Depressive pseudodementia: everything you need to know

Because of concern about cognitive symptoms, such as memory loss or confusion, a diagnosis of dementia is often made. Perhaps, in the background, there is a depression.

Last update: September 11, 2022

“It’s that he forgets things, you ask him something and it’s like he’s in his world”. Many consultations for alleged cases of dementia begin with phrases that reveal everyday situations. Nevertheless, there may be a depression in the background. Thus, depressive pseudodementia appears.

Dementias can function as the mixed bag where concerns about cognitive performance fall. If we delve a little, we will find alterations in mood.

What is dementia and depression?

To understand what depressive pseudodementia is about, it is convenient to start by asking what dementia is and what depression is. Dementia It is a term used to identify those degenerative diseases that usually have multiple causes and involve a progressive deterioration, especially in certain brain functions. Perhaps the best known example is Alzheimer’s.

For its part, depression refers to a mood disorder, which also has subtypes and is expressed through multiple symptoms. Among the best known we find the following:

  • Reluctance.
  • Apathy.
  • Fatigue.
  • Changes in sleep and appetite.
  • Loss of interest in activities that were pleasurable.
Alzheimer’s disease is the most well-known dementia. It has a strong association with age-related cognitive decline.

Let’s talk about depressive pseudodementia

We speak of a depressive pseudodementia because, although it is not a dementia, it is often confused with it. This is so because cognitive alterations occur. However, in most cases, there is a previous psychiatric disorder, which coincides with depression.

It is important to identify the symptoms to arrive at accurate diagnoses.

Usually, depressive pseudodementia begins with a mood disturbance, with primacy of anguish, sadness and discomfort. More cognitive signs may then appear, such as memory loss, inattention, difficulty concentrating, starting and finishing tasks, and impaired judgment.

In a third moment, the need arises to want to be alone, to do nothing (isolation and inactivity), which makes interaction difficult. This leads to a progressive impairment of social skills.

We can also mention that mood disturbance influences the way patients behave when solving some neurological tests. For example, those who have depression, retain their apathy and reluctance and simplify with a “I dont know”.

Depressive pseudodementia may be reversible.

Main differences with neurodegenerative dementias

Many professionals consider depressive pseudodementia to be a challenge, since the overlapping signs and symptoms of dementia can initially make it difficult to navigate. However, those who know more about the subject, suggest that there are elements to clarify the diagnosis.


As for the timing, It is important to take into account the age of the patients.. For example, those with these signs who are age 65 or older are often told right away that they have dementia. However, it is necessary to reconstruct his story and the case.

Frame evolution

A pseudodementia has a subacute onset and more rapid evolution. In this sense, it affects daily and functional functioning in a more evident way, especially the emotional component, compared to the cognitive one.

Neurodegenerative dementias have a slower and more progressive development.

The memory

In depressive pseudodementia, immediate and remote memory are affected simultaneously. While in the case of dementias, the deterioration begins with immediate memory.

Social skills and relationships with the environment

Usually, depression has an almost immediate impact on social relationships from its onset, since the person tends to isolate himself, he is reserved, with little interest in interaction. In dementia this does not have to be the case. Someone may be having a hard time sharing a recent memory, but still want to get together with their friends.

The change in mood is a key point for the differentiation between neurodegenerative dementias and those associated with depression.

Some keys to act against depressive pseudodementia

Some initial recommendations to consider are the following:

  • Try to do some activities during the day. As difficult as it is and you feel little desire to do it, you have to overcome that resistance to movement. Start with simple activities, of short duration, such as going for a walk for 10 minutes a day, putting clothes to wash, establishing hygiene habits, reading.
  • Try to stick to a routine for getting up and going to bed. Even if you want to stay in bed all day, you need to try to continue with certain activities. If you find it too difficult, you can try multiple alarms or commit to some responsibilities that you oblige to get up
  • avoid substance use, such as illicit drugs or alcohol.
  • Ask for professional help. Depression and its variants, such as depressive pseudodementia, require a comprehensive approach, beyond medication. There are different types of psychological therapies that can collaborate with the process.

It is important that you know that, when doing these activities, you will not feel good right away, nor will you do them with complete happiness, as you may have in the past. Don’t start looking for that because it can be frustrating.

You can keep in mind that a small step helps you get out of the place where you are today and walk towards where you want to be tomorrow.

Understanding health as a whole

Beyond the fact that there are many factors involved, one of the central points that sustains the confusion in the diagnosis has to do with the data provided to the professional. It is common for family members to worry about cognitive symptoms and make special emphasis on them, neglecting the emotional.

Quality of life and well-being are a whole. Although we may worry that someone cannot start and finish a task, in the case of depressive pseudodementia, the problems started earlier, with other signs (loss of interest, pessimistic outlook, discouragement).

In this sense, Let’s not underestimate the role of emotions. Mood is an essential component to be able to live better.

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