Conditions that involve cognitive decline, such as Alzheimer's—a progressive disease that is the most common cause of dementia—aren't just prevalent; they're on the rise. Alzheimer's Disease International reports that more than 55 million people across the globe were living with dementia in 2020. That number is predicted to double every 20 years, making for 139 million people with dementia in 2050.
Although there is currently no cure for dementia, an early diagnosis can lead to interventions that may help slow its progress. That makes catching the first signs of cognitive decline crucial. However, there's one common condition that can easily be mistaken for dementia, and may lead to a misdiagnosis. Read on to learn what it is—and when doctors say it's likely to develop into dementia down the line.
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Dementia can manifest in many different ways.
Symptoms associated with dementia may include memory loss, confusion, and disorientation, according to the Mayo Clinic. But cognitive decline can manifest in unexpected ways as well, including having problems managing money and experiencing certain food cravings.
Personality and mood changes are more commonly known potential symptoms, however. "People with dementia often act in ways that are very different from their 'old self,' and these changes can be hard for family and friends to deal with," according to the experts at the Weill Institute for Neurosciences. They go on to explain the reasons for these behavior changes, writing that, "In dementia, it is usually because the person is losing neurons (cells) in parts of the brain. The behavior changes you see often depend on which part of the brain is losing cells."
Depression is another early sign of cognitive decline, they say: "People with dementia often suffer from depression, especially in the early to moderate stages of the disease when they have some awareness of losing their abilities." But depression is a condition with many potential causes, and it isn't necessarily a symptom of dementia.
Dementia and depression often look alike.
According to the Mayo Clinic, "Early Alzheimer's disease and depression share many symptoms, so it can be hard—even for doctors—to distinguish between the disorders." Complicating the diagnoses further is the fact that people with Alzheimer's disease are often also depressed.
While there is no simple way to differentiate between dementia and depression, Harvard Health lists some of the differences between the two. Problems with focus and concentration are more likely to be caused by depression, while dementia may manifest with memory loss. Disorientation and apathy are more likely to occur with Alzheimer's, not depression. Another difference is that people suffering from depression often notice and discuss their symptoms with loved ones, while those experiencing dementia may not appear to be aware of the issues. And depression does not usually affect writing, speaking, or motor skills.
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Depression often goes unrecognized by doctors.
Over two million Americans over the age of 65 have some type of depression, but the condition is often misdiagnosed. Mental Health America reports that "primary care physicians accurately recognize less than one half of patients with depression."
When manifestations of depression resemble those of cognitive decline, it's known as "pseudodementia"—and it's not actually dementia at all. There's a crucial difference between the two conditions, as well:"Depressive pseudodementia has symptoms of dementia but, unlike true dementia, these symptoms may be reversible with treatment for depression," according to VeryWell Health.
A diagnosis of depression necessitates "a thorough evaluation of an individual's medical history, physical and mental examinations, and possibly, interviews with family members by a medical professional," advises the Alzheimer's Association. In addition, "it may be helpful to consult a geriatric psychiatrist who specializes in recognizing, diagnosing, and treating depression in older adults."
Some people with depression may be more likely to develop dementia.
Not only are the symptoms of dementia and depression similar, the two conditions are linked in other ways as well. A study published by the Archives of General Psychiatry reports that "people who became depressed late in life had a 70 percent increased risk of dementia, and those who'd been depressed since middle age were at 80 percent greater risk."
The study notes that while some research found that depression follows—or coincides with—cognitive decline, "most studies and several meta-analyses have concluded that depression precedes dementia and is associated with approximately a twofold increase in the risk of developing cognitive impairment or dementia."
The good news is, there are things you can do to help mitigate your risk of both depression and dementia. Studies show that certain activities help decrease the risk of dementia, such as good oral hygiene, meditation, and even drinking tea. Similarly, healthy habits like getting regular exercise, plenty of sleep, and eating a nutritious diet can help ward off depression.
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