Distinguishing between depression and dementia in seniors

Depression and dementia, two common conditions in seniors, are sometimes difficult to tell apart.

Depression and dementia, two common conditions in seniors, are sometimes difficult to tell apart. They can sometimes occur simultaneously, and some studies even suggest that one condition could be a precursor to the other.

Here, we will focus on distinguishing between signs of depression versus early signs of dementia (not accompanied by depression).

According to the Association des médecins psychiatres du Québec, dementia, also known as mild or major neurocognitive disorder, is characterized by a loss of mental faculties that reduce a person’s ability to care for themselves independently, while major depression is a mental illness characterized by loss of pleasure and sustained sadness for several weeks.

Dementia sets in rather slowly. Onset of the condition is difficult to pinpoint. The changes observed are gradual; interests and motivation slowly decline over a long period of time. Whereas with depression, loss of interest and the ability to feel pleasure will develop within a few weeks. The same is also true for changes in weight, sleep, psychomotor agitation and energy levels. These changes occur gradually with dementia and appear more quickly in depression. The speed at which these changes occur is not the only difference, however. The way in which symptoms are presented may also differ depending on the disorder. For example, if we look at changes related to sleep, in dementia there are more disturbances to the sleep-wake cycle, whereas in depression, we see more of an increase or decrease in sleep periods.

Other symptoms usually present in depression, such as suicidal thoughts, low self-esteem and guilt, are rarely found in dementia. In early dementia, concentration generally remains good, whereas those with depression experience a sudden decrease in concentration and a marked sense of indecision. Regarding memory problems, in depression memories are often disturbed, whereas in dementia, short-term memory takes a hit and long-term memory remains relatively unaffected.

People with dementia also voice fewer complaints regarding their cognitive difficulties, whereas people with depression tend to name their difficulties, including forgetfulness.

Changes such as the ones mentioned above are worth looking into and discussing with a physician. A good tip for family members is to write down their observations, using these facts as a starting point. These notes can be shared with the family member’s physician. Finally, be aware that depression or dementia are not normal or expected consequences of aging, which is why you should seek help.