There is a complex relationship between dementia, depression, and anxiety.

• If a person has had depression or anxiety in the past, they are more likely to experience it again if they develop dementia. 

• Depression can be an early sign of dementia and is often mistaken for dementia. Depression symptoms such as confused thoughts, loss of appetite, insomnia, and social isolation are often seen as dementia.

• A person with dementia and anxiety may also have changes in their behavior, such as being agitated or hoarding. They may constantly ask for reassurance and not want to be left alone. 

• People in the early stages of dementia may have anxiety that is linked directly to their worries about their memory and the future.

• Depression and anxiety may lead to disengagement from daily activities, social withdrawal, and discontinuation of cognitively stimulating activities, which further exacerbates memory difficulties.  

• A person with dementia may stop participating in activities they once enjoyed, resulting in feelings of anxiety and depression.

Dementia, Depression, and Anxiety Share Many Traits

• Disturbed sleep

• Neglected personal hygiene

• Weight loss

• Feelings of anxiety or irritability

• Avoidance of social situations

• Difficulty concentrating

• Increased forgetfulness

• Increased agitation and anxiety

• Loss of interest in formerly enjoyable activities or apathy

Differences between Depression and Dementia

• Depression tends to develop much more quickly than most types of dementia.

• People with dementia may have problems with speech and awareness of time or place. 

• With depression, individuals who say they cannot remember something will remember when prompted. 

• With dementia, they are not likely to recall an event and may try to cover up their memory loss.

• People with depression may have problems with their reasoning or memory due to poor concentration.  These concerns usually resolve with treatment. This does not happen with dementia.

Treatment for Depression and Anxiety for People with Dementia

Difficulties with attention, communication, memory, or reasoning can make it more difficult to treat depression and anxiety in people with dementia. However, people with dementia can still benefit from talking about their thoughts and feelings with a professional counselor or attending a support group. 

Although antidepressants are not as effective in people with dementia; they should not be ruled out.  People should discuss medication options with their physician, including medications that can address symptoms of depression and anxiety.

Addressing Depression

Treating depression or anxiety in a person with dementia should include improving their quality of life by: 

• Addressing underlying issues, such as loneliness, boredom, or pain.

• Having a daily routine to stay engaged and active.

• Involving your loved one in a useful activity, such as helping around the house or doing something to "help" another person.

• Helping your loved one to get started on an activity. People with dementia and depression may have difficulty starting a task.

• Engaging in regular physical activity, such as walking or yoga.

• Participating in regular activities with other people, including one-to-one interactions.

• Making changes to their environment, such as improved lighting and reduced noise. 

Depression and apathy occur in many persons with dementia. Apathy is different from depression. With apathy, a person may experience a lack of motivation, effort or energy to do everyday tasks, no longer have interest in talking with others or participating in activities, or show a lack of reaction to people or things that occur. People with depression may be sad or tearful, irritable, restless and have feelings of low self-worth. People with depression may also have sleep problems, loss of energy and appetite changes. See medical attention if the behavior is significant or if it is a sudden change from their usual self.