title: Depression in dementia patients: issues and challenges for a physician.
abstract: Depression and dementia share a complex and interesting relationship, with a possibility of biological linkages between the two disorders. Research has shown consistently increased prevalence of depression in patients suffering from dementia. As many as one fourth to half of dementia patients are likely to experience clinical depression during the course of illness. However, the onset of depressive symptoms is often misinterpreted as worsening of cognitive decline and hence, it remains under-diagnosed. The lack of a coherent account from patient, frequent overlap of symptoms, inadequate sensitization of physicians may enhance the diagnostic difficulty. Undetected depression adds to patient disability and caregiver burden. Early recognition and proper intervention will improve the patient outcomes including quality of life. Selective serotonin reuptake inhibitors, especially Sertraline and Citalopram, with a very gradual dose titration are likely to benefit. Certain behavioral interventions e.g involvement of patient in physical activity and pleasant activities has been found to be useful. All dementia cases should be routinely screened for depression and managed accordingly.
authors.affiliation: Department of Psychiatry, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India-110029.
authors.forename: Raman Deep
authors.initials: RD
authors.lastname: Pattanayak
authors.forename: Rajesh
authors.initials: R
authors.lastname: Sagar
mesh_terms: D000375:Aging / Q000502:physiology / Q000523:psychology; D000928:Antidepressive Agents / Q000627:therapeutic use; D017028:Caregivers / Q000523:psychology; D015928:Cognitive Behavioral Therapy; D003704:Dementia / Q000150:complications / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy; D003863:Depression / Q000150:complications / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy; D006801:Humans; D010820:Physicians
chemical_list: D000928:Antidepressive Agents