Pseudodementia describes the phenomenon whereby a psychiatric condition may mimic the clinical presentation of dementia, generating cognitive symptoms (e.g. poor memory) that resolve when the condition is treated 1,2.
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Terminology
The term pseudodementia is commonly used to describe cognitive symptoms co-presenting with depression, especially when they occur in older persons, although other psychiatric conditions (e.g. mania, psychosis, conversion disorder, and malingering) can also result in pseudodementia 2,3.
It should be noted that pseudodementia is distinct from reversible causes of dementia, such as chronic subdural hematomas. The distinction is that these do actually cause dementia rather than mimic dementia due to psychiatric overlays.
It has been argued that pseudodementia is a descriptive term best avoided in clinical practice, in part due to its erroneous implication that dementia and depression cannot coexist. It does, however, have value in aiding clinicians to consider conditions that may mimic dementia, and that some of these may not only be reversible but also require specific treatments.
Diagnosis
Pseudodementia is not a formal diagnosis under the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and the term itself has sparked considerable criticism since it was popularized in 1961 1,4. Issues have been raised regarding the reversible nature of symptoms, given that depression with cognitive dysfunction can be a common prodromal phase of 'true' neurodegenerative dementia and should prompt appropriate investigation 5. This is in addition to the considerable overlap and complex link between dementia and depression, both in pathology and in clinical presentation 6.
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