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Depression and Anxiety in Dementia Subjects

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Neuropsychiatric Symptoms of Cognitive Impairment and Dementia

Part of the book series: Neuropsychiatric Symptoms of Neurological Disease ((NSND))

Abstract

Depression and cognitive disorders, including dementia and mild cognitive impairment, are common disorders in old age. Depression and anxiety are frequent in dementia, causing distress, reducing the quality of life, exacerbating cognitive and functional impairment and increasing caregiver stress. Even mild levels of depression can significantly add to the functional impairment of dementia patients, and the severity of psychopathological and neurological impairments increases with increasing severity of depression with increased disability, poor quality of life and higher mortality. Depressive symptoms may be both a risk factor and a prodrome of dementia and can often be difficult to distinguish in the early stages. Also, depression is often associated with deterioration in cognitive functioning which is not always completely reversible with treatment. Both depressive and anxiety symptoms are common in mild cognitive impairment and can coexist with higher rates of conversion to dementia.

Despite having a significant negative impact on the quality of life of people with dementia as well as their caregivers, both these conditions are usually under-recognised and as a consequence undertreated. Hence assessment and effective treatment of anxiety and depression in dementia could improve patient’s quality of life and should become more established in good clinical practice. Nonpharmacological approaches and watchful waiting should be attempted first in patients who present with mild to moderate symptoms. In cases not able to be managed through nonpharmacological means, treatment with medication should be considered.

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Authors and Affiliations

  1. North East London NHS Foundation Trust, Department of Old Age Psychiatry, Brentwood Community Hospital, 2 Crescent Drive, Brentwood, Essex, CM15 8DR, UK

    Afifa Qazi

  2. Retzdorffpromenade 3, Berlin, 12161, Germany

    Hans Gutzmann

  3. North East London NHS Foundation Trust, Department of Old Age Psychiatry, Sunflower Court, Goodmayes Hospital, Ilford, Essex, IG3 8XJ, UK

    Saheem Gul

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  1. Afifa Qazi
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  2. Hans Gutzmann
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  3. Saheem Gul
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Correspondence to Afifa Qazi .

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Editors and Affiliations

  1. Department of Neurosciences and Mental Health, Centro Hospitalar Lisboa Norte-Hospital de Santa Maria, Instituto de Medicina Molecular (IMM) and Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal

    Ana Verdelho

  2. CEDOC, Chronic Diseases Research Center, Nova Medical School, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisboa, Portugal

    Manuel Gonçalves-Pereira

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Qazi, A., Gutzmann, H., Gul, S. (2017). Depression and Anxiety in Dementia Subjects. In: Verdelho, A., Gonçalves-Pereira, M. (eds) Neuropsychiatric Symptoms of Cognitive Impairment and Dementia. Neuropsychiatric Symptoms of Neurological Disease. Springer, Cham. https://doi.org/10.1007/978-3-319-39138-0_8

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