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Depression and Dementia: Similarities and Differences

Diseases often times mimic one another yet have distinct differences as well. This is no different with depression and dementia. Both can display the same symptoms, from lethargy to confusion, yet they have notable differences that define them. One can even mask the other. Add the hospice component to the equation and your loved one’s symptoms may be compounded. The good news is that quality of life can be improved with proper treatment. If you are facing the need for hospice in San Francisco for your aging parent of other loved one who suffers from one or both of the above, Pathways Home Health and Hospice is here to help. Here we will discuss the similarities and differences between depression and dementia.


There are several similarities in symptoms between depression and dementia. The two disorders can go hand in hand, sort of like a never-ending cycle. That’s because so many people who have Alzheimer’s disease are also depressed, either due to their condition or some other cause. Those who suffer from both Alzheimer’s and depression often find it easier to deal with the changes caused by Alzheimer’s when they feel less depressed, says the Mayo Clinic.

The following symptoms are common to both Alzheimer’s and depression:

  • Loss of interest in normal hobbies
  • Withdrawal from social situations
  • Forgetfulness
  • Sleeping too much or not enough
  • Difficulty concentrating
As you can see, there is a big over-lap in symptoms that can make diagnosis difficult. It’s important for the patient to get a comprehensive physical exam and psychological evaluation to assist in making a clear diagnosis. Problems arise, though, when those with advanced Alzheimer’s become increasingly unable to express their feelings. As a result, doctors must look at non-verbal cues and caregiver reports instead — more so than symptoms reported by the patient.
The following guide may be helpful in determining if a person with Alzheimer’s also has depression. As a general guide, if someone shows one of the first two symptoms in this list, along with at least two other components within a 14-day period, depression may be present:
  • Intense depressed mood; feelings of extreme sadness, hopelessness and discouragement
  • Reduction in pleasure in usual activities
  • Social isolation and withdrawal
  • Not eating enough or eating too much
  • Sleeping too much or too little
  • Agitation and lethargy
  • Apathy
  • Increased irritability
  • Fatigue and loss of energy
  • Feeling worthless, hopeless or inappropriately guilty
  • Recurring thoughts of death or suicide


Adding to the confusion of it all are the differences between the two. Those with Alzheimer’s may experience depression differently from that of people without. For instance, those with Alzheimer’s disease may:

  • Display symptoms of depression that are less severe
  • Experience episodes of depression that come and go
  • Not talk of suicide as much
Unfortunately, the exact relationship between Alzheimer’s disease and depression is still largely unknown. Some researchers believe the biological changes brought on by Alzheimer’s can strengthen a pre-disposition to depression. Others say depression can increase the risk of developing Alzheimer’s disease. It’s like a chicken-and-the-egg scenario: which came first? What is known is that depression has a clear effect on the quality of life for Alzheimer’s patients, with depression having the potential to lead to:
  • Decreasing cognitive decline
  • Increasing difficulty handling daily living skills
  • Increasing dependence on caregivers

Studies have shown that many older people who have depression go on to develop Alzheimer’s disease as a result of multiple small strokes in the brain, points out CNN. Thus, depression is the first manifestation of the brain starting to break down, and as this worsens, depression can blend into dementia. Treating that depression can initially improve outlook; however, eventually the gradual destruction of the brain gets to be too much and things can go downhill quite rapidly.


The treatment of depression must be taken seriously by caregivers. Telling someone who suffers from both conditions to simply “cheer up” or “snap out of it” is not helpful. Depressed people need the support of their loved ones because they can’t get themselves out of that hole on their own — especially when they are dealing with other chronic illnesses or are facing end of life care in hospice. According to the Alzheimer’s Association, the most common treatment for depression in Alzheimer’s involves a combination of medicine, counseling and gradual re-introduction to activities and people that inspire happiness.

Before a proper treatment can be prescribed, a doctor should perform the following:

  • Review of the person’s medical history
  • Physical and mental examination
  • Interviews with family members

Contact Pathways Home Health and Hospice

If your loved one requires hospice yet suffers from both depression and Alzheimer’s disease, Pathways Home Health and Hospice has the resources to help in San Francisco, specifically in regards to dementia care. Please contact us today at 888-755-7855.