical cause. Owen had been a music lover, and his family was encouraged to involve a music therapist in his care. Also, they were told of the value of physical activity and social involvement in reducing feelings of isolation and despair. An antidepressant trial, fortunately, was well-tolerated. The medication seemed to improve Owens appetite and sleep. During the follow up visit, his family reported significant improvement in his outlook and no more nihilistic or suicidal comments. After depressive symptoms were absent for six months, Owens antidepressant was tapered and stopped. Two years later, there had been no recurrence.

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Managing Depression In At

The specific factors that underlie the depression-dementia link are still unclear. However, the need to effectively identify and treat depression in adultsregardless of their ageis unmistakable.

The National Institute of Mental Health estimates that major depression affects more than 17 million American adults each year. Although depressive symptoms can strike at any age, older adults are particularly susceptible, especially those living with one or more chronic health conditions. In fact, the Alzheimers Association estimates that up to 40 percent of Alzheimers patients suffer from significant depression. However, depression is not a symptom of aging it is a legitimate psychological condition that requires intervention.

Family caregivers are another at-risk group. Caregiving is a high stress job that can be physically and emotionally taxing. Many family members provide unpaid care for months or even years, and chronic caregiver stress can take a heavy toll on ones physical and mental health. It is important to watch for the warning signs of depression, both in yourself and in your elderly loved one.

Common symptoms of depression include:

• Feelings of hopelessness, worthlessness or helplessness
• Excessive worrying

Demographic Characteristics Before And After Propensity Score Matching

shows the sociodemographic characteristics of patients before PSM matching. Before PSM, 72.5% of the total number of depressed patients were women and 84.5% were younger than 65 years, indicating that depression was more common in women than men and more prevalent in younger individuals than those 65 years of age. The percentage of patients with depression increased as the income tertile increased, reaching 47.9% in the high-income tertile .

ORs for developing dementia in patients with depression by sex and age

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Deterrence And Patient Education

The heightening number of the elderly population gives rise to an increasing number of old-age mentally ill. Disorders such as dementia and late-onset depression not merely cause difficulties among their sufferers they diminish the quality of life and inflict a heightened responsibility on the caregiver. Depressive cognitive disorders, neurodegenerative dementia, and late-onset depression contribute to all disability-adjusted life years in the senior community. Hence, aging possesses a profound impact on public and health programs. Thus, knowledge about the symptoms and signs of the depressive cognitive disorder is essential for cases and caretakers, which would encourage them to seek timely assistance and avoid setting their lives at risk.

These Conditions Are Common In Dementia Here Are A Few Ways To Deal With Them

• Find a therapist to overcome anxiety

Depression, anxiety, irritability, and agitation are some of the most common mood and behavior problems that individuals with Alzheimers disease and dementia experience. In this final article of our three-part series, we discuss medications that can help with these problems. If you or a loved one is living with dementia, speak to your doctor for more information.

Depression and anxiety may be caused by psychological and biological factors.

There are few things as depressing and anxiety-provoking as being aware that one is losing ones mind from Alzheimers or another neurodegenerative disease. Just worrying about dementia can cause depression and anxiety.

In addition, the pathology of Alzheimers disease and other dementias often causes the depletion of neurotransmitters, including serotonin, dopamine, and norepinephrine, whose levels are directly related to mood and calmness. Thus, whether because of an understandable emotional reaction to having a devastating brain disease or because of the disease process itself, depression and/or anxiety occur in more than half of individuals with Alzheimers disease and other causes of dementia.

Non-pharmacological therapy for depression and anxiety may be effective.

Pharmacological therapy is also an option for depression and anxiety.

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How Are Depression And Dementia Related

As we work to unravel the mysteries of Alzheimers disease and other dementias, one of the more interesting areas of research is depression and its connection to dementia. It appears that depression impacts people living with dementia in at least two different ways. First, individuals who have had significant depression in their lives may be at greater risk for developing dementia. Second, many people living with dementia have depression left untreated it makes confusion and forgetfulness worse, damaging quality of life.

Lets discuss both these aspects of depression and dementia.

A number of studies have suggested that there is a link between depression and dementia. It now appears that individuals with long histories of clinical depression have a greater risk for developing dementia.

Its important to note that a risk factor is something that is likely to increase the chances that a particular event will occur. Having a risk factor for Alzheimers disease doesnt mean that you will ever get Alzheimers disease many people with histories of depression never get dementia.

What should an individual do if he or she has depression, particularly at a younger age? Common approaches include medicines and talk therapy. Many people with depression benefit from increased activity and socialization, including things like exercise, meditation, time with children and activities involving pets.

Resources:

Social Isolation And Lack Of Stimulation As Risk Factors For Dementia

Social isolation, social withdrawal, and lack of mental and social stimulation are common lifestyle impacts that often accompany depression.

Several studies suggest that maintaining social and mental activity throughout life may support brain health and decrease the risk of developing dementia. Meta-analyses found that social isolation or loneliness in older adults is associated with a 50% increased risk of developing dementia.

In addition to the evidence of this connection in research, emerging theories suggest that social and neurocognitive stimulation can help build up your cognitive reserve, where cognitive reserve refers to your brains ability to efficiently use networks of neuron-to-neuron connections. This enables individuals to effectively execute neurocognitive tasks, even as the brain changes over time.

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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.

• Mood Disorders Association of BC www.mdabc.net, 604-873-0103, toll-free 1-855-282-7979

• BC Partners for Mental Health and Substance Use Information, www.heretohelp.bc.ca

• Canadian Coalition for Seniors Mental Health www.ccsmh.ca, 416-785-2500 ext. 6331

• Crisis Centre Seniors Distress Line 604-872-1234, www.crisiscentre.bc.ca

About the author

Patient And Public Involvement

Flowchart of the study design. NHIS, National Health Insurance Service.

Patients with missing sociodemographic and medical data for 11 years were excluded. The case group included patients newly diagnosed with depression in 2003. If depression had been diagnosed between the ages of 45 and 64 years, it was classified as mid-life depression if it was diagnosed at 65 years or above, it was classified as late-life depression. Using the International Statistical Classification of Diseases and Related Health Problems, 10th revision , patients were included in the case group if they received a primary or secondary diagnosis of depression more than once. In this study, data from the year 2002 was not included, in order to exclude patients with pre-existing depression and/or dementia. The final number of patients in the case group was 1824. The control group consisted of patients with no diagnosis of depression in 2002 and 2003, and no diagnosis of dementia in 2002. The initial number of control patients was 374852. For each patient in the case group, age, sex, income, Charlson Comorbidity Index score, presence of disability and area of residence were matched to randomly select the control patients, using the PSM method to balance the confounders and reduce the selection bias, as described in detail below. The study population is shown in .

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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 .

Comparing Lld And Ndc

At baseline, the LLD group compared to the NDC performed worse in all domains except for the visuospatial domain . The LLD group declined more rapidly than the NDC only in the verbal domain however, this difference appears to be related to a lack of a practice effect among LLD compared with NDC rather than actual declinelack of a practice effect is often due to cognitive impairment .

Fig. 1: Graph of cognitive trajectories comparing NDC vs. LLD.

There were baseline differences between LLD and NDC in all domains except visuospatial ability. LLD group differed over time compared to the NDC in the verbal ability onlythis may be due to lack of practice effect rather than cognitive decline.

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