In dementia patients, depressive symptoms may be reduced with high-intensity exercise and group activities. Author of the dissertation Gustaf Boström explained, “Unfortunately, depression is common among older people, especially in people with dementia. Treatment with antidepressant drugs is often ineffective in older people and people with dementia. In addition, the risk of drug-related side effects increases with higher age and poor health, which is yet another reason to find other treatments.”
Boström investigated whether seniors with dementia who engaged in high-intensity exercise for 45 minutes every other weekday for four months experienced an improvement in depressive symptoms – compared to those who remained seated in a group activity of the same duration and frequency.
“Previous studies have shown that people with dementia at residential care facilities have few social interactions, which can negatively affect a person’s well-being. The positive effects could therefore be the results of social interactions in these kinds of group activities. However, more research is needed to confirm this,” added Boström.
Boström also investigated any possible association between impaired balance, general dependency in daily activities, and depression. The study involved 392 participants. The results showed a correlation between loss of balance and depressive symptoms.
“The link between impaired balance, dependency in transfer or dressing, and depression is an important finding and may be the subject of future studies focusing on prevention or treatment of depression among people in older age,” Boström explained.
In his last study, Boström investigated whether seniors with dementia were at an increased mortality risk associated with the ongoing use of antidepressants. Previous studies have shown an increased risk of mortality among seniors taking antidepressants. Boström’s study did not find a significant increase in mortality risk associated with antidepressant use. On the other hand, he did note there were gender differences when it came to the effects of antidepressants. Very old women taking antidepressants had a higher risk of mortality, compared to men. Among those with dementia, antidepressants were shown to actually reduce mortality risk among men, but not women. The findings can inform appropriate treatment recommendations without increasing the risk of mortality.
Treatments to manage depression in dementia patients
As it turns out, early-onset dementia and depression share similar symptoms. There’s the social withdrawal, memory problems, loss of interest in once enjoyable activities and hobbies, sleeping too much or too little, and impaired concentration. It can be difficult for physicians to tell the two disorders apart. In addition, many people with dementia are also depressed, which adds another level of confusion in diagnosing.
When it comes to treating depression in dementia, there are non-drug approaches along with medications to treat depression.
Non-drug approaches to managing depression in dementia include:
- Utilizing support groups
- Creating a scheduled routine for the patient and scheduling important tasks during times of the day when the patient is in a better mood
- Making a list of activities or places to visit which the patient enjoys and scheduling them often
- Encouraging the patient to exercise
- Acknowledging the patient’s feelings
- Finding ways to have the patient contribute to the family life
- Providing reassurance that the patient is loved
- Reassuring the patient that they are taken care of
- Offering the patient things they like such as certain foods or activities
As for medications, there are several different types of antidepressants, the most common being selective serotonin reuptake inhibitors (SSRIs) as these offer the lowest risk to the patient.
Work with the patient’s doctor in order to develop an appropriate treatment plan to better manage their depression.