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Pseudodementia – An Overview

pseudodementia

Leslie Kiloh, a psychiatrist, came up with the term Pseudodementia (PDEM) in 1961.

In short, describes a range of dementia-like symptoms.

These may include hysteria, depression, and schizophrenia.

Experts agree that depression is the major culprit that makes people feel as though they have dementia.

Also known as depression-related cognitive dysfunction, there are three primary cognitive components that Pseudodementia involves:

I. Deficits in executive functioning
II. Problems with memory
III. Challenges with language and speech

People who go through this worry too much about their experience a high percentage assuming that they have dementia.

Thankfully, this is not the case because the psychiatric conditions that a person goes through while dealing with this form of cognitive impairment are reversible through treatment.

If the treatment of depression, hysteria, or schizophrenia is successful, then the cognitive symptoms also go away.

Background

background
Even though people were using the term Pseudodementia before, it was not until Kiloh published a paper titled “Pseudo-dementia” in 1961 that many others took up interest.

The Scientific journal Acta Psychiatrica Scandinavica published her paper that presented vignettes of ten people a majority with depressive features.

This sparked a huge debate opening up areas of scientific study and research examining whether it is possible to reverse cognitive deficits in depression cases and whether these end up causing dementia in the long-run.

Symptoms of Pseudodementia

symptoms of pseudodementia
Persons with PDEM might experience a wide range of symptoms. Most of these usually overlap with those of individuals with dementia.

Examples of the symptoms may include:

  • Anxiety
  • Delayed motor response
  • Difficulty making decisions or completing tasks
  • Trouble remembering things
  • Difficult times communicating with others
  • Lower processing speed
  • Feelings of hopelessness and helplessness
  • Hypersomnia or insomnia
  • Fatigue
  • Loss of appetite or overeating
  • Suicide thought
  • Cognitive impairment is mostly seen in middle-aged and older adults

Diagnosis

diagnosis
There have been very many misdiagnosis cases of people who have Pseudodementia because a majority usually conclude that they have dementia. Thus, start getting into a lifestyle to manage the illness because it still has no cure.

This is especially in cases that touch on elderly persons who experience negative changes in behavior or thinking.

Statistics suggest that between 2-32% of seniors who experience cognitive problems may not have dementia.

Proper diagnosis is also tricky because some older adults can experience both PDEM and dementia.

It is, therefore, crucial for a person to go through an extensive clinical interview. This helps to reveal essential clues that professionals can use for proper diagnosis.

A GDS (Geriatric Depression Scale) may also be necessary. It can help differentiate between dementia and other forms of cognitive disorders.

Most of the time, medics and geriatricians will combine this with current functioning and medical history to come up with a diagnosis.

Treatment Options for Pseudodementia

treatment options for pseudodementia
It is important to note that even though this is a reversible cognitive disorder, treating it is still complex.

This type of cognitive dysfunction requires a combination of treatment modalities that may include psychotherapy, drugs, or a combination of both.

Various treatments can help with this condition such as:

1. CBT (Cognitive Behavioural Therapy)

CBT cognitive behavioural therapy
This generally seeks to enhance the mood of a person going through conditions like depression. It involves the changing and exploring of behaviors as well as thought patterns.

2. Interpersonal Therapy

interpersonal therapy
The other treatment option that experts recommend is interpersonal therapy. This mostly focuses on the relationships of the impaired individual.

Professionals seek to identify if these have any link between the relationships and feelings of depression.

3. Antidepressants

antidepressants
Some antidepressant drugs can help to eliminate cognitive dysfunction brought about by depression.

Keep in mind that depression has different causes; thus, treatment may vary from one person to the next, depending on what is most suitable.

How PDEM differs From Dementia

how PDEM differs from dementia
There are clear differences between dementia and cognitive impairment that mimics the illness.

This is one of the factors that can help to reduce misdiagnosis.

For instance, when looking at the history of dementia, you will notice that it is stealthy while this cognitive decline is quick and short.

Doctors usually test the memory of individuals to know whether they have reversible cognitive impairment or dementia.

This may involve asking several questions. For persons with this depression-related cognitive dysfunction, the answer will always be they do not know.

Concentration and attention, however, are usually intact though affected persons may appear as though they are upset.

It is a different case with dementia because individuals with the illness have poor concentration and attention, give out wrong answers, and typically appear like they are unconcerned.

Persons with PDEM might also complain about their memory but do reasonably well when it comes to mental status tests and exams that evaluate cognitive function.

On the other hand, people with dementia may deny experiencing any memory problems, but they do not do well with cognitive exams.

Most people with the reversible cognitive disorder will not show signs of severe mood swings.

The opposite is true for people with dementia because many showcase an extensive range of emotions where some have inappropriate responses like crying when everyone else is laughing.