Alzheimer's Disease or Depression? Why Getting an Accurate Diagnosis Isn't Always Easy

Getting a reliable, initial early diagnosis of Alzheimer's disease can be difficult, as both depression and Alzheimer's disease can present similar symptoms, signs and behaviors. And before you can treat a problem, you have to know for certain what the problem is. The challenge has to do, in part, with the problems of today's health care crises—a growing number of patients, too few specialized geriatric physicians and too little time to perform a complete patient assessment.

Choosing the Right Physician Is Key to an Accurate Diagnosis

If a physician is not trained in geriatrics or is not familiar with the more subtle aspects of Alzheimer's disease, it is possible that he or she may misdiagnose signs and symptoms of cognitive problems. Too frequently, that misdiagnosis is depression. If a doctor assumes that the patient's symptoms are depression-related, he may miss the opportunity to render a proper diagnosis, and in doing so might prescribe an incorrect drug for a problem that doesn’t exist, while missing the true diagnosis of very early Alzheimer's disease.

If your loved one shows memory loss or changing behavior, document the changes you notice and accompany your loved one to the doctor's appointment. Be sure that you report and discuss all of the signs and symptoms that you have noticed with the physician. Don't be afraid to demand the necessary time with the physician to provide enough information to assure the likelihood of an accurate diagnosis—it matters.

Distinguishing Between Depression and Alzheimer’s Disease

Depression can be described as feelings of sadness. Everyone, at one time or another, experiences mood changes or feelings of being down or "blue." These negative feelings can be caused by a myriad of factors ranging from loss of a favorite pet to divorce or loss of a job. Typically these examples trigger feelings that are collectively referred to as normal depression.

One common form of "normal" depression is referred to as grief-induced depression. Among seniors, it is often the result of some incredible change, such as the death of a spouse, the loss of friends due to relocation, illness or death, or the loss of personal independence. Grief-induced depression can also result from seniors' awareness of their own issues related to aging or physical decline.

Alzheimer's disease and depression are relatively common problems. Both impact the brain, both can impair memory and thought processes, and both can disrupt our daily activity. In Alzheimer's dementia, memory loss is the main symptom, but other functions can also be affected.

Recognizing Symptoms of Memory Loss

Cognitive decline can exhibit many signs: a diminished orientation to time and place; poor reasoning and logic; a lack of (or reduced) problem-solving ability; loss of good judgment; diminished command of language and vocabulary; and a change in personality and emotions. These are outward indicators of a problem and can present themselves individually or as a combination of several problems. But the results of the decline are typically seen as a deterioration of a person’s social and functional abilities.

For people over the age of 80, Alzheimer's disease is the most common form of dementia. With proper testing by a physician trained in geriatric medicine, Alzheimer's disease can be diagnosed with about a 90% assurance of accuracy.

Getting an Early Diagnosis in Cases of Alzheimer's

There is no substitute for a complete physical exam and mental evaluation. If there is any question in your mind as to whether your loved one has depression or is showing what you believe may be signs of Alzheimer's disease, a neurological evaluation including neuropsychological testing can help determine brain function related to problem-solving, processing information and judgment. Finding the right physician to help make the proper determination—a geriatric physician, geriatric neurologist or internist with geriatric medical training—is critically important when there is a possibility that the problem may be either depression or Alzheimer's disease.

In some patients, depression and dementia may occur at the same time because some people with early Alzheimer's disease may react to the challenges of their dementia by showing signs and symptoms of depression.

It cannot be overstated: getting an accurate—and early—diagnosis is critical because medical treatments of dementia and depression are very different. It is also important to note that not everyone who shows signs of impaired thinking or diminished memory has dementia. Depression is fairly common, may be associated with difficulties in thinking and memory, and its presence does not exclude the possibility of dementia. However, depression is treatable with or without Alzheimer's disease or other forms of dementia.

Until next time, thanks for caring.

Ron Kauffman

Ron Kauffman is a Certified Senior Advisor, radio talk show host and an expert on issues of aging and caregiving. He is the author of Caring for a Loved One with Alzheimer's Disease, available at www.seniorlifestyles.net.

Editor's Note: For further reading, see Recognize the Signs of Early Memory Loss in Your Elderly Parent and Alzheimer's Association Updates 10 Early Warning Signs of Alzheimer's Disease.

Posted in Assessment & Warning Signs, Caregiving: Parenting Your Parents, Criteria for Diagnosing, Early Signs & Symptoms