Caring for Seniors with Alzheimer’s: Depression
Depression or Alzheimer’s or both? You can certainly have both. And unfortunately, if you have depression, you may be twice as likely to develop Alzheimer’s.
In 2010, the journal Neurology published two studies that said older adults with depressive symptoms raise the risk of Alzheimer’s by 50%. The studies could not conclude that depression is a risk factor for Alzheimer’s. But one of the study’s authors, Robert Wilson, theorizes that depression fundamentally alters the brain.
The other study’s author, Jane Saczynski, says that the inflamed brain tissue caused by depression may contribute to Alzheimer’s. The theory is that depression weakens the body’s defenses against the disease by reducing the blood supply to the brain.
Other factors connecting depression to Alzheimer’s include social factors such as diet and amount of social engagement.
About 6 million senior Americans suffer from depression but only one in 10 receives treatment. The reason: depression is often seen as a normal part of aging. It’s not.
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So there is a chance that depression in seniors is an early sign of Alzheimer’s. We’ll look at symptoms and treatment.
Symptoms of Depression
The symptoms of depression vary from person to person. But they may include some of the following:
- Loss of interest in once-enjoyed daily activities
- Feeling sad, hopeless and apathetic for weeks or even months
- Social withdrawal
- Feeling anxious or agitated
- Short-term memory problems
- Poor appetite/weight loss or increased appetite/weight gain
- Trouble sleeping or sleeping too much
- Trouble concentrating or focusing
Symptoms of Early Alzheimer’s
See the above symptoms of depression. Many similar symptoms occur between Alzheimer’s and depression. If you or your loved one experiences these symptoms, you should consult a physician immediately.
Treating Depressed Alzheimer’s Seniors
Seniors with both Alzheimer’s and depression is a pernicious combo. Whether they had depression that lead to Alzheimer’s or became depressed after being diagnosed (not uncommon), treatment options should be employed immediately.
A combination of medication and support is usually the best approach. Let’s look at some non-drug options first as recommended by the Alzheimer’s Association and the Mayo Clinic.
- Engage the person in regular daily exercise, especially in the morning
- Make difficult tasks (e.g. bathing) part of a daily routine; same time each day
- Schedule enjoyable activities and social events more often
- Have the person contribute to family life in some meaningful way
- Tell them they are a respected and appreciated member of the family
- Celebrate small successes
- Acknowledge their frustration while offering encouragement that things will get better
- Reassure the person that you will be there for them in the future
- Consider support groups, counseling and/or psychotherapy before the disease deteriorates their communication skills too much. The Alzheimer’s Association has a geographic listing of support groups as well as online chat rooms and message boards for those with Alzheimer’s and their caregivers.
Drugs for Depression in Alzheimer’s Seniors
Doctors can prescribe antidepressants for Alzheimer’s seniors who have depression. Keep in mind these drugs can have side effects. The first drug prescribed may not be the best option. Sometimes it takes “experimenting” (under doctor’s supervision) until the right drug is found.
- bupropion (Wellbutrin)
- paroxetine (Paxil)
- sertraline (Zoloft)
- citalopram (Celexa)
- fluoxetine (Prozac)
- mirtazapine (Remeron)
- trazodone (Desyrel)
- venlafaxine (Effexor)
Electroconvulsive Therapy (ECT)
What sounds like a scene out of a Ken Kesey novel is actually quite safe and making a comeback for treating depression. In past decades, electroconvulsive therapy was painful and led to serious side effects. Today, the procedure is relatively safe and painless and the side effects have been dramatically reduced.
How it Works?
The actual ECT procedure takes about 15 minutes with added time for preparation and recovery. It’s performed in a hospital or as an outpatient procedure while you are under general anesthesia.
Electrode pads are placed on your head. Electric current passes through these pads to the brain producing a seizure that lasts from 30 to 60 seconds, all while you are unconscious.
Improvement in depressive symptoms is usually noticed after several treatments. It’s not known exactly why this procedure works. But it is known that chemical changes occur in the brain, somehow reducing the symptoms of depression.
ECT treatments are typically given three times a week for two to four weeks, according to the Mayo Clinic.
The safety of someone with Alzheimer’s can never be 100% guaranteed. But as a caregiver, you can mitigate many potentially harmful situations with first a thorough survey of your home. Then with additional safety measures such as a location management system. Finally, day-to-day vigilance goes a long way to keeping your loved one and others safe.
To find Alzheimer’s care options—from home care to respite care to nursing homes—near you, search the Seniorliving.org database.
For further reading on Alzheimer’s:
Updated: May 21, 2012