Mental Health Symptoms Associated with Dementia

It’s estimated that almost 98% of people living with dementia will experience at least one significant mental health symptom over the lifespan of their condition. A challenge faced by loved ones and caregivers is being able to determine the cause of the symptoms, with possible explanations including:

  • Pre-existing mental health conditions worsened due to the progression of dementia
  • New mental health symptoms as a result of the onset or decline of dementia
  • Medical issues that exacerbate behavioral symptoms in dementia, including Urinary Tract Infections (UTIs), constipation, and chronic pain

Symptoms of depression and anxiety often seen in dementia include poor sleep, low energy, changes in appetite, mood swings, and increased confusion. These symptoms can also all be viewed as signs of cognitive decline due to dementia rather than symptoms of a mental health condition.

Because these symptoms overlap, it’s important to pay attention to these symptoms and, even more importantly, to share your observations with your loved one’s care team. Families are often the experts in their loved one’s care. Share any history of mental health treatment or medications with staff. Even if your loved one was never diagnosed with a mental health condition, your observations are essential to their care.

Considerations and treatment options

It’s important to consider all contributing factors to one’s mood besides dementia symptoms. Other possible influences include medication side effects, physical illness, social isolation, fatigue, a recent hospitalization, and environmental factors such as light and noise.

In the world of dementia, treatments for mental health can include a wide range of therapy styles including one-on-one counseling, expressive therapies such as art or music therapy, exercise, activities for cognitive stimulation, increasing access to natural light, pet therapy, psychiatry support, and medication.

Common medication names and types

Medications are often prescribed to address mental health symptoms related to behaviors and cognitive losses. Below are some examples of the medications that are utilized. Keep in mind every individual responds to medication differently.

Name of Medication (Brand Name)What it Commonly Treats
Donepezil (Aricept®):Symptoms related to memory, thinking, language, judgment and other thought processes
Memantine (Namenda®)Improves memory, attention, reason, language, and the ability to perform simple tasks
Citalopram (Celexa®)
Paroxetine (Paxil®)
Sertraline (Zoloft®)
Trazodone (Desyrel®)
Low mood, irritability
Lorazepam (Ativan®)  Anxiety, restlessness, verbally disruptive behavior, and resistance
Aripiprazole (Abilify®)
Olanzapine (Zyprexa®)
Quetiapine (Seroquel®)
Risperidone (Risperdal®)
Hallucinations, delusions, aggression, agitation, hostility, and uncooperativeness

Behaviors where Medications are Ineffective
UnfriendlinessPoor self-careMemory problems
InattentionRepetitive verbalizationsWandering

Sources

Understanding neuropsychiatric symptoms in Alzheimer’s disease: challenges and advances in diagnosis and treatment – PMC (nih.gov)

The Associations Between Neuropsychiatric Symptoms and Cognition in People with Dementia: A Systematic Review and Meta-Analysis | Neuropsychology Review (springer.com)

Dementia – mental health changes – Better Health Channel

Behavioural and Psychological Symptoms of Dementia (BPSD) – PsychDB

Medications for Memory Loss | Alzheimer’s Association

Treatments for Behavior | Alzheimer’s Association

Overview of Pharmacologic Treatment for BPSD – Psychopharmacology Institute