Do not treat depression in the elderly as dementia
Do not treat depression in the elderly as dementia
Geriatric depression and Alzheimer’s disease rank first and second respectively in the incidence of mental disorders in the elderly.
However, in some cases, old age depression is treated as senile dementia, which leads to delays in the disease and affects rehabilitation.
How to identify the two?
Fang Yaming, the chief physician of the Department of Geriatric Psychiatry at Kangning Hospital in Shenzhen, introduced the reporter.
1, depression in the elderly, more than dementia “Depression is one of the most common mental disorders in old age.
Fang Yaming told reporters that experiencing the prolongation of life expectancy, the aging of society, the increasing incidence of senile diseases, and senile depression will become more common.
According to the World Health Organization, in the elderly population, depression accounts for about 7% to 10% of the elderly; half of the elderly with physical illnesses are accompanied by depression.
The survey of mental illness in the elderly around the world shows that depression is the highest incidence among the elderly, followed by Alzheimer’s disease.
Fang Yaming pointed out that if the elderly in the family are often depressed, insomnia, forgetful, have no appetite for eating, and are unwilling to participate in various activities, then he may suffer from senile depression.
The high-risk groups of geriatric depression include elderly people who are lonely, elderly people who feel lost after retirement, or elderly people who have just encountered grief in their lives.
In addition, 20% of stroke or hypertensive patients also suffer from the psychological state of depression, while the proportion of women suffering from depression is double.
2, pay attention to the early signs to avoid misdiagnosis Fang Yaming told reporters that geriatric depression will cause great harm to the body, but for various reasons, depression is often misdiagnosed, the clinically common elderly have visited the hospital for many times.Psychiatric treatment, so the focus on the early signs of senile depression is particularly important.
Fang Yaming pointed out that headache and dizziness are common signs of depression in the elderly.
Such as headache can be expressed as pain, shortness of breath or jumping pain, but generally can withstand; most of them are tension headaches and non-biased headaches, and there is no special fixed position in the pain area, so such elderly people often feel headache and painThat hurts.
Dizziness is often manifested by feelings of rising or top-heavy after getting up in the morning, and the feeling of dizziness at noon is aggravated.
Fang Yaming said that about half of all elderly patients with depression will develop this symptom.
In addition, sleep problems occur: about 48% of people with depression have insomnia as the first symptom.
The early signs of senile depression include: sweating, sweating when you are emotionally excited or slightly active, especially in the head, torso, sweating in the hands and feet, and even sweating in the lively occasions.Painful, short-sighted, patients with anxiety, nervousness, palpitations, chest tightness, shortness of breath, feeling poor breathing, often suspected that they have coronary heart disease, usually tired and weak, tone of voice is also weak; loss of appetite, stomach full of food, stuffy, snoring, eating and tasteless, stomach pain after a meal, consciously ventilated in the abdomen, greasy in the mouth, even feel nausea and vomiting; body pain, limbs, shoulders, knee joints, head,Waist pain in the waist, the examination found no abnormalities, but always felt uncomfortable, feet and calves are cold, taking warm measures and drug treatment is still not effective; gaze and tinnitus, feeling blurred, read the newspaper and think that the two lines in the wordMutual transfer or tremor, but the ophthalmologic examination is normal, before rest or sleep, or in a nervous and noisy back of the ear will appear a variety of sounds, the patient is not irritated安, Long treatment refractory.
Fang Yaming said that if these symptoms appear, it is necessary to be alert to the possibility that the elderly may suffer from depression.
3 Differences with Alzheimer’s disease The family once suspected that 70-year-old Wang Apo got Alzheimer’s disease.
After her husband passed away last year, she has been surrounded by sorrow, silent, and rarely went out, always feeling unhappy.
She also became particularly forgetful. She didn’t forget to bring her wallet or forget the key. She also blamed the babysitter for stealing, so she lost her temper with the babysitter and locked her room, but she was very polite to the outside world.
After being sent to the general hospital, Wang Apo was diagnosed with Alzheimer’s disease, but after half a year of treatment, the effect was not obvious.
Later, he was diagnosed with senile depression by a psychiatrist. After only two weeks of treatment, his condition improved significantly.
”The elderly face a sudden major mental stimulation, and emotional depression occurs in the body. This is normal and not morbid.
However, if there is persistent depressive symptoms and progress to a serious degree, it is necessary to consider whether or not depression has occurred.
At this time, special attention should be paid to the difference between Alzheimer’s disease, so as not to delay the illness and affect rehabilitation.
Fang Yaming said.
He explained that when some elderly patients with depression develop to a severe stage, their thinking and movements are inhibited (especially thought inhibition), and some clinical manifestations similar to Alzheimer’s disease appear.
The identification of senile depression and Alzheimer’s disease can be carried out in the following aspects.
The first is that the onset and the course of the disease are different: in comparison, the onset of depression in the elderly is faster and develops rapidly, and the onset of Alzheimer’s disease is slow to develop.
From the persistence of symptoms: Alzheimer’s patients have more emotional changes, distortions, like young children, unlike the depression of old age depression will last longer.
From a smart point of view: elderly depression patients sometimes seem to show mental barriers, but the barriers are temporary, partial, each time the results of intelligent examinations are different; and the intelligent damage of Alzheimer’s patients is comprehensiveSexual, and presented progressive deterioration.
Are there symptoms of the central nervous system: elderly patients with depression do not have symptoms of the central nervous system, and brain CT findings are not positive; in the case of dementia patients, the opposite is true, they have symptoms and signs of the central nervous system.Too many patients also have a history of hypertension, arteriosclerosis or “small stroke”, and brain CT examinations may show varying degrees of brain atrophy or (and) cerebral infarction.
The effects of antidepressants are different: after the use of antidepressants, elderly patients with depression will begin to recover and return to the pre-existing state of mind; and antidepressants do not have any effect on Alzheimer’s patients.
However, it should be noted that some people with Alzheimer’s disease also have some depressive symptoms in the early stage of the disease, much like elderly depression, but only in the middle and late stages of the disease, the true face of Alzheimer’s disease will be fully demonstrated.
Older women should pay more attention to the prevention of depression. Most elderly patients with depression are introverted. They do not like communication before the onset of illness. If they are not understood or misunderstood by family, colleagues or friends after the onset, it may be difficult to avoid depression.Shadow, unfavorable recovery.
Therefore, in a warm family, proper social interaction is a good medicine in itself, leading to depression in the elderly.Fang Yaming said.
Because elderly women suffer from depression up to 25%, which is much higher than that of older men, Fang Yaming presents that depression is more important in older women.
He explained that this is because women have to undergo lactation, pregnancy, menopause, etc., and they are more susceptible to hormone secretion than men in their lifetime. They are more likely to suffer from depression than men. “And menopausal women suffer from it.If there are menopausal syndromes, the complications in them will have varying degrees of depressive symptoms. If you do not receive correct and thorough treatment at that time, it will often be delayed into chronic depression. When you are old, it will recur, which will greatly affect your later years.Quality of life”.