What is Pseudodementia?

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In this blog we will discuss what pseudodementia is. 

We will briefly touch on what its symptoms are, factors that cause this condition, how it differs from dementia, and the treatment options available for this condition. 

What is Pseudodementia?

Pseudodementia is a condition that presents itself as a set of symptoms that is very similar to or is said to mimic those of dementia. 

However, unlike dementia that is a neurological disorder, pseudodementia is caused by other factors including mental disorders like depression. 

Pseudodementia is not recognised as a medical condition and there is no official diagnosis for it however, an evaluation of the symptoms tied to the possible causes of this condition and treating this underlying cause can help treat it. 

Treating pseudodementia will require an intensive treatment for underlying causes and this condition has a positive outlook especially when the treatment is long term coupled with lifestyle changes for the individual. 

What are the symptoms of pseudodementia?

The symptoms of pseudodementia often mimics that of dementia as well as mental disorders like depression. 

Some of the main observable symptoms of pseudodementia, according to MedicalNewsToday, include:

  • speech and language problems. 
  • Lapses or losses of memory
  • Problems related to difficulty maintaining attention
  • Emotional dysfunction
  • Difficulting planning and organising daily tasks

Other symptoms also include:

  • Depressed mood
  • Feelings of helplessness and hopelessness
  • Low energy levels
  • Social isolation
  • Loss of appetite or overeating
  • Reduced psychomotor function
  • Slower thought processes
  • Muted or delayed reactions to stimuli. 

History of Pseudodementia 

The term pseudodementia became widely used in the medical field after the publication of  Leslie Kiloh’s 1961 paper. 

Kiloh described cases where individuals with treatments with cognitive impairment and deficits were also exhibiting symptoms related to dementia. In the paper, Kiloh mentioned that the symptoms of cognitive decline was not because of the degeneration of neurological symptoms as that in dementia but rather due to mental health conditions. 

It was in this paper, that Kiloh also mentioned that the prognosis of Pseudodemtai was fairly positive with high potential for the reversibility of cognitive impairment in many of these cases.

It has to be mentioned that the term pseudodementia and the condition itself was present before this paper however experts and professionals in the field were against the use of this term aas there was no clear criteria for diagnosis.

They were against the use of the term as it was also feared that it could lead to many misconceptions about dementia as a disease. However, Kiloh’s work legitimised the condition of Pseudodementia. 

However, psychiatrist Leslie Kiloh in the paper mentioned that this condition could be linked to  psychiatric disorders, such as depression by presenting vignettes of 10 patients which introduced a whole area of research and scientific study in the field of neurodegenerative diseases. 

What causes Pseudodementia?

While the case of pseudodementia is not clearly known, most experts and medical providers believe that pseudodementia could be caused by underlying conditions such as mood-related disorders like depression. 

Often, medical providers do not consider the possibility of pseudodementia until they rule out dementia and other cases of impairments related to neurodegenerative diseases as well as depression. 

Other mental health conditions — such as schizophrenia or dissociative disorder — may cause similar symptoms and could be what causes pseudodementia. 

According to Carrie Hill for Verywellmind, there is a possibility that this condition might also be observed in bipolar- manic episodes, dissociative disorders, Ganser syndrome, and during the use of psychoactive drugs.

What is the difference between dementia and pseudodementia?

Pseudodementia, the condition is termed as such because of how similar the symptoms are to dementia.  However, there are key differences when it comes to these two separate conditions. 

A person with pseudodementia is often aware of their cognitive impairments- they have insight and awareness about their memory loss and their inability to focus and pay attention however, a person with dementia might not always recognise dmtoms and even deny that the intensity of the symptoms that is affecting their life. 

People affected with pseudodementia show less impairments involving tasks related to memory when tests are administered to them even if they have trouble with recall. Whereas individuals with dementia do not perform well on neuropsychological memory tests.

Another difference is that people with dementia may show non-congruent emotions inappropriate for the situation and a wider range of emotions compared to people with pseudodementia. 

The symptoms of pseudo dementia are reversible- if treatment is successful the cognitive impairment and other seemingly degenerative symptoms can be reversed completely however in dementia, these deterioration is generally progressive and often not able to be reversed. 

Older adults are at risk of developing both dementia and depression and it is often the case that when an individual experiences a combination of both- this condition can lead to doctor misdiagnosing one or the other. 

For a doctor to treat the condition that is affecting the individual effectively, they need to be able to identify whether the individual has dementia or whether that has been affected with depression related pseudodementia. 

The major difference between the two is that people with pseudodementia might report memory decision however, their mental status examinations have responsable results and they are able to perform on these tests that examine cognitive function. 

Whereas people with dementia don’t do as well on cognitive eat and do not score well on cognitive functions related to tasks, panning, organising, executive functioning etc.

A person with pseudodementia might also show less of severe mood swings compared to someone with dementia and might have more of a sustained low mood rather than volatile changes in mood. 

