Pseudodementia is a set of symptoms that mimic those of dementia, such as problems with speech, memory, or attention. However, it typically has other underlying causes, such as depression.

Pseudodementia appears similar to dementia but does not occur due to neurological degeneration. Some people call the condition depressive pseudodementia, as the symptoms often stem from mood-related conditions such as depression.

Treating any underlying issues contributing to pseudodementia may reduce the symptoms, though long-term treatment and lifestyle changes may give a person the best outlook.

What are the symptoms of pseudodementia?

A doctor may recommend imaging tests to help diagnose pseudodementia.

Symptoms of pseudodementia may include changes to or difficulty with:

• speech and language
• memory
• maintaining attention
• regulating emotions
• organizing or planning

These symptoms are common in people with dementia. Therefore, a doctor may diagnose and treat individuals with pseudodementia as though they have dementia.

However, because pseudodementia often has links to depression, the person may also have symptoms of depression, such as:

• a loss of interest in activities
• a persistent depressed mood
• social withdrawal
• suicidal thoughts or behaviors
• insomnia or hypersomnia
• general fatigue
• a loss of appetite or overeating

The condition is most common in people over the age of 50.

Suicide prevention

If you know someone at immediate risk of self-harm, suicide, or hurting another person:

• Ask the tough question: “Are you considering suicide?”
• Listen to the person without judgment.
• Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
• Stay with the person until professional help arrives.
• Try to remove any weapons, medications, or other potentially harmful objects if it’s safe to do so.

If you or someone you know is having thoughts of suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988.

Find more links and local resources.

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Pseudodementia vs. dementia

Pseudodementia may appear or feel similar to dementia. The main difference between them is that pseudodementia does not occur due to the physical of neurons (nerve cells in the brain). Meanwhile, neurodegenerative dementia involves the irreversible degeneration of regions of the brain.

Insight and cognitive (thinking) tests can also be different between dementia and pseudodementia. For example, a person with dementia may not notice that they have problems with memory but may not perform well on cognitive tests.

Someone with depression that causes cognitive symptoms may experience the opposite. They may complain of memory problems but perform well on cognitive tests.

Treatment of dementia and pseudodementia may also vary. In depression-related pseudodementia, treating the underlying depression may cause a person’s symptoms to improve significantly.

Similarly, pseudodementia can occur due to anxiety, schizophrenia, or other mental health conditions. Treating these disorders may cause some or all of the symptoms of pseudodementia to improve.

In cases of neurodegenerative dementia, treatment typically focuses on symptom management, as there is currently no cure. Treatment may vary depending on the type of dementia a person has and its severity.

In some cases, pseudodementia can be a predictor of dementia that occurs before neurodegenerative dementia begins to cause symptoms. It can also be a risk factor that may make it more likely for someone to develop neurodegenerative dementia.

What causes pseudodementia?

Mood-related conditions are potential causes of pseudodementia. According to a 2023 , depression is the most common cause, but other potential causes include:

• schizophrenia
• anxiety
• post-traumatic stress disorder (PTSD)
• mania
• conversion disorder

In adults, depression may cause significant cognitive impairment, which may lead to symptoms relating to pseudodementia, and the risk is higher with advancing age.

The 2023 review’s authors highlight the complex relationship between depression and dementia since both conditions can cause depressive symptoms and cognitive impairment.

Because of this, doctors may not consider pseudodementia until they have completely ruled out dementia and other possible causes of these impairments.

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How do doctors diagnose pseudodementia?

Pseudodementia and dementia can be challenging to differentiate. In fact, some doctors do not agree with using the term pseudodementia, seeing it as more of a description of symptoms rather than a diagnosis itself.

Because of this, doctors will be very careful to eliminate other potential causes before making a diagnosis.

Aging increases the risk of many conditions that cause changes in cognition and brain function, including:

• stroke
• heart disease
• diabetes
• liver disease

It may be challenging for doctors to tell the difference between these aging-related changes and early signs of depression or dementia.

Another difficulty in diagnosing pseudodementia is that the symptoms of depression and many progressive neurological conditions may overlap in older adults.

It is also possible for someone to have neurodegenerative dementia and depression at the same time.

For this reason, diagnosing pseudodementia can take time. A doctor will want to rule out neurodegenerative dementia and other cognitive impairments before moving on to other possible causes.

Diagnostic tests

A thorough diagnosis may a conversation about symptoms and various tests. In-office evaluations can help give the doctor an idea about the person’s cognitive abilities and neurological condition.

This evaluation may include testing for:

• memory
• visual perception
• language and speech use
• problem-solving
• organization
• attention
• reflexes
• movement and balance

A doctor may also order blood tests to check for signs of underlying conditions or deficiencies, such as a deficiency in folate or vitamin B-12.

Imaging tests may also be an important tool in helping diagnose pseudodementia. In dementia cases, imaging scans can sometimes reveal neurological disorders or effects of brain degeneration.

Pseudodementia treatment

According to the earlier 2023, treatment for pseudodementia can take time, and different people may respond well to different treatment options.

If a doctor suspects someone has pseudodementia, they may focus on treating the underlying cause. In many cases, this involves treating depression.

Depression treatment can vary according to the individual and the underlying cause. However, it typically involves a combination of psychotherapy, including cognitive behavioral therapy, and medication, such as selective serotonin reuptake inhibitors (SSRIs).

For other people, treating anxiety, PTSD, or schizophrenia may help relieve some pseudodementia symptoms.

It is important for anyone with depression to work with a mental health specialist to find a long-term treatment plan that works.