When Williams started at Tidelands she showed signs of depression, according to Andy Cheshire, a clinical psychologist who coordinated Aging Services for the mental health center. You'd ask a question and she wouldn't respond to you. She'd take three or four minutes to formulate an answer. She never smiled. She moved slowly.
Depression can cause memory loss in older people.
And since Alzheimer's remains a diagnosis of exclusion, doctors rule out other memory loss causes until they're left with no other explanation but Alzheimer's. The anti-depressant Paxil and a predictable daily routine at Tidelands improved Williams' mood. But her confusion continues. For the test, Williams sits across a narrow table from Cheshire. Worried but eager to please, her fly-away gray hair forms a halo above freckled cheeks.