Forgetfulness is the symptom most commonly linked to dementia, but new analysis suggests that depression could be one of the very first warning signs of the brain condition.
Rethinking the First Signs of Alzheimer's
Dementia is an umbrella term for a range of conditions involving the gradual deterioration of the brain, with Alzheimer's disease being the most common form. While memory loss and cognitive decline severe enough to disrupt daily life are hallmarks of Alzheimer's, a comprehensive scientific review from 2017 indicates these may not be the initial symptoms.
The research, which involved an extensive examination of medical literature from 1937 to 2016, aimed to catalogue the warning signs that appear before a formal Alzheimer's diagnosis. The findings challenge the common assumption that memory problems are the primary early indicator.
The Overlooked Link: Depression and Dementia
The scientists discovered that depression and cognitive decline were among the first symptoms to manifest. In cases of late-onset Alzheimer's, these symptoms were present in 98.5 per cent and 99.1 per cent of participants, respectively. For early-onset Alzheimer's, the figures were nine per cent and 80 per cent.
While memory issues did appear early—noted around 12 years before a clinical diagnosis of advanced Alzheimer's—the study concluded that neurological and depressive behaviours are an early occurrence. However, the researchers cautioned that their review was limited because each finding was based on a single study.
The Challenge of Identifying Depression in Dementia
Spotting depression can be difficult on its own, and it becomes even more complex when it is a symptom of Alzheimer's. The Alzheimer's Association (AA) highlights symptoms common to both conditions, which include:
- Apathy
- Loss of interest in activities and hobbies
- Social withdrawal and isolation
- Trouble concentrating
- Impaired thinking
The health organisation also notes that the cognitive impairment experienced by people with Alzheimer's can make it hard for them to articulate feelings like sadness, hopelessness, or guilt. Furthermore, depression in Alzheimer's patients may not look like typical depression; it is often less severe and can come and go, rather than being a persistent feeling.
Additionally, a person with Alzheimer's may be less likely to talk about or attempt suicide compared to someone suffering from depression alone. Recognising these nuanced signs is crucial for early intervention and improving the quality of life for patients and their families.
