Depression Vs. Dementia

Dementia and depression are major disorders can be be difficult to distinguish, especially in older adults. Alzheimer's disease is the leading cause of dementia in adults 65 and older (see Reference 1). Depression, however, is also common in older adults and can have symptoms that mimic dementia cases. Even though there are rigorous testing procedures that help determine whether a patient has dementia or depression, differences and similarities between the two include cognitive symptoms, language and motor problems, and behavioral signs.

Types

• When discussing depression and dementia, there are several different classifications that help to distinguish one from the other. When referring to depression, changes of mood are commonly discussed, and some of the common types include major depressive disorder, seasonal affective disorder, dysthymia, and bipolar disorder. All four of those have separate characteristics, but all are usually a form of the mood changes seen in depressed individuals.

  There are also several types of dementia (see Reference 2). Although dementia shares some characteristics with depression, the three major classifications of dementia are:

  Primary: Dementia resulting from a brain disease such as Alzheimer's.

  Secondary: Dementia resulting from or caused by some other disease or injury. Head injuries, multiple sclerosis, strokes and AIDS are all common disorders or injuries that could cause a secondary dementia.

  Pseudodementia: This describes a situation where the symptoms experienced by the patient might be very similar to true dementia, but they are caused by something else, such as depression.

Cognitive Similarities

• There are a couple reasons why it is confusing to try to distinguish dementia from depression. First, cognitive impairments are common with both disorders. Memory problems that consist of difficulty remembering simple events can disrupt a person's daily life and relationships. Second, it might be especially difficult to differentiate depression from dementia in older adults because there might be less of a mood change that is usually present in depressed individuals but not prevalent in dementia disorders.

Language / Motor Differences

• There is a striking difference between dementia and depression when it comes to language and motor difficulties. Dementia patients often have mild to severe motor and language problems that progress throughout the disease. For example, difficulty remembering simple terms such as "pen" might be difficult, and using the wrong words or speech is common. In addition, dementia patients might have trouble remembering how to perform routine tasks, such as how to tie their shoes or put on a pull-over sweater.

  In contrast, depressed individuals do not have the language and motor skill problems as those with dementia do. Even though depression might slow speech or movements, language and motor skills are usually quite normal.

Behavioral Differences

• There are tell-tale behavioral differences between those with dementia and those with depression. With depression, there is a constant negative spin placed on events or things in daily life, such as memory lapses that might occur. On the other hand, dementia patients might simply try to cover up or give an excuse for a memory lapse that occurred instead of being negative. Hiding memory problems is especially seen in early stages of dementia where the individual might be in denial or disbelief.

Treatments

• The treatments for depression and dementia are different based upon the type of disorder or disease. Depression is commonly treated with a combination of antidepressant prescription medications and psychotherapy.

  There are some forms of treatable and untreatable dementia. For treatable dementia that is caused by some kind of infection or hydrocephalus, the right therapies can often cure it. For progressive dementia disorders such as those caused by Alzheimer's, medications are available that can decrease some of the symptoms but not cure the disease.