Changes in Mood

We all experience fluctuations in our mood from time to time. However, there are specific changes in mood that many people with Alzheimer's disease and related dementias experience. In particular, people with dementia may become depressed, withdrawn, and lose interest in previously enjoyed activities. Sometimes, the person may lose the ability to control their emotions.

It is important to remember that even in the later stages of Alzheimer's disease and related dementias, individuals are still able to experience a variety of emotions. Joy, love, fear, and sadness continue to be felt by the person, so it is always important to acknowledge and address their emotional health.

The section below provides details about depression and apathy, which are mood changes commonly experienced by people with dementia. It offers possible explanations for these changes and suggests several coping strategies.

Depression

Many people with dementia experience depression at some point. When depression and dementia co-exist, it is important to properly identify and address the depression in addition to the dementia. This is because depression has the potential to make the symptoms of Alzheimer's disease and other dementias worse. For example, depression can cause increased forgetfulness, confusion, and anxiety.

Diagnosing depression in people with Alzheimer's disease and other dementias is also important because symptoms associated with depression may respond to treatment.

The symptoms of depression can be similar to those associated with dementia. Therefore, it can often be difficult to identify depression in people with dementia. There are some common signs of depression to be aware of:

  • Loss of interest in previously enjoyed activities
  • Lack of energy
  • Problems sleeping
  • Increased confusion
  • Loss of appetite and weight

If you are concerned about depression, it is always best to speak to the person's doctor.


Possible Causes of Depression

  • In the earlier stages of dementia, the person may experience depression as a result of hearing their diagnosis.
  • Social isolation may also be the cause depression in some people with dementia.
  • Fatigue is also associated with depressive symptoms.
  • Depression can sometimes be a side effect of certain medications. Ask the person's doctor to review the drugs they are currently taking.


Coping with Depression

  • Encourage pleasant activities that the person can still enjoy, such as short walks or outings.
  • Set realistic expectations for the person with dementia. If you expect too much from them, they may feel frustrated and discouraged.
  • Be sure to establish a daily routine which is consistent, as this will help reassure the person with dementia as well as decrease confusion.
  • Antidepressant medications are sometimes benficial for people with dementia who are experiencing depressive symptoms. Talk to the person's doctor about their options.

Apathy

Apathy is an emotional state characterized by a loss of motivation, feeling indifferent, low social engagement and lack of persistence. The person with dementia may develop this psychological symptom and feel unmotivated to do anything. Apathy can be a symptom of depression but it can also occur separately from depression.

As a caregiver or family member, it can be distressing to see the person with dementia withdrawing for social gatherings and other activities. Understanding the causes of apathy and how to cope with it can be helpful.

Possible Causes of Apathy

  • Apathy is the result of damage to the frontal lobe, an area of the brain that is responsible for planning, judgment, and insight.
  • Apathy may also be the result of the person with dementia not understanding what is happening.

Coping with Apathy

  • Try to engage the person with dementia in activities that they enjoy.
  • Make sure that they can participate at all levels and that they are not overwhelmed.
  • Try introducing a small amount of the activity at one given time.
  • Choose flexible activities that can be changed to suit the person’s needs.
  • Emphasize more on the process of doing things and not the results.
  • Avoid activities where the person may not be able to complete the task.
  • Make the person with dementia feel valued and productive.
  • You may have to assist the person with starting an activity.
  • Make the person with dementia feel included in groups.
  • Have the person with dementia participate in activities that do not require avid participation, such as listening to music.
  • Some people with dementia may respond to cholinesterase inhibitors (you may want to speak with a doctor).

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