What are the treatment options available for pseudodementia?

People who have pseudodementia might also show similar symptoms like that of Alzheimer’s and Parkinson’s disease dementia which makes it very difficult for medical providers to differentiate between dementia and pseudodementia.

Treating Pseudodementia involves treatment for depression since some of its symptoms mimics that of mood disorders and the condition improves when the symptoms that resemble depression are addressed. 

In most cases, the prognosis of the treatments for pseudodementia are positive when cognitive functioning is regained completely by the end of treatment. 

The treatment of pseudodementia includes both therapy or medication, and for best results; a combination of both. Therapeutic intervention like that of Cognitive behavioural therapy and interpersonal therapy are two specific treatments that have been observed to be effective for the treatment of depression-like symptoms of pseudodementia. 

The treatment for pseudodementia can take time and often doctors and medical professionals believe that long term treatment with lifestyle changes serve the best results. 

The treatment of the condition begins with a screening to rule out other possible causes. The Geriatric Depression Scale (GDS) is one screening tool that is used to detect depression.

The doctor might also screen for alzheimers and dementia and use tools such as Cornell Scale for Depression in Dementia to screen for both depression and dementia.

If the doctor suspects that a person has pseudodementia, the treatment is usually focused on treating the underlying cause. In many cases, this involves treating the depression that has led to symptoms. 

The doctors would recommend either therapy or antidepressants and in most cases, for best results, both. Medications for depression may include antidepressants and selective serotonin reuptake inhibitors. 

Conclusion

In this blog we have discussed what pseudodementia is. 

We have briefly touched on what its symptoms are, factors that cause this condition, how it differs from dementia, and the treatment options available for this condition. 

FAQ related to Pseudodementia

Is pseudodementia in the DSM 5?

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) does not recognize pseudodementia as a clinical disorder. 

Pseudodementia is not recognised as a medical condition and there is no official diagnosis for it however, an evaluation of the symptoms tied to the possible causes of this condition and treating this underlying cause can help treat it. 

What is considered pseudodementia?

Pseudodementia is a condition that presents itself as a set of symptoms that is very similar to or is said to mimic those of dementia. However, unlike dementia that is a neurological disorder, pseudodementia is caused by other factors including mental disorders like depression. 

What is another name for pseudodementia?

Pseudodementia is also known as depression-related cognitive dysfunction because one of the major symptoms of this condition is cognitive dysfunction related to memory and executive function. 

While the case of pseudodementia is not clearly known, most experts and medical providers believe that pseudodementia could be caused by underlying conditions such as mood-related disorders like depression which is why it is termed as “Depression related”.

Can you recover from pseudodementia?

In most cases, the prognosis of the treatments for pseudodementia are positive when cognitive functioning is regained completely by the end of treatment. 

The treatment of pseudodementia includes both therapy or medication, and for best results; a combination of both. Therapeutic intervention like that of Cognitive behavioural therapy and interpersonal therapy are two specific treatments that have been observed to be effective for the treatment of depression-like symptoms of pseudodementia. 

The treatment for pseudodementia can take time and often doctors and medical professionals believe that long term treatment with lifestyle changes serve the best results.

What is depressive pseudodementia?

Depressive pseudodementia is another term for depressive cognitive disorders, also called pseudodementia and it refers to  a condition that presents itself as a set of symptoms that is very similar to or is said to mimic those of dementia. 

However, unlike dementia that is a neurological disorder, pseudodementia is caused by other factors including mental disorders like depression. The symptoms of pseudodementia often mimics that of dementia as well as mental disorders like depression

Is pseudodementia a diagnosis?

Pseudodementia is not recognised as a medical condition and there is no official diagnosis for it however, an evaluation of the symptoms tied to the possible causes of this condition and treating this underlying cause can help treat it. 

References

Kang, H., Zhao, F., You, L., Giorgetta, C., D, V., Sarkhel, S., & Prakash, R. (2014). Pseudodementia: A neuropsychological review. Annals of Indian Academy of Neurology, 17(2), 147–154. https://doi.org/10.4103/0972-2327.132613

Johnson.J. What to know about pseudodementia. MedicalNewsToday. Retrieved on 5th Feb 2022. https://www.medicalnewstoday.com/articles/pseudodementia#definition

Pseudodementia. GoodTherapy. Retrieved on 5th Feb 2022. https://www.goodtherapy.org/blog/psychpedia/pseudodementia

Hill.C. An Overview of Pseudodementia. Verywellmind. Retrieved on 5th Feb 2022. https://www.verywellhealth.com/pseudodementia-98155#toc-experiencing-both-dementia-and-depression

Waichler. I. Pseudodementia: Symptoms, Causes, & Treatments. ChoosingTherapy. Retrieved on 5th Feb 2022. https://www.choosingtherapy.com/pseudodementia/

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