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Vail Daily column: Depression common among those with dementia

Research has not made a definitive connection between depression and dementia. However, a tremendous amount of research and a number of clinical studies have been done that indicate people 50 years of age and older who have depression have a greater likelihood of developing dementia.

The connection between depression and dementia has a biological relationship. There is data that suggests elevated levels of the hormone cortisol have a greater presence in persons with depression.

Cortisol is produced in glands in our endocrine system. This system works with the brain to control numerous activities in the body. When our bodies encounter stress and depression, cortisol is produced. Elevated levels of cortisol have an adverse effect on the part of the brain responsible for new learning and short-term memory. While our endocrine system usually keeps hormone levels well regulated, depression inhibits many of the neurotransmitters that provide information to our endocrine system for proper regulation.



TREATING DEPRESSION

Depression is toxic to the brain. Therefore, addressing depression and the signs of depression early on is important. Treating depression can be addressed with medicines, physical exercise, social support, counseling and, when necessary, electroconvulsive therapy. Often, treatments are most effective when they are used together.



Studies at the Washington University School of Medicine department of neurology have demonstrated that there are precursor symptoms to the development of dementia. According to a study conducted by Catherine Roe, an assistant professor of neurology, “Symptoms occurred in three phases. Irritability, depression and nighttime behavior changes developed first. This was followed by anxiety, appetite changes, agitation and apathy. Finally, elation, mobility disorders, hallucinations, delusions and impulsive, inappropriate behavior.”

KNOW THE SYMPTOMS

Symptoms of depression include:



• Social withdrawal.

• Feelings of helplessness and hopelessness.

• Loss of interest or pleasure in hobbies and activities.

• Self-loathing.

• Feelings of isolation and of being cut off from other people.

• Loss of remembering, concentrating or making simple decisions.

• Agitation and restlessness.

• Tiredness or loss of energy.

• Appetite and/or weight changes.

• Aches and pains that appear to have no physical cause.

SEEK MEDICAL HELP

Depression is very common among people with dementia. Depressive symptoms have been reported to occur in approximately 40-50 percent of people with Alzheimer’s disease.

If you question whether depression is affecting a loved one with dementia, you should speak with their family and primary medical provider. Medical providers can often perform a thorough examination to rule out other medical conditions. When appropriate, primary medical providers can administer a number of assessments to screen for and identify depressive symptoms. The Cornell Scale for Depression in Dementia and the Geriatric Depression Scale are two such clinical tools commonly used to conduct depression assessments.

Medications such as antidepressants may be prescribed and can be very helpful in improving the symptoms of sadness, and they may improve appetite and sleep problems. Be aware, however, they often have side effects.

For those who would like to avoid medications, other approaches exist to address depression. Increased social support and modifications to the surrounding environment have proven to be very effective. Additionally, changing one’s behavior, physical activity and lifestyle can be treatments for depression.

Addressing depressive symptoms is essential to increasing a quality of life. Further, by addressing depression early on, we may be able to mitigate the effects it has on dementia. Making the right diagnosis and getting appropriate treatment can help make the difference for the person with dementia, the family and loved ones who surround them.

Judson Haims is the owner of Visiting Angels Home Care in Eagle County. For more information, go to http://www.visitingangels.com/comtns or call 970-328-5526.


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