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Depression v. Dementia

Sometimes it is difficult to distinguish between the symptoms of dementia and Depression. Often Depression accompanies dementia, but is difficult to diagnose as a separate issue. On the other hand, Depression may be incorrectly diagnosed as dementia. Following is a guide to distinguishing the two:

Dementia

Dementia is defined as progressive cognitive decline. It affects up to 10% of adults age 65 to 85, 20% of adults age 75 to 85, and 50% of adults over age 85. Alzheimer's disease accounts of 65% of dementia cases. Other common causes include Parkinson's disease, vascular dementia, alcoholism, and drug intoxication. Less common causes include vitamin deficiencies (B1 and B12), endocrine abnormalities, chronic infections and degenerative disorders.

Although most causes of dementia are irreversible, early diagnosis and treatment of an underlying or exacerbating condition (such as hypertension, alcoholism, Depression, normal pressure hydrocephalus, head injury or Parkinson's disease) may lessen the condition's severity or slow its progress.

Fluctuation in symptoms is the hallmark of many dementias. Symptoms include:

  • Memory loss that affects every day life (must be present)
  • Difficulty finding words
  • Difficulty performing familiar tasks (e.g., using an appliance)
  • Problem naming common objects
  • Often losing things, or misplacing them
  • Getting lost in familiar places
  • Problems with abstract thinking, planning, organizing, following directions, doing things in order, taking care of oneself, poor or decreased judgment
  • Change in mood, behavior and/or personality
  • Loss of interest in usually pleasant activities and/or lack of initiative doing things

Depression

Older adults typically experience a series of losses, such as the death of a spouse and friends, diminished physical capabilities, changes in living situations, and dwindling financial resources. Because of these losses, many people wrongly assume that sadness is an inevitable consequence of aging. Instead, extreme or prolonged sadness should be recognized as a possible warning sign of Depression, a treatable condition.

Five or more of the following symptoms, every day, for at least two weeks can indicate Depression:

  • Must have depressed/irritable mood or loss of interest or pleasure in usual activities for most of the day, nearly every day
  • Decrease in ability to think, to concentrate or to make decisions
  • Significant weight loss or weight gain or a significant decrease or increase in appetite, nearly every day
  • Not sleeping or sleeping too much
  • Fatigue or loss of energy, nearly every day
  • Feelings of hopelessness, helplessness
  • Thoughts of death, wanting to die, thinking about suicide, or trying to kill oneself
  • Feeling worthless or excessively or inappropriately guilty
  • Agitation or being slowed down
  • Headaches
  • Loss of interest in sex
  • Symptoms must cause significant problems in living, such as at work, doing the household chores, or carrying on other aspect's of one's life
  • Symptoms must not be due to alcohol abuse, effects of medication, or medical illness.

In the elderly, Depression may present in the following ways as well:

  • Increased focus on bodily aches and pains
  • Anxiety, irritability, and agitation may be more prominent than with the general adult population
  • Recurrent statements about fear of becoming dependent on others, of being disabled, of feeling helpless or of feeling that life is not worth living

Depression in the elderly can cause mild to severe cognitive difficulties that will improve with treatment of the Depression. If the individual is treated for Depression, be sure to have him/her checked for dementia a few months after the Depression symptoms have lifted, just to be sure that your doctor did not miss a diagnosis of dementia.

Contact the Elder & Disability Law Center through this Web site, by phone at 202-769-0207, 866-399-4324, or by e-mail.