In honor of Alzheimer Awareness Month I have been asked to contribute several articles on the connection between Alzheimer’s disease and depression and how depression can affect both patients and caregivers. In an interview with practicing psychologist Dr. Deborah Serani, we discussed how caregivers may be more at risk for developing a mood disorder and strategies to prevent stress, burn-out, and depression among caregivers. In a second post we talked about the early warning signs of depression in Alzheimer’s patients and how to prevent these symptoms from becoming entrenched. In this post we are going to continue the conversation about depression and Alzheimer’s disease with an exclusive interview with Dr. Nitin Sethi, a practicing neurologist in New York City. He is going to be answering questions about the nature of depression among Alzheimer patients.

Dr. Sethi, can you tell us a little about yourself?

I am a neurologist with interests in Clinical Neurology, Epilepsy (clinical neurophysiology) and Sleep Medicine. I am certified by The American Board of Psychiatry and Neurology (ABPN) and have further subspecialty boards namely ABCN General Clinical Neurophysiology Board with added competency in Epilepsy Monitoring and in Intraoperative Monitoring. I am currently Assistant Professor of Neurology at New York-Presbyterian Hospital, Weill Cornell Medical Center in New York City. The human brain has always fascinated me both in health and disease and I have written extensively about it. About 3 years ago I decided to start a blog (http://braindiseases.wordpress.com) and a website (http://braindiseases.info) with a goal to disseminate information about neurological diseases.

Q: Can you tell us about the different types of dementia including Alzheimer’s disease?

Dementia is a disorder in which a person has cognitive impairments in multiple domains. By that I mean that a patient with dementia has problems with memory (forgets things), language (speech gets sparse and content/vocabulary is reduced), calculation (person loses the ability to calculate: subtract, multiply etc), and abstract thinking. Depending upon what part of the brain gets affected, a patient with dementia may also suffer from personality changes and problems with executive functions like planning and other goal directed actions.

They may also experience what we neurologists refer to as Apraxias. Apraxia is an inability to do a learned act. Like for example you can tie your own shoelaces as it is an act you learnt as a small child. Now assume you have dementia. You may lose the ability to tie your shoes laces even though you are not weak and have full strength in your arms and legs. Patients with dementia may suffer from various kinds of apraxias. As the disease evolves the patient become dependent on caregivers for nearly all activities of daily living: cannot drive, cannot tie their shoelaces, cannot feed themselves or take a shower on their own.