So why talk about these two different topics in the same sentence? They are actually very similar, yet have subtle differences and sometimes get misdiagnosed.
For a long time doctors dismissed forgetfulness and mental confusion as a normal part of aging. But scientists now know that memory loss as you age is by no means inevitable. Indeed, the brain can grow new brain cells and reshape their connections throughout life.
Most people are familiar with at least some of the things that can impair memory, including alcohol and drug abuse, heavy cigarette smoking, head injuries, stroke, sleep deprivation, severe stress, vitamin B12 deficiency and illnesses such as Alzheimer’s disease and depression.
Depression is not a normal part of aging as many people believe, if it were, everyone would be depressed. Everyone is impacted by daily life and things that happen can be very depressing such as loss of our partner, loss of health, loss of our home of many years, children and grandchildren disappointing us to name a few. But, if ignored, symptoms of depression can cycle into a much more serious problem.
Why does depression often get misdiagnosed in older adults, because the symptoms are similar to dementia or we complain about physical symptoms that doctors are forced to evaluate and can also be one of the contributing factors to higher healthcare costs.
Dementia warning signs include: short term memory loss, difficulty performing familiar tasks, problems with language, disorientation to time and place, poor judgment, problems with abstract thinking, misplacing things, changes in mood or behavior, changes in personality and loss of initiative. Some of these symptoms are often present in depression but not reversible when associated with dementia. There are also diagnostic tools to evaluate for dementia beginning with the Mini-Mental Status Exam, and AD8 = Eight-item Informant Interview to Differentiate Aging and Dementia; AWV = Annual Wellness Visit; GPCOG = General Practitioner Assessment of Cognition; HRA = Health Risk Assessment; MIS = Memory Impairment Screen; MoCA = Montreal Cognitive Assessment; SLUMS = St. Louis University Mental Status Exam; Short IQCODE = Short Informant Questionnaire on Cognitive Decline in the Elderly.
Subtle differences between the two diagnoses:
Mainly a mood disorder Progressive brain damage
Others are aware of problem Others may not be aware
Short duration, rapid progression Long duration, slow progression
Patient is aware of memory loss Unaware of loss or denies
Little energy to perform simple tasks Struggles with tasks
Forgetfulness varies day to day Forgetfulness is progressive
Highlights failures Grandiose
Reports distress Doesn’t recognize distress
Sad and grieving Mood swings
Withdrawn, loss of interest in food, activity or sex Often uninhibited
Usually worse in the morning Usually worse in the evening
Memory loss equal for short and long term memory More recent memory loss
Wants to be left alone Affection seeking, uninhibited
Usually not incontinent Often incontinent
If you have questions or concerns about a loved one’s mood, behavior, motivation or activity level, please contact us for an assessment or resources for obtaining a diagnostic evaluation.