Vitality - Healthy Aging NewsletterSpring 2012

Dementia, Depression, or Something Else?

If you have been experiencing confusion, forgetfulness, or fatigue, don't automatically assume that these are symptoms of dementia or a normal part of aging.

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Many health conditions and medications can cause or mimic dementia. For example, your symptoms could result from a poor diet, hypothyroidism, side effects from drugs or drug interactions, stress, depression, or simply being overwhelmed.

If you have any concerns or troubling symptoms, contact your doctor, says Douglas Kalunian, MD, psychiatrist, Group Health Behavioral Health Services in Tacoma. "Diagnosis and treatment of one of these causes of memory loss is important, because if caught early enough, the symptoms can potentially be reversed."

You could also be suffering from depression. It's estimated that as many as 10 percent of people diagnosed with dementia actually suffer from depression because both conditions can cause mood changes, memory problems, slow speech, and low motivation.

However, there are also differences. In dementia, mental decline occurs slowly over time. Writing, speaking, and motor skills are impaired and it's common to get confused and disoriented. In depression, mental decline is relatively rapid, language and motor skills are slower but still normal, and the person is usually aware of the correct day, time, and location.

It may be more difficult to identify depression when you're older. You may notice that you suffer from fatigue or lack of appetite, or that you can't concentrate. Or you may not be able to muster the energy to go to church, get out in the garden, or do some of the things you used to enjoy. But as we get older, we're also less likely to seek help for these kinds of symptoms.

"Many patients are reluctant to speak up because they're not comfortable talking about their feelings," says Dr. Kalunian. "They grew up in a time or environment when having a mental health problem was considered unacceptable. We want to assure them that depression is not uncommon, and that it's a condition that can most often be treated successfully."

Matt Handley, MD, an associate medical director for Group Health Physicians who also practices at the Capitol Hill Campus in Seattle, reminds us that a decrease in memory as we age is normal. "Most people who are forgetful don't have dementia," he says.

To help stay sharp and prevent dementia, drink alcohol only in moderation or not at all; stimulate your brain with mental challenges such as reading, writing, working crosswords and other puzzles; and spend time with others.

It's also important to eat a healthy diet and exercise regularly. "Exercise is a good 'medication' for depression, as well as for maintaining or improving function in those with dementia," says Nipali Bharani, a psychiatrist at Group Health Behavioral Health Services in downtown Seattle. "Even small amounts of exercise are better than none. Consider walking or water exercises, which are gentle on the joints."

The most important thing you can do is take charge of your own health by being aware of any changes in your physical or mental condition, communicating openly with your doctor, understanding what's causing any troublesome symptoms, and taking steps to improve your health and outlook on life.

"We encourage you to be open and honest when it comes to discussing your well-being with us," says Dr. Kalunian. "Remember: we're here to help."

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