【セルフチェック】実は似ている!?認知症と高齢者のうつ病

高齢者に「最近もの忘れがひどくなった」「一日中ぼーっとしてやる気がでない」といった様子が見られたとき「認知症かも?」と心配になるご家族は少なくないでしょう。

しかし、このような変化は「うつ病」が原因の可能性もあります。
今回は、「認知症」と「高齢者のうつ病」の違いについてご紹介します。

目次

認知症と高齢者のうつ病の原因の違い

・認知症の原因
脳の病気や障害など様々な原因により、「脳に何らかの問題が起こる」記憶力や判断力が低下します。
日常生活に支障が出る状態をいいます。
一度発症してしまうと元の状態に戻すのは多くの場合困難で、治療は進行を抑えることが主な目的となります。 

・うつ病の原因
高齢になると、「環境の変化」「加齢に伴う衰え」「病気」などの影響でうつ病になりやすいと考えられています。
環境的な原因としては、「退職」「家族、友人などの病気や死」「子どもの自立」など大きな生活環境の変化によって、気分が落ち込む原因と考えられます。
身体的な原因としては、「体力の衰え」や「病気」、加齢に伴う「脳の機能の衰え」などが原因と考えられます。
また、「抑うつ状態が長く続く」ことが原因で、日常生活の行動ができなくなる、無気力になるなどの症状が現れるようになります。

※抑うつ: 「気分が落ち込んで何にもする気になれない」、「憂鬱な気分」などの心の状態。

認知症・高齢者のうつ病のもの忘れ特徴

・認知症
出来事の全てを忘れている場合は認知症の可能性があります。
例えば、「朝食で何を食べたかを思い出せないだけではなく、食事をとったこと自体を全く覚えていない」「鍋に火をかけっぱなしで出かける」「洗濯機などの使いかたがわからなくなる」認知症ではもの忘れを認めないことがほとんどです。 

・高齢者のうつ病
うつ病の物忘れは、記銘力(新たな事柄を覚えること)の低下です。
例えば、新聞を読んでもなかなか頭に入らず、時間をかけて読んだのに内容を覚えていなかったりすることがあります。
うつ病では「もの忘れがひどくなった」と悲観することが多いです。

症状のスピードの違い

・認知症
認知症は徐々に悪化していきます。
進行のスピードがゆっくりであり、記憶障害などが徐々に進行することが多く、最初は気づきにくいと言われています。 

・高齢者のうつ病
きっかけとなる出来事があることも多く、そのタイミングから様々な症状が現れます。
ご家族が「どうしたかな、いつもと様子が違うな」と気付きやすいという特徴があります。

認知症と高齢者のうつ病を見分ける方法

認知症と高齢者のうつ病の症状には上記のような違いがありますが、実際に一般の人が見分けるのは難しいです。
内科系の病気や脳の病気によって認知症や高齢者のうつ病のような症状がある可能性もあるので、医療機関で詳しい検査を行う必要があります。

認知症や高齢者のうつ病の症状が見られたら、まずは認知症の専門外来や物忘れ外来などを受診しましょう。

病院によって検査の方法に違いはありますが、一般的には以下のような流れで診察・検査が行われることが多いです。 

・問診
最近の出来事などの記憶について簡単な質問をしたり、計算をしてもらったりして、認知機能に異常がないか調べます。 

・脳画像検査
CT・MRI検査で、認知機能に影響を与えるような脳の異常(脳の萎縮や脳梗塞、脳出血など)の有無を調べます。(脳波検査で、脳機能の低下の有無を調べる場合もあります) 

・血液検査
認知機能に影響を与えうる、ホルモンバランスの異常や隠れた内科系の病気がないか調べます。 

参考資料: “認知症と高齢者のうつ病にはどのような違いがあるの?|100年人生レシピ|認知症を考えるみんなのためのメディア” 

