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Why Is Depression Often Mistaken for Dementia?

When it comes to taking care of their aging loved ones, families are often careful to take notice of changes to the person’s personality, mood, and behaviour. Oftentimes, two conditions come to mind when these distinct changes take place: depression or dementia.

There are many symptoms these illnesses share, which is why it can be difficult to differentiate between the two. Generally, the distinction can be made by understanding what is generally behind both conditions:

  • Dementia: A chronic, progressive disease caused by brain disease or injury that presents itself through impaired memory, personality change, and decreased reasoning
  • Depression: A mental health disorder that affects behaviour, thinking, and disposition
  • Delirium: Often caused by being put into a new place, dehydration, or medication (out of the norm)

Another important distinction between the two is that depression is considered a mental health issue, while dementia, although it can affect overall mental well-being, is not.

A third condition that is sometimes confused with depression or dementia is delirium. Delirium is a short-term memory loss that results from a person being put into new, unfamiliar surroundings or living conditions, becoming dehydrated, or having a reaction to medication. This condition is often reversible if treated early, whereas most types of depression and dementia can be treated but aren’t reversible. 

The importance of knowing the differences between depression and dementia has been made even more important with the advent of the COVID-19 pandemic, and the resulting lockdowns at long-term care facilities across Ontario. In many cases, seniors were denied or discouraged from having visits from their loved ones, whether they lived in a long-term care facility or in their own homes. This situation can trigger feelings of loneliness, helplessness, and abandonment, which can lead to depression, but not necessarily dementia. 

It’s helpful to know which symptoms to look for to help determine which illness might be causing the changes in your loved one, however only a doctor can make a proper diagnosis and dispense the appropriate treatment plan.

What are the symptoms of dementia in seniors?

Dementia is the umbrella term for many different conditions that deal with reduced brain function. The most common of these conditions is Alzheimer’s disease, which accounts for 60 – 80% of dementia diagnoses

It’s important to speak to the affected person’s doctor if you suspect they are beginning to show the signs of Alzheimer’s disease or another form of dementia. Although in almost all cases the condition can’t be reversed, it can certainly be slowed down with the right treatment.

Here are some of the signs to watch out for:

  • Impaired memory: Although occasional forgetfulness is part of the normal aging process, losing one’s memory is an early sign of dementia. As the dementia progresses, the person can start forgetting how to take care of themselves in terms of nutrition and hygiene. 
  • Trouble communicating: Dementia can often cause someone to forget words, mix up word usage, or trail off without completing a sentence.
  • Confusion: Increased confusion is another early indicator of cognitive decline associated with dementia. The person may also exhibit signs of being disoriented, unsure of the time of day, have trouble recognizing family members or close friends, or being unable to find items (and possibly accusing others of theft).
  • Changes in personality: Often as a result of the memory loss and confusion associated with dementia, the person can have severe mood swings, or become depressed, fearful, or display other personality traits that are contrary to their normal behaviour. 

Identifying depression in seniors

Depression and other forms of mental illness are not part of the normal aging process. However, a 2017 study noted that 14% of Canadian seniors reported having feelings of depression, anxiety, and other mental health issues. This number might actually be much higher this year due to feelings of anxiety and isolation during the COVID-19 pandemic. Older adults who have mobility issues that restrict their movement may also develop depression.

Unlike Alzheimer’s disease and dementia, mental illness can be treated and managed under the care of a doctor. It’s perfectly normal to seem down or “depressed” at times, but seek out medical help for someone if they seem to be constantly in a state of sadness or demonstrate these signs of depression for more than two weeks:

  • Increased anxiety: Someone who seems to be consistently worrying about family, friends, or money, might be suffering from depression.
  • Restlessness and irritability: A person with depression might seem to have racing or unwanted thoughts, such as feeling life is pointless and not worth living. 
  • Loss of interest in previously enjoyable activities: Another sign of depression is when someone suddenly stops doing activities they used to love, such as hobbies, watching sports, walking, or playing a musical instrument.
  • Changes in sleeping habits: A person suddenly experiencing bouts of insomnia or sleeping too much can be a symptom of depression.
  • Lack of focus or emotion: Depression might be the cause if someone doesn’t seem to be paying attention to what’s being said, and seems to be off in their own world. They might also seem confused, indecisive, or indifferent.
  • Excessive crying and unresolved regret: A person might also cry continually if they are depressed. 
  • Dwelling on unhappy memories: Dwelling on things that happened in the past, no matter how long ago, is common in people with depression
  • Always feeling tired: Someone with depression may display a lack of energy, and want to simply sit or lie in bed or lengthy periods of time.
  • Poor living habits: A lack of hygiene or proper nutrition, or an indifference to their living conditions might suggest depression.

What symptoms are similar between depression and dementia?

Most of the differences between the two conditions have to do with memory loss. There can also be mood and behavioural changes in dementia, but this is due more to cognitive decline than a mood disorder like depression. 

However, depression can also cause confusion and forgetfulness, which can easily be mistaken for dementia. This is why it’s important to have a doctor perform a complete evaluation to try to ascertain which condition, if either, is affecting the person, and then arrange for the appropriate treatment.

When is Depression really dementia?

Depression and dementia are closely related in many ways. That’s why when a positive diagnosis can’t be made, they tend to treat the signs of depression first while encouraging ongoing monitoring of the person for symptoms related to dementia. Symptoms that can indicate that depression is really dementia include:

  • Forgetting names, facts, or recent conversations even when prompted (which people with depression can normally do)
  • Inability to correctly determine time and place (not a typical symptom of depression)
  • Attempting to cover up or deny forgetfulness 

In this case, it’s not uncommon for someone with dementia realizing what is happening to them during moments of clarity, which can lead to depression. This is why the cognitive, mental, and emotional challenges of aging adults need to be handled with patience, empathy, and loving care. 

Seeking professional care for your aging loved one in Toronto

Depression and dementia during one’s vintage years cannot be taken lightly. The need to maintain a positive, joyful quality of life should always be fulfilled. That’s why the caregivers at CareHop provide professional care that prioritizes good nutrition, mental stimulation, physical activity, and safe socialization, along with meeting every one of their specific healthcare needs. Whether you loved one needs help around the house, casual companionship, or specialized care due to an Alzheimer’s disease or dementia diagnosis, we bring peace of mind to families that their loved one is getting the best care possible.

If you need any support at all on a full or part-time basis, or have any questions about our services, please reach out to us anytime.

About the Author

Michael Lu is the founder of CareHop, specializing in providing compassionate support for individuals and families touched by Alzheimer’s disease and dementia.