Lately you’ve noticed that your mom has lost interest in all the activities that she used to enjoy. She has no desire to host Thursday night mahjong with friends and spends most of her time watching reruns of Jerry Springer. When you talk to her on the phone, she sounds distracted and repeats information she told you just a couple of days ago. What gives?

All the above symptoms are signs of dementia. But they’re also signs of depression. In fact, Mom could have both! We know; this is getting confusing.

To help break it down for you, here are some important stats. Only about 5% of people over the age of 65 have depression. But that number rises to about 13% if they live in a nursing home, or require home health care, according to the Centers for Disease Control and Prevention (CDC).

Depression and dementia also often go hand in hand. Around 10% of all folks over the age of 65 have Alzheimer’s or another form of dementia. About 40% of those folks also have depression. It’s hard to know which comes first: one study found that people who became depressed later in life had a 70 percent increased risk of dementia.

“They are related somehow,” Nicole Purcell, DO, senior director of clinical practice at the Alzheimer’s Association, told the Mirror this past July. “But [whether] one leads into the other or one causes the other is unclear.”

Here’s a closer look at the two and how to tell them apart.

Differences between depression and dementia

It might seem hard to figure out if your loved one is depressed or has developed dementia. They have the following similarities:

●      Being withdrawn

●      Memory problems

●      Trouble concentrating

To figure out what’s going on with your loved one, ask yourself the following questions:

Has the change been sudden or gradual?

Depression develops much more quickly than dementia. You’ll notice changes over months, or even weeks. Dementia, however, is gradual.

Does your loved one have trouble with speech or remembering words?

That’s usually a sign of dementia, not depression.

Does your loved one ever forget where they are or what time it is?

Feeling disoriented is a sign of dementia, not depression.

Will your loved one forget something but remember when prompted?

When your father forgets about your upcoming trip, you might say, “Hey, don’t you remember I told you I was going on vacation at our Bingo game last weekend?” If he replies, “Oh, right, you told me you were going to Florida,” that’s a positive sign. Someone with dementia won’t remember even with these sorts of prompts.

Does your loved one comment on their memory changes?

Believe it or not, someone with dementia may not notice their memory issues. If you bring it up to them, they may deny it or even get defensive. Someone with depression, however, will acknowledge it.

Is your loved one complaining about aches and pains more than usual?

This is usually a sign of depression. In fact, older adults with depression report more health anxiety and physical symptoms than younger people with depression.

What to do if you suspect dementia, depression, or both

If you think your loved one is beginning to develop dementia or is depressed, encourage them to make an appointment with their primary care provider. Their doctor can screen them for both conditions using a simple questionnaire in their office. If their doctor has any concerns, they can refer them to a neurologist (to diagnose dementia) or a psychiatrist (to diagnose depression). Offer to go with them, as a source of support.

You should phrase your concerns carefully. You don’t want to make your loved one defensive. You also don’t want to scare them away from getting the help they need. Some ways to handle the conversation include:

Get comfortable

Pick a familiar, relaxing place to talk. Find a quiet time, so you’re not rushed or interrupted.

Ask your loved one if they’ve felt any different

Do they feel sad or lonely? Have they noticed that they struggle more with things like paying bills or making a grocery list?

Mention a couple of examples of things you are worried about

Be as specific as possible. For example, “I noticed that you’ve missed mortgage payments a couple of times,” or “You stopped going to mahjong.” Stress that you raise these concerns because you are genuinely worried about them.

Be positive

Point out that memory loss could be due to a new medication they are taking or an undiagnosed medical condition.  Their doctor may be able to prescribe medications to help them feel better.

Take the time to listen to your loved one

If they respond, “You’re just saying this because you want to put me in a nursing home,” make sure you address their concerns. Point out that you’re bringing this up because you want them to stay in their home and live independently for as long as possible.

Unfortunately, you can’t make your loved one go to the doctor if they don’t want to. Unless you have medical power of attorney, they call all the shots.

But if they really won’t listen to you, consider calling their physician. Their medical providers cannot speak to you about your loved one’s condition. They can, however, listen to your concerns.

Pick your Part D plan wisely

If your loved one is diagnosed with depression or dementia, their doctor may prescribe medications to help. Particularly in the case of Alzheimer’s disease, these medications can get very expensive. It pays to have the right Medicare Part D plan!

When shopping for a Part D plan for yourself or your loved one, be sure to consider each plan’s premium, deductible, and formulary, or list of covered medications. Learn more about choosing a Part D plan, or check out our easy-to-use Find a Plan tool.

Additional resources

• ClearMatch Medicare: Find a Medicare Plan
• CDC: Alzheimer's Disease and Healthy Aging
• Alzheimer's Association: Alzheimer's Disease Facts & Figures
• International Journal of Geriatric Psychiatry: Prevalence of Depression, Anxiety, and Apathy Symptoms Across Dementia Stages
• National Library of Medicine: Midlife vs Late-Life Depressive Symptoms and Risk of Dementia