Carole Carson: Dementia or depression?
On a day when you’ve had one too many senior moments, the worrisome fear that you may be “losing it” can stealthily sneak into your awareness. Stephen King expressed this fear — common to many seniors, including me — when he said, “I’m most afraid of losing my mind. You lose your identity, your sense of who you are, where you are.”
An unfortunate 7% of Americans age 60-plus suffer from dementia and are slowly losing their minds. The good news, however, is that some of those dementia patients may actually be suffering from a treatable depression called pseudodementia.
The distinction between the two conditions is hard to make because the symptoms of depression can closely mimic the symptoms of dementia. They include loss of memory and difficulties paying attention, regulating emotions and organizing and planning. Problems with speech and language may also be present.
So, how do you or your doctor know whether memory loss and related symptoms are the result of neurodegeneration associated with dementia or are treatable symptoms of depression? Knowing which is which is critically important; otherwise, patients may be treated for the wrong condition.
Teasing out the difference is the job of neuropsychologists, who work with individuals who have brain and central nervous system disorders that can alter cognitive and behavioral functioning.
In our modest-sized community, we’re fortunate to have the resources of Dr. Jodi Snyder, a neuropsychologist in Grass Valley, who helps individuals and their physicians make the distinction. Dr. Snyder, who completed her postdoctoral training in neuropsychology at UC Davis Medical Center, evaluates patients referred by their physicians who suspect dementia.
In the process of completing her neuropsychological evaluation, Dr. Snyder interviews and tests the patient. But, in addition, she says, “I always request a family member be present because I value their perspective as well as that of the patient’s.”
During the interview, Dr. Snyder gathers information about the patient’s psychosocial and occupational history, educational background, and medical history including current medications, as well as cognitive, behavioral and emotional symptoms. She also explores other factors that might be contributing to the symptoms.
Neuropsychological testing may involve paper-and-pencil tests or computerized tests, but for certain it will involve multiple queries.
After completing the evaluation, Dr. Snyder meets with the patient and family to discuss the results, offers an opportunity to ask questions, and reviews treatment recommendations.
Treatment often includes other disciplines, such as speech therapy, physical therapy, psychotherapy or psychiatry. Although Dr. Snyder is trained to provide treatment, she is currently focusing on testing.
“Through the process of evaluation, I try to help each patient come away with a more balanced view of both their strengths and vulnerabilities,” she says. “I’ve found that having a more balanced view assists in the adjustment process.”
Dr. Snyder continues, “My ultimate goal when working with families is to educate them about their loved ones’ cognitive and emotional functioning so they can make the best decisions going forward.” She adds, “I love working collaboratively with the patient’s physicians and other care providers. I believe this multidisciplinary approach best serves our patients.”
Carole Carson, of Nevada City, is an author, former AARP website contributor, and leader of the 1994 Nevada County Meltdown. Contact: email@example.com.
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