Overview of Pseudodementia

The definition and history of pseudodementia

Old man staring out the window
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Pseudodementia is a condition that resembles dementia but is actually due to other conditions such as depression, schizophrenia, mania, dissociative disorders, Ganser syndrome, conversion reaction, and psychoactive drugs

The History of the Term

Though the term was being used, it wasn’t until psychiatrist Leslie Kiloh published the paper “Pseudo-dementia” in 1961 that others were given the impetus to try reversing cognitive impairments that may have been due to other psychiatric disorders, such as depression, schizophrenia, and conversion disorder.

In Kiloh’s paper, he presented the vignettes of 10 patients, most of whom were expressing depressive features. When this paper was published in the scientific journal, Acta Psychiatrica Scandinavica, dementia was irreversible. What his paper did was open a whole area of research and scientific study that examined whether cognitive deficits in cases of depression could be reversed and whether there are underlying causes of dementia. Basically, the term has remained useful in fostering discussion of potentially treatable psychiatric symptoms, even in cases of progressive dementia.

Symptoms of Pseudodementia

A person may appear confused, exhibit symptoms that have to do with any of the conditions associated with pseudodementia. For instance, if they are depressed, they may experience depressive symptoms such as sleep disturbance, and complain of memory impairment and other cognitive problems. However, upon careful testing, memory and language functioning are intact. 

However, there are no clear-cut symptoms for pseudodementia. Instead, it is a practical term that helps define that someone may have a treatable condition; unlike dementia itself. But that hasn’t stop scientists from searching.

One of the most cited descriptions of cognitive deficits of pseudodementia is that patients:

  • had equal loss for recent and past events;
  • experienced patchy or specific memory loss;
  • exhibited intact attention and concentration;
  • gave frequent “Don’t Know” answers;
  • and performed variably on similarly difficult neuropsychological tasks.

Though others have made this list more clinical specific, the above has been a good benchmark to start.

The Importance of Diagnosing Dementia and Depression

Pseudodementia has become an important condition to understand so that a correct diagnosis of either dementia or depression can be made. The timely recognition and treatment of depression in the elderly can prevent them from progressing into it but also to prevent them from enduring the evaluations needed to diagnose dementia. 

Confusion caused by age-related cognitive deficits make it difficult to assess the elderly for pseudo dementia as compared to younger patients. This may be the reason that there have been reports of high rates of both false-positive and false-negative errors in the diagnosis of dementia.

To make things even more difficult in diagnosis, depression and dementia can co-exist. 

Do you think you might be depressed? Here are 9 symptoms of depression that you should know.

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