Depression and Anxiety in Dementia Subjects

Abstract

Depression and cognitive disorders, including dementia and mild cognitive impairment, are common disorders in old age. Depression and anxiety are frequent in dementia, causing distress, reducing the quality of life, exacerbating cognitive and functional impairment and increasing caregiver stress. Even mild levels of depression can significantly add to the functional impairment of dementia patients, and the severity of psychopathological and neurological impairments increases with increasing severity of depression with increased disability, poor quality of life and higher mortality. Depressive symptoms may be both a risk factor and a prodrome of dementia and can often be difficult to distinguish in the early stages. Also, depression is often associated with deterioration in cognitive functioning which is not always completely reversible with treatment. Both depressive and anxiety symptoms are common in mild cognitive impairment and can coexist with higher rates of conversion to dementia. Despite having a significant negative impact on the quality of life of people with dementia as well as their caregivers, both these conditions are usually under-recognised and as a consequence undertreated. Hence assessment and effective treatment of anxiety and depression in dementia could improve patient's quality of life and should become more established in good clinical practice. Nonpharmacological approaches and watchful waiting should be attempted first in patients who present with mild to moderate symptoms. In cases not able to be managed through nonpharmacological means, treatment with medication should be considered. (PsycInfo Database Record (c) 2023 APA, all rights reserved)