Skill Checkup: A 71-Year-Old Woman With Signs of Self-Reported Cognitive Impairment and Primarily Short-Term Memory Loss

Shaheen E. Lakhan, MD, PhD, