Depressive pseudodementia is cognitive impairment on the background of a depressive illness, sometimes in the absence of typical symptoms of depression.
Figure 72.7 . Comparison and contrast of numerous neuromuscular conditions associated with iodine-induced hyper- and hypothyroidism. These occur at both peripheral and central nervous systems.
In this case, it’s not uncommon for someone with dementia realizing what is happening to them during moments of clarity, which can lead to depression. This is why the cognitive, mental, and emotional challenges of aging adults need to be handled with patience, empathy, and loving care.
- Depression looks like dementia
- Depression and dementia
- Depression Also Looks Like
- 48 How does one differentiate pseudodementia and dementia?
- Why Is Depression Often Mistaken for Dementia
- Delirium and Dementia
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Depression looks like dementia
Here are some of the signs to watch out for:
Simulated dementia is cognitive impairment that has been feigned deliberately in the pursuit of some form of gain.
The term pseudodementia has been used historically to describe the reversible cognitive impairment that may accompany depression, but it has lacked precise and consistent definition. The neuropsychological profile of older depressed patients varies according to the age at which depression first occurs, suggesting the involvement of different biological mechanisms ( Herrmann et al 2007 ). Late-onset depression is accompanied by impairment of executive functioning and processing speed and is associated with frontal and temporal white matter hyperintensities on MRI ( O’Brien et al 2006 ), with deep rather than periventricular lesions being most implicated. By contrast, in those with early-onset depression episodic and semantic memory is more typically affected, and neuroimaging reveals evidence of hippocampal atrophy ( McKinnon et al 2009 ). It is thought that hippocampal damage is mediated via neurophysiological stress – possibly cortisol hypersecretion – but there is no apparent correlation with raised cortisol levels. Recent studies refute the claim that the neurocognitive changes associated with late-life depression are temporary and remit after recovery. Bhalla et al (2006) found that 94% of those with depression who were cognitively impaired at baseline remained so a year later, despite being no longer depressed. Moreover, this study and others suggest that depressive symptoms without apparent cognitive impairment predict the later development of cognitive decline and dementia, especially in those with persistent and more severe depressive symptoms.
Depression and dementia
The difficulties people with dementia may have with their mental abilities can make it harder to treat depression. This could include difficulties with their attention, communication, memory or reasoning. To have the most benefit, some types of talking therapy need a person to have these mental abilities intact. This includes cognitive behavioural therapy (CBT).
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If a person has had depression in the past, they are more likely to have it again if they develop dementia.
It’s helpful to know which symptoms to look for to help determine which illness might be causing the changes in your loved one, however only a doctor can make a proper diagnosis and dispense the appropriate treatment plan.
What are the symptoms of dementia in seniors?
Depression Also Looks Like
A person who has depression should be offered a range of treatments, depending on how long they’ve had it and how severe it is.
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48 How does one differentiate pseudodementia and dementia?
Most people feel low or sad from time to time. This is not the same as being depressed. Depression is a condition that can last for several weeks or months. When a person has depression a number of negative feelings can dominate their life, including sadness, hopelessness and a loss of interest in things they used to enjoy.
A third condition that is sometimes confused with depression or dementia is delirium. Delirium is a short-term memory loss that results from a person being put into new, unfamiliar surroundings or living conditions, becoming dehydrated, or having a reaction to medication. This condition is often reversible if treated early, whereas most types of depression and dementia can be treated but aren’t reversible.
Dementia is the umbrella term for many different conditions that deal with reduced brain function. The most common of these conditions is Alzheimer’s disease, which accounts for 60 – 80% of dementia diagnoses.
Why Is Depression Often Mistaken for Dementia
In ‘ pseudodementia ’, which is a functional psychiatric disorder or rarely a deliberate simulation, the clinical picture is similar to that of an organic dementia. However, there are differences which aid in differential diagnosis:
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Delirium and Dementia
Retention of normal cognitive function in some domains (patients may be able to learn new information, for example)
Seeking professional care for your aging loved one in Toronto