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Depression and Alzheimer’s disease are two very different conditions, but many people experience both at once. Sometimes, depression shows up years before Alzheimer’s disease. Other times, it develops after an Alzheimer’s diagnosis, while dealing with the challenges of memory loss due to Alzheimer’s.
For people living with Alzheimer’s, as well as their loved ones and caregivers, understanding the connection between these two conditions can help aid in earlier diagnosis and treatment, with the goal of improving overall quality of life.
Depression, which is usually shorthand for major depressive disorder (MDD), is more than just a temporary feeling of sadness or a bad day. It’s a serious mental health condition that affects the way a person thinks, acts, and functions in society. Nearly 3 in 10 adults have been diagnosed with depression.
Symptoms of depression may include:
Now, everyone may feel this way once in a while. To be diagnosed with depression by a medical professional, you must experience these symptoms nearly all day, every day, for at least two weeks. In addition, these symptoms must make it difficult for you to perform your usual activities, like going to work or school.
People of all ages and backgrounds can develop depression. It may be triggered by an event, such as illness or grief from a loss, or it can happen out of the blue. Some people are more likely to get depression, including people with family members who have depression or people experiencing stressful life events.
Certainly, being diagnosed with a long-term or life-threatening illness, including Alzheimer’s disease, can lead to depression. Similarly, caregivers of people with Alzheimer’s may develop depression, due to the loneliness and isolation that comes along with seeing memory and personality changes in a loved one.
Research shows that depression may not only coexist with Alzheimer’s, but it may also increase the risk of dementia later in life. One study that combined the results of 28 different research studies showed that people with depression were 1.5 times more likely to be diagnosed with Alzheimer’s disease compared to people without depression.
What is the reason for this potential higher risk? Scientists have many hypotheses, but no clear answer. One hypothesis is that certain antidepressant medications are connected to dementia risk. Another hypothesis has to do with changes to the shape of the brain and hormone levels seen in depression.
If you’re living with depression, there may be a slightly increased risk of developing Alzheimer’s later in life. There needs to be more research on this topic before we truly understand it. And it’s another strong reason to seek mental healthcare early for depression symptoms.
It’s estimated that 4 in 10 people with Alzheimer’s experience depression.
Depression may be an early sign of Alzheimer’s. It’s not uncommon for people with Alzheimer’s to be misdiagnosed with depression first or have both conditions at the same time.
Picture this: a 75-year-old widowed retiree who stops attending his weekly book club, loses 10 pounds, and has trouble sleeping through the night. To a doctor or a loved one, these may appear to be signs of depression. Without further investigation, however, it’s difficult to tell the difference between major depressive disorder and early Alzheimer’s disease. That’s why medical providers need to be on the lookout for memory loss and mood symptoms in older adults.
If you’re someone who has been recently diagnosed with Alzheimer’s, this life-changing diagnosis alone can be enough to trigger an episode of depression. “My husband’s driving skills have deteriorated to the point of having to quit driving. Naturally, this is depressing for both of us,” one myALZteam member said. As you begin to notice changes in your memory, thinking, and ability to perform daily tasks, this can lead to feelings of frustration, sadness, or hopelessness.
Does depression look any different in someone in their 70s versus their 20s? Certainly.
“Mom has started crying almost every few minutes throughout the day,” one myALZteam member shared of her mother with Alzheimer’s disease.
Older adults with depression may tend to withdraw from social activities, including family events. They may seem disinterested or unengaged when they were previously lively and social. They may have a severe change in sleeping patterns, such as waking up very early and not being able to go back to sleep. It’s important to be aware that there’s a high suicide risk among people who were recently diagnosed with dementia.
On top of Alzheimer’s, it may be hard to tell which symptoms are from depression and which ones are from dementia.
Neurons are brain cells that send messages through the brain and spinal cord. They help us move, talk, breathe, and eat. In Alzheimer’s, there’s a buildup of abnormal proteins — called amyloid plaques and tau tangles. These proteins cause neurons to lose their connections to one another and eventually die off. Over time, people with Alzheimer’s lose their short-term memory, followed by the ability to think, reason, communicate, and take care of themselves.
According to Harvard Medical School, the relationship between depression and Alzheimer’s disease is a two-way street. The part of the brain that affects mood may be directly affected by Alzheimer’s. In addition, inflammation and changes in blood flow in Alzheimer’s may contribute to depression symptoms. This is why it’s so common to see mood and personality changes in people living with Alzheimer’s disease.
If you or someone you love is experiencing depression symptoms after an Alzheimer’s diagnosis, it’s easy to dismiss depression as “just another symptom.” However, depression is a treatable condition, and it’s important to seek help. Treatment of depression can have many benefits to quality of life, such as:
“My mother with Alzheimer’s had been crying regularly,” one member shared. “Her geriatric psychiatrist prescribed a mood-elevating drug because he feels she’s depressed. Mom seems to be getting some relief.”
How depression is treated may depend on many factors, such as how severe symptoms are and how long someone’s been living with it.
Treatment may involve a combination of therapy, a social support group, self-help activities, and medications. Even if someone has memory loss, they can still benefit from participating in therapy or speaking with a trained counselor.
Some of the medications usually used to treat depression may not always be safe or effective for older adults with dementia, due to potential side effects and drug interactions. However, there are medication options that help people with dementia and depression improve their quality of life. Speak to your doctor to find the treatment that is most suitable for you as an individual.
If you or a loved one with Alzheimer’s shows symptoms of depression, it may be time to speak with their primary care provider or neurologist. Sadness, withdrawal, guilt, and hopelessness are not a normal part of dementia — these are symptoms that deserve attention and care.
Although depression and Alzheimer’s are deeply connected on a social, emotional, and neurologic level, there is hope. Recognizing and treating depression in people with Alzheimer’s can improve quality of life. Don’t hesitate to reach out for help.
On myALZteam, the social network for caregivers of people with Alzheimer's disease, members come together to ask questions, give advice, and share their stories with others who understand life with Alzheimer’s.
Has your loved one had mood changes, like feeling sad or depressed, while living with Alzheimer’s disease? How has mental healthcare become part of their treatment?
Has your loved one had mood changes, like feeling sad or depressed, while living with Alzheimer’s disease? How has mental healthcare become part of their treatment? Share your experience in the comments below, or start a conversation by posting on your Activities page.
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