Alzheimer’s disease is a debilitating and degenerative disorder that often robs both the senior's who have it and friends and family of emotional and physical reserves. This can leave the person diagnosed with Alzheimer’s related depression in a bad way and leave the caregiver depressed, too.
Interestingly researchers have found several links between the diagnosis of Alzheimer’s and the diagnosis of depression in older adults and their caregivers. In several studies scientists have found a link between people who have suffered a lifetime of major depressive disorder and the development of Alzheimer’s disease.
In a study from Mount Sinai School of Medicine in New York the researchers did postmortem study of the brains of 44 people who had a lifetime history of depression and 51 people who had been diagnosed with Alzheimer’s but no diagnosis of depression.
What they found was that people who were depressed had more plaques and tangles in the brain (a key feature of Alzheimer’s), those with Alzheimer’s and depression showed a more marked and pronounced change in the hippocampus (part of the brain where tangles and plaques occur) and that those who had depression through most of their life had a more rapid decline into Alzheimer’s.
Alzheimer related depression has been found to be a risk factor for Alzheimer’s but it is also is preventable and treatable. Researchers are currently investigating the possibility that with consistent treatment throughout their lives this can delay the onset of Alzheimer’s and thus increase the quality of life that these people can enjoy.
People who are already diagnosed with Alzheimer’s are at greater risk of developing depression, even if they’ve never experienced this psychological disorder before. The stress, both physically and emotionally, on a person who is suffering the signs and symptoms can take a huge toll on them leaving them with signs of depression that may be difficult to tell the difference between the depression and the Alzheimer’s.
People with a major depressive disorder will find they experience at least four or five of these symptoms:
- Depressed mood
- Marked loss of interest or pleasure in activities
- Sleep problems – insomnia, early morning awakening or sleeping too much
- Significant weight loss or loss of appetite
- Fatigue and loss of energy
- Increased difficulty with concentration or ability to think
- Feelings of excessive guilt
- Feelings of worthlessness
- Suicidal feelings or attempts
- Agitation or marked slowing of motor movements
Unfortunately these are also symptoms of Alzheimer’s and differentiating and treating the two can present challenges to the physician and family members.
These are medications that can be used to treat depression in people with Alzheimer’s that include SSRI (selective serotonin reuptake inhibitors) antidepressants, tricyclic antidepressants and electroconvulsive therapy. Each of these options have their pros and cons that must be matched to the individuals specific situation.
Monitoring of medications falls to the responsibility of the caregiver, physician and home health care nursing because the person suffering these symptoms isn’t able to perform these tasks. Medication may trigger a psychotic episode.
And the effectiveness does vary from person to person. The physician and psychiatrist will depend on the feedback of caregivers when assessing the effectiveness of the medication.
Some people with depression and Alzheimer’s don’t respond to medications. In these cases electroconvulsive therapy may be tried to relieve symptoms of severe depression. This isn’t the procedure of decades ago but rather is more humane and less severe.
Slight amounts of electricity are delivered to the brain for a few seconds to trigger a seizure under general anesthesia in a hospital. This option is used more in older adults than younger – maybe because older adults have more side effects from antidepressants or have more severe complications from severe depression.
