Definition: Basically, pseudodementia is a condition in which symptoms of dementia are caused by depression rather than an organic disease such as Alzheimer's.

When younger people get depressed, they often suffer from obsessions or feelings of anxiety--they may agonize over their problems to no end and spend a lot of time talking (or whining) about whatever's bothering them. In the elderly, however, depression more commonly involves feelings of apathy--older people who are depressed will feel that life has no meaning, that their best and happiest days are behind them, and that there's no point in trying anything anymore. In turn, the apathy may make them seem forgetful or confused; they'll miss appointments, forget to enter checks in their checkbook, and seem "out of touch" in conversations. They may even appear impaired on neuropsychological tests of memory and concentration. This syndrome is called pseudodementia and is one of the reversible causes of dementia-like symptoms.

Diagnosis: Obviously, you can start by asking the patient if he or she is depressed; however, elderly adults often show quite a bit of reticence when they're asked to discuss their moods and emotions with strangers, so you might not get an accurate answer. Often, an indirect approach works better: you can ask if they recently experienced a tragic event (such as the loss of a spouse), a significant change in lifestyle (retirement and a shift to a smaller fixed income), or an illness (anything from incurable cancer to a relatively minor injury that prevents them from pursuing a favorite hobby). If so, it's worth considering treatment for depression.

Treatment: As with most forms of depression, antidepressants work well. ECT often provides relief if the drugs fail and the case is severe; however, shock therapy often causes brief memory loss, thereby worsening the symptom you're trying to alleviate. Ultimately, though, doctors prefer not to keep the elderly on medications if they don't have to, so it's useful to try to find some non-pharmacological way to keep them happy and healthy. Patients in this situation should be encouraged to pick up new hobbies, join church organizations, go to senior citizens' meetings, go on trips, meet new people--in short, they should do as much as they can for as long as they can.

Technically, pseudodementia is only diagnosed when other organic diseases are absent. Depression is, however, common in people who have Alzheimer's disease or multi-infarct dementia (which makes sense; patients with these diseases often are the first to know they're having troubles and, quite understandably, get depressed about it). Antidepressants may help these patients to an extent; unfortunately, they cannot cure the disorder entirely.

Log in or register to write something here or to contact authors.