The Diagnosis and Differential Diagnosis of Dementia and Pseudo-dementia in the Elderly

Depression occurring in an elderly patient calls for evaluation. Though depressive illness may result in cognitive impairment and may occasionally mimic true dementia, that impairment more commonly occurs in the early stages of a dementing illness. If the patient is suffering from an organic brain disease, treatment of depressive pseudo-dementia rarely results in complete restoration of the patient's normal cognitive function. Nevertheless, antidepressant therapy is extremely valuable in improving the quality of the sufferer's life. Remediable factors contribute to, and sometimes are responsible for, the dementia syndrome. These factors are discussed, and suggestions are made for their investigation and management.