There is a growing number of people with Alzheimer’s disease. At the age of 85, the disease occurs in 50% of patients. Depression accompanies Alzheimer’s disease and is diagnosed in 30-50% of patients. It is depression that exacerbates the symptoms of Alzheimer’s disease — passivity, leads to the need for early patient care, and increases the risk of mortality. Diagnosis of depression in Alzheimer’s disease is difficult due to the prevalence of cognitive deficits and dementia.
Depression and Alzheimer’s disease have common manifestations:
- apathy – decreased activity;
- decreased libido;
- decreased appetite;
- sleep disturbance.
Patients with Alzheimer’s disease and depression have many somatic complaints, anxiety disorders. But melancholy and sadness are not typical for depression of old age and Alzheimer’s disease (according to the clinic of Doctor of Medical Sciences V.L. Minutko)
If there is a history of fluctuations in activity, periodic depression, then alertness and active diagnosis of the disease are necessary.
Depression of old age is accompanied by dysphoria, guilt, and suicidal tendencies. Depression in dementia is characterized by a decrease in interest, impaired motor skills, daytime sleepiness, weakness, a decrease in intellectual abilities, and a decrease in social activity.
Reactive depression, for example, after the death of a loved one, can trigger the onset of Alzheimer’s disease. Diagnosis is complicated by the fact that depression is also observed in the prodromal period of Alzheimer’s disease.
There is no consensus among psychiatrists about the use of antidepressants in Alzheimer’s disease, their tolerance. Mirtazapine and escitalopram are commonly used . But side effects in the form of aggravation of somatic, cardiovascular diseases, limit the use of drugs. According to the data of Doctor of Medical Sciences V.L. For a moment, for depression in patients with Alzheimer’s disease, it is better to use citalopram at an initial dosage of 10 mg, escitalopram – 5 mg. When using these drugs, the effect occurs at 4-8 weeks. But if after 6 weeks the medications do not have a positive effect, then the drug must be changed. In this case, you should not prescribe amitriptyline and melipramine .
Communication of Alzheimer’s patients with each other reduces depression. And cognitive stimulation allows you to get out of depression. Light therapy, music therapy improve the condition of patients. Treatment of depression in Alzheimer’s disease is a difficult task for the psychiatrist and must be carried out in a comprehensive and individual way.