What distinguishes Pseudodementia from true dementia?

Pseudodementia is characterized primarily by cognitive impairment stemming from an underlying mood disorder, most commonly depression, rather than a neurodegenerative process. Individuals with pseudodementia may present with significant memory and cognitive issues similar to true dementia, but these deficits are often reversible once the underlying depression is treated.

The key distinguishing feature is that in pseudodementia, the cognitive dysfunction is a consequence of depression. Patients may exhibit difficulty with concentration, memory loss, and other cognitive tasks, but these symptoms often improve with appropriate treatment of the depression. In contrast, true dementia typically results from progressive neurological conditions that lead to irreversible cognitive decline.

While memory deficits are present in both conditions, and changes in behavior may occur, these features alone do not differentiate pseudodementia from true dementia in the same way that the underlying cause—depression—does. Thus, recognizing that the symptoms of pseudodementia are due to an underlying depressive disorder is critical for appropriate management and treatment.