Pseudodementia is a set of symptoms that mimic those of dementia. However, it typically has other underlying causes, such as depression. The symptoms require a full evaluation to properly diagnose and treat.

Treating any underlying issues leading to pseudodementia may also reduce the symptoms themselves, though long-term treatment and lifestyle changes may give a person the best outlook.

Keep reading to learn more about pseudodementia.

a person having a medical scan to detect pseudodementiaShare on Pinterest
A doctor may recommend imaging tests to help diagnose pseudodementia.

Pseudodementia is a condition that appears similar to dementia but does not have its root in neurological degeneration. Some people call the condition depressive pseudodementia, as the symptoms often stem from mood-related conditions such as depression.

The main symptoms of pseudodementia include:

  • problems with speech and language
  • lapses or losses of memory
  • difficulty paying attention
  • difficulty regulating emotions
  • difficulty organizing or planning

These symptoms are very common in people with dementia. Therefore, a doctor may diagnose and treat these people as though they have dementia.

However, because pseudodementia often has a link to depression, the person may also have symptoms that include:

  • a loss of interest in activities
  • a depressed mood that lasts for weeks at a time
  • social withdrawal
  • suicidal thoughts or behaviors
  • insomnia or hypersomnia
  • general fatigue
  • a loss of appetite or overeating

The condition generally occurs in people as they age. Some hypothesize that mood-related conditions such as depression may cause these cognitive changes in the aging brain.

Mood-related conditions such as depression are some potential causes of pseudodementia. Although a number of causes may lead to pseudodementia, depression may be the most common.

As a study paper in the Annals of Indian Academy of Neurology notes, the relationship between depression and pseudodementia is complex. Depression itself may cause cognitive impairment. Likewise, dementia may also manifest with depressive symptoms.

Because of this, many doctors will not consider pseudodementia until they have completely ruled out dementia and other possible causes of these impairments.

In older adults, depression may cause significant cognitive impairment, which may lead to the symptoms associated with pseudodementia.

Even though the condition is most commonly associated with depression, other mental health conditions — such as schizophrenia or dissociative disorder — may cause similar symptoms. These may cause unique additional symptoms alongside the apparent symptoms of dementia.

Pseudodementia and dementia can be difficult to differentiate. In fact, many doctors do not agree with using the term pseudodementia, seeing it as more of a description of symptoms rather than a diagnosis itself.

Because of this, doctors will be very careful to completely eliminate other potential causes before making a diagnosis.

As the symptoms of pseudodementia typically occur in older adults, there are some challenges associated with properly diagnosing the condition.

For instance, aging itself causes general changes in cognition and brain function. These changes can vary greatly, and it may be difficult to tell the difference between aging-related changes and early signs of depression or dementia.

Another difficulty in diagnosing pseudodementia is that the symptoms of depression and many progressive neurological conditions often overlap in older adults.

It is also entirely possible for a person to have true dementia and depression at the same time.

For this reason, diagnosing pseudodementia can take time. A doctor will want to rule out dementia and other cognitive impairments before moving on to other possible causes.

A thorough diagnosis generally requires a number of tests. In-office evaluations can help give the doctor an idea about the person’s mental state and where the problem may lie.

This evaluation may include testing for:

  • memory
  • visual perception
  • language and speech use
  • problem solving
  • organization
  • attention
  • reflexes
  • movement and balance

These tests can help the doctor determine the affected area of the brain and help them move on to additional testing.

A doctor may also order blood tests to check for signs of underlying conditions or deficiencies. For example, a person with chronic vitamin B-12 deficiency or an underactive thyroid may show some similar symptoms. In other cases, they may check for specific proteins or compounds in the blood.

In many cases, imaging tests are also an important tool in helping diagnose pseudodementia. In cases of dementia, imaging scans can give hints as to the underlying causes or show the effects of degeneration in the brain.

Treatment for pseudodementia can take time, and different people may respond well to different treatment options.

If a doctor has ruled out other possible causes and suspects that a person has pseudodementia, the treatment they recommend will focus on treating the underlying cause.

In many cases, this involves treating the depression that has led to symptoms. Depression treatment can vary based on the individual and the underlying cause, but it typically involves a combination of psychotherapy and medication.

Medications for depression may include antidepressants and selective serotonin reuptake inhibitors. If these medications are successful, the person may notice a significant reduction in their symptoms.

Therapies focusing on mental health are another important aspect of depression treatment. Forms of psychotherapy, such as cognitive behavioral therapy or interpersonal therapy, may help improve the symptoms and treat the underlying cause.

Even in people whose depression responds well to treatment, symptoms such as cognitive impairment may linger. They may also return over time.

It is important for anyone with depression to work with a mental health specialist over time to find a long-term treatment plan that works.

Pseudodementia may appear or feel very similar to dementia, but the two are very different issues.

The main identifier between them is that pseudodementia does not cause actual degeneration in the brain, whereas true dementia does.

Therefore, pseudodementia and dementia will appear differently on brain scans, despite causing very similar symptoms.

The differences may also show up in testing. For example, a person with dementia often will not notice that they have problems with memory, but they will not perform well on cognitive tests. Someone with depression that causes cognitive symptoms may experience the opposite. They may complain of memory problems but perform well on cognitive tests.

Additionally, pseudodementia often responds to treatment. In depression-related pseudodementia, treating the underlying depression will often cause the symptoms to significantly improve.

In cases of true dementia, treatment may focus on symptom management, as there is currently no cure for the condition itself. Treatment may be more or less successful based on the stage of dementia the person has and how severe their symptoms are before treatment.

When diagnosing pseudodementia, doctors can bear these differences in mind to help them rule out dementia and identify the true cause.

Pseudodementia refers to a set of symptoms that mimic those of dementia, but there is typically no degeneration in the brain.

Depression in older adults may cause similar symptoms, though doctors will be very careful to fully evaluate and diagnose the issue before working toward treatment.

Treating pseudodementia involves treating any underlying conditions the person has.

Working with a mental health specialist in the long term may help prevent recurring symptoms and ensure that the person gets the appropriate treatment for the condition they have.