dementia, no topic to mention

Before doctors diagnose dementia, they often diagnose depression. How and why it can lead to such a diagnosis Claudia Dallmann, Specialist in Psychiatry and Psychotherapy at the Alzheimer Therapy Center.

Caring relatives often report that their dementia partner first diagnosed depression. Not infrequently resonates with it incomprehension and they ask the question, as it could only be that a doctor makes such a misdiagnosis. Or they may discover symptoms that their demented relatives have at the beginning of their illness, and are now worried that they will end up with dementia themselves.

In addition to a dementia disease, depression is one of the most common mental illnesses in old age. Nevertheless, these diseases are often not properly diagnosed. But what makes it so difficult to distinguish these two diagnoses?

Because the symptoms of these disorders are very similar, distinguishing them from depression is often very difficult, especially with incipient dementia. In addition, there are people who suffer from both dementia and depression at the same time.

For example, Especially in the early stages of dementia, depressive symptoms also occur because those affected notice the progressive loss of their mental abilities and experience the growing restrictions full of fear, worry and sadness. In 35 to 40 percent of all patients with Alzheimer's disease, a depressive mood develops in the course of the disease. If depression is particularly strong, demarcation or a clear diagnosis can become so difficult that it can only be achieved under inpatient conditions in a psychiatric hospital and with the observation of the entire treatment team.

Here are some of the main distinguishing features between the two conditions. These serve only as a guide, because the symptoms - as previously described - can be very similar. If you or any of your family member have any of these symptoms, you should seek medical attention. For this purpose, the first point of contact should be the family doctor, with whom they can discuss the further diagnostic procedure.

Symptomatic differences of depression and dementia

Onset of the disease: While dementia begins slowly and continues to worsen over months to years, it is characterized by rapid onset and a duration of illness often less than 6 month.

Orientation: As part of a depression, the sufferers are largely completely oriented. Those affected know how to get help and do so purposefully. In the presence of dementia, it often comes at the beginning of the disease to memory and orientation disorders that increase in the course. Dementia patients are increasingly looking for untargeted help.

Problem solving: People with depression often put their limitations in the foreground with very detailed descriptions. They often respond to performance demands with statements like "I can not do it" or "I can not do that". Questions that are addressed to them often come from "I do not know" answers, and those concerned tend to worry about it, but people who suffer from dementia often trivialize their restrictions or blame their environment for their deficits.

Cognitive Disorders: This refers to disorders of information processing and implementation. In the context of a depression, it is often only slightly impaired, which are then more consistent. Those affected often have good everyday skills, which are in contradiction to the often poor performance tests. With regard to their impairments, depressives often suffer from feelings of guilt. In dementia, on the other hand, there are increasing cognitive dysfunctions consistent with the deterioration of performance tests. Everyday competencies are steadily decreasing and thus also correspond to the test results.

Sleep: Depressed people often suffer from trouble falling asleep and staying asleep due to a worried grudge, while dementia tends to increase nocturnal restlessness and activity.

Social Activities: Depressed people tend to retire socially, while people with dementia often try to stay socially active at the very beginning of the illness.

Mood: In depression, it often comes to a low mood in the morning while in a dementia illness rather comes to a low mood in the evening.

Antidepressants: These drugs can improve mood in both conditions. However, in contrast to dementia, antidepressants in depression also improve cognitive impairment.