Dementia versus Mental Illness in Seniors

It can be difficult to differentiate between the effects of mental illness and dementia in senior citizens. Misdiagnosis is common between the two conditions because of their similar signs and symptoms, such as confusion and mood swings.

According to the World Health Organization, dementia is a “syndrome in which there is deterioration in memory, thinking, behavior and the ability to perform everyday activities.” It occurs when the parts of the brain used for learning, memory, decision making, and language are damaged or diseased. Also called neurocognitive disorder (NCD), it is not itself a disease but a set of symptoms caused by other conditions.

The most common cause of NCD is Alzheimer's disease (AD). Between 60 and 80 percent of patients with dementia have been diagnosed with Alzheimer's. According to the Alzheimer’s Association, AD is the 6th leading cause of death in the United States, but there are some 50 other causes of dementia.

Mental illness, on the other hand, refers to a wider variety of mental health conditions that affect mood, thinking and behavior. While dementia does affect overall mental health, it is not a mental illness in itself.

Important Distinction

About one fifth of adults aged 55 or older have experienced some type of mental health concern, but sadly most of them have not received any treatment for it.

Problems with thinking, memory, and behavior are frequently seen as an inevitable outcome of aging when in fact they could be symptomatic of a medical condition. Such symptoms could be caused by an temporary infection or inadvertent interactions of medication. If the infection is diagnosed correctly and treated successfully or the medication regime adjusted, the onset of dementia symptoms could be quickly reversed.

Dementia symptoms could also mask an unrecognized mental illness. Senior citizens with anxiety or depression are not necessarily suffering from NCD. However, symptoms suggesting the possible onset of Alzheimer's disease can easily trigger anxiety or depression in older people. This overlap can lead to a misdiagnosis.

The Geriatric Mental Health Foundation lists a number of potential triggers for mental illness in the elderly:

  • Substance use disorder (SUD)
  • Dementia-causing illness (e.g. Alzheimer’s disease)
  • Change of environment, like moving into assisted living
  • Loss of a loved one
  • Long-term illness (e.g., cancer or heart disease)
  • Medication interactions
  • Physical disability
  • Physical illnesses that can affect emotion, memory and thought
  • Poor diet or malnutrition

A severe substance use disorder caused by or co-occurring with anxiety, depression, or trauma could also eventually present with dementia-like symptoms. If recognized on time, many of those triggers can be counteracted with treatment. Simple changes like a healthier diet or more physical activity can make a big difference. Various forms of recreation can be used to help older adult patients. Exercise and games can promote positive emotional states and improve cognitive functions.

Comprehensive Care

The Pavilion at Williamsburg Place offers a geriatric program specifically designed for adults aged 55 and over. Medical advances have allowed people to live longer and our understanding of elderhood has changed in recent decades. But aging can be accompanied by many challenges, including decreased physical and mental capabilities, the loss of loved ones, and end-of-life issues. Often, seniors do not seek the care they need although they may require highly specialized care designed specifically to address their psychological issues.

Symptoms may include behavioral disturbances, severe depression with suicidal ideation, anxiety, hallucinations, and delusions. Common admission diagnoses at the Pavilion include dementia, depression, anxiety, mood and behavior changes, and substance abuse. Medical specialists may be consulted to manage underlying physical illnesses that may be contributing to behavioral, emotional, and cognitive instability. The Pavilion is ideally suited to provide this level of integrated, comprehensive care for older adults.