Recognize difference Am I dementing or depressed?

Difference between dementia and depression
Depression and dementia are the most common mental health problems in old age. How this can be differentiated despite similar initial symptoms and what helps in the case of a disease, explains an expert.

Where is the house key again? What's the name of the ophthalmologist again? And what did I want to buy urgently? As forgetfulness increases, the fear of incipient dementia increases, especially in old age. According to the German Alzheimer's Association (DAlzG), about 1.6 million people were affected in 2016 in this country. "But by no means are" felicity "and absent-mindedness the sign of incipient dementia," emphasizes Dr. med. Thorsten Bracher, chief physician of Schlossparkklinik Dirmstein. "Rather, they can also be symptoms of depression," says the specialist in psychosomatic medicine, psychiatry and psychotherapy.

Behind constant unrest can hide a depression. Picture: kichigin19 - fotolia

A reliable diagnosis is often difficult. Because "conversely it happens not infrequently that people with incipient dementia from their doctor first wrongly classified as depressed and thus treated wrong," explains the expert. One key reason: "People with incipient dementia are watching their declining mental abilities full of worry and despair - and can thus fall into a depression." Experts estimate that almost every second person suffering from Alzheimer's disease is seriously distressed.

While dementia usually develops creeping, depression is triggered rather suddenly - often by a particularly stressful or incisive experience. At a young age these are often unemployment or other problems in the job or the partnership - in old age mostly health and physical complaints and loneliness caused by the death of the partner. "But it's not always the heavy blow of fate that makes us fall into a deep hole," Dr. Bracher to concerns. "Declining mental and physical abilities and the feeling of isolation can also greatly influence one's own appreciation and emotional state of mind."

What the daily performance curve reveals

But how can dementia and depression be differentiated at an early stage? According to experts, there are some clear signs that can also help those affected or their relatives in the classification of the changes: For example, demented people suffer from an often pronounced disorientation and declining cognitive abilities, in contrast to depressives. In addition, their everyday skills are severely impaired. Other differences can be seen in the daily "performance curve": people suffering from dementia are usually very mentally active in the morning and then progressively decline over the course of the day. In depressed people, the reverse is true: in the early cognitive, anything but fit, their mental performance often increases as the day progresses. It is also typical that demented people play down the problems more and depressive ones judge them more dramatically.

One in four suffers from old age depression

The risk of developing depression increases significantly with advancing years: while the quota in the total population is five percent, in people over 70 it is about 25 percent, experts estimate. In addition to the general symptoms such as deep mourning and lack of drive and hopelessness they often come with physical symptoms, often back pain or cardiac arrhythmia. "Not infrequently, the physical symptoms are more noticeable than the mental ones and thus make the diagnosis more difficult," emphasizes Dr. med. Bracher. The result: Only 10 to 20 percent of all depression in old age are even recognized and treated accordingly, specialists are sure. The combination of psychotherapy and antidepressants offers effective help. "If you have professional support, you have a good chance of significantly improving your symptoms, even at an advanced age. Bracher. It comes back to more joy of life and mental stability.

As in the case of depression, the risk of dementia increases considerably in old age. According to the DAlzG, less than four percent are affected in the 70 to 74 age group, and over 80% of the 80 to 84 year olds are already over 15% and over 90-year-olds even 41 percent. There is no cure yet. In the course of time, progressive impairments of thinking and memory performance, personality changes, disorientation and physical complaints are added to the initial distraction. (Sb, Pm)