Pseudodementia

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Pseudodementia (otherwise known as depression-related cognitive dysfunction or depressive cognitive disorder) is a condition that leads to cognitive and functional impairment imitating dementia that is secondary to psychiatric disorders, especially depression. Pseudodementia can develop in a wide range of neuropsychiatric disease such as depression, schizophrenia and other psychosis, mania, dissociative disorders, and conversion disorders. The presentations of pseudodementia may mimic organic dementia, but are essentially reversible on treatment and doesn't lead to actual brain degeneration. However, it has been found that some of the cognitive symptoms associated with pseudodementia can persist as residual symptoms and even transform into true neurodegenerative dementia in some cases.^[3]

Psychiatric conditions, mainly depression, is the strongest risk factor of pseudodementia rather than age. Even though most of the existing studies focused on older age groups, younger adults can develop pseudodementia if they have depression. While aging does affect the cognition and brain function and making it hard to distinguish depressive cognitive disorder from actual dementia, there are differential diagnostic screenings available.^[4] It is crucial to confirm the correct diagnosis since depressive cognitive disorder is reversible with proper treatments.

Pseudodementia typically involves three cognitive components: memory issues, deficits in executive functioning, and deficits in speech and language. Specific cognitive symptoms might include trouble recalling words or remembering things in general, decreased attentional control and concentration, difficulty completing tasks or making decisions, decreased speed and fluency of speech, and impaired processing speed. Since the symptoms of pseudodementia is highly similar to dementia, it is critical complete differential diagnosis to completely exclude dementia. People with pseudodementia are typically very distressed about the cognitive impairment they experience. Currently, the treatment of pseudodementia is mainly focused on treating depression, cognitive impairment, and dementia. And we have seen improvements in cognitive dysfunction with antidepressants such as SSRI (Selective serotonin Reuptake Inhibitors), SNRI (Serotonin-norepinephrine Reuptake Inhibitors), TCAs (Tricyclic Antidepressants), Zolmitriptan, Vortioxetine, and Cholinesterase Inhibitors.