【セルフチェック】認知症

①財布や鍵など、物を置いた場所がわからなくなることがありますか 
(はい いいえ)
②5分前に聞いた話を思い出せないことがありますか 
(はい いいえ)
③周りの人から「いつも同じ事を聞く」などのもの忘れがあると言われますか 
(はい いいえ)
④今日が何月何日かわからないときがありますか 
(はい いいえ)
⑤言おうとしている言葉が、すぐに出てこないことがありますか 
(はい いいえ)
⑥貯金の出し入れや、家賃や公共料金の支払いは一人でできますか 
(はい いいえ)
⑦一人で買い物に行けますか 
(はい いいえ)
⑧バスや電車、自家用車などを使って一人で外出できますか 
(はい いいえ)
⑨自分で掃除機やほうきを使って掃除ができますか 
(はい いいえ)
⑩電話番号を調べて、電話をかけることができますか 
(はい いいえ)

「はい」が5個以上の方【認知症の可能性があります】

【セルフチェック】うつ病

①1日中憂うつな気分が続いている 
(はい いいえ)
②何に対しても興味や喜びが持てない 
(はい いいえ)
③疲れやすくやる気がおきない 
(はい いいえ)
④集中力、注意力が低下している 
(はい いいえ)
⑤自分には価値がないと感じ、自信を喪失している
(はい いいえ)
⑥自分が悪い、自分の責任だと罪の意識を感じる
(はい いいえ) 
⑦将来に希望が持てず、悲観的な気分である 
(はい いいえ)
⑧自殺を考えることがある 
(はい いいえ)
⑨夜寝付けない、夜中に目が覚める、朝早く目が覚める、寝過ぎてしまう 
(はい いいえ)
⑩食欲低下または食欲増加(過食)している 
(はい いいえ)

・「はい」が1~2個の方【軽度のうつ状態の可能性があります】
・「はい」が3~5個の方【軽度~中軽度のうつ状態の可能性があります】
・「はい」が6~8個の方【中軽度~重度のうつ状態の可能性があります】
・「はい」が9個以上の方【重度のうつ状態の可能性があります】

対処法

・趣味でストレス発散
認知症・高齢者のうつ病は何らかのストレスによって引き起こされていると考えられます。
気晴らしと適度な運動が大切です。
ストレスを溜め込まないためには、趣味などの気晴らしで発散します。
趣味だけでなく、体を使うこと、頭を使うこと、誰かと一緒にやることなど、バリエーションがあるのが理想です。
例えば、ジョギングなどの有酸素運動と読書、おしゃべり、食べ歩きなど、興味のある趣味を組み合わせて楽しむとストレスが発散になり、認知症・高齢者のうつ病の予防になります。

 ・もの忘れはあんまり気にしない
物忘れ対策には、メモが役立ちます。重要なことはすぐにメモをとる習慣をつければ、物忘れを減らすことが可能です。
予定などは書き込み欄のあるカレンダーや、手帳にすぐ書くようにしましょう。
また、年をとれば、誰でも忘れっぽくなるので、ただの物忘れであれば必要以上に心配して気に病まないことも大切です。

さいごに

高齢者のうつ状態の場合、話しかけても反応が乏しい場合もあります。
しかし、話は聞いてくれています。一緒に過ごす時間を嬉しく思っているかもしれません。
ただし認知症の方は、たとえ嬉しくとも、気持ちを表現しづらくなっています。
そのことを理解した上で、取り組んでみましょう。

認知症と高齢者のうつ病の似たような症状を持つ病気はたくさんあります。
病気によって治療法が違います。処置次第では症状が改善されることもあります。
認知症やうつ病のような症状が出てきた場合は、自分で判断することなく専門の医師の診断を受け適切な処置をしてもらうようにしてください。 

介護の相談窓口
  • 「今後の生活環境が変わる事への不安」や「介護を使って生活をどうデザインをしていったら良いか」など介護は協力体制で成り立っております。 ちょっとでも解決できる、ストレス軽減できる記事を目指し、一つの相談場所のメディアを目指しております。

セルフチェック認知症高齢者

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