Understandably, dementia is one of the most feared health conditions. Memory loss, confusion, and changes in personality can be devastating for families. But Dr Rupa Parmar, says not every case of forgetfulness or brain fog signals dementia. In some cases, the real cause may be depression or pseudodementia, a treatable condition that can mimic dementia and lead to the same kind of worry and fear.
Dr Parmar said: “It’s easy to assume a loved one is developing dementia. But in some cases, these symptoms may be a sign of depression, rather than irreversible damage.
“In older adults, depression can lead to symptoms that mimic dementia, such as memory problems, slowed thinking, lack of concentration, and mood changes. This is usually referred to as pseudodementia, a cognitive decline that looks like dementia but is driven by depression, rather than by brain degeneration. The good news is that there are important clues to help you tell them apart.
How Dementia and Pseudodementia Differ
Here are key differences to help you determine when symptoms may be due to depression rather than dementia.
- Onset and Progression – One key difference lies in how quickly symptoms appear. Generally, dementia creeps in slowly over the years, with a gradual decline that becomes noticeable over time. Depression-related memory problems, on the other hand, usually develop much more suddenly. In some cases, over weeks or months, and may seem to come and go
- Time of Day – When it comes to pseudodementia, it’s not uncommon for symptoms to be worse in the morning, while dementia symptoms usually worsen in the evening or at night. This is referred to as sundowning, when confusion and agitation become more noticeable. In the early stages, families may not even realise anything is wrong. After all, the person may be able to hide or compensate for small lapses until they become too regular to ignore
- Self-awareness – Those with depression usually worry and are more conscious about their forgetfulness, while people with dementia may not even realise the extent of their memory loss or be completely unaware of mistakes. In some cases, they may even become defensive when this is brought to their attention
- Motivation and Effort – Depression can rob people of energy and interest. For example, people with depression may have difficulty concentrating, appear disinterested or give up easily on tasks. But with dementia, people may try to respond, making confident guesses, but struggle to recall information
- Motor Skills – Dementia can impair your writing, speaking, and motor skills, but this isn’t usually the case with depression
Why It Matters – And What to Do About It
Dr Parmar concluded: “Misdiagnosing dementia when depression is the root problem can lead to lost opportunities for improvement. It’s also worth noting that depression in older adults may increase the risk of developing dementia in the future. Thankfully, when depression is treated effectively through therapy, lifestyle support, or medication, concentration and memory can return.
“If you or a loved one is experiencing memory problems, confusion, or slowing, don’t just assume it’s dementia. It’s important to pause and consider whether mood, motivation, or depression may be involved.
“It’s crucial to see a specialist as soon as possible for a full evaluation, including mood screening, memory tests, and possibly brain imaging or blood tests to rule out medical causes. After all, a correct diagnosis can change the path forward.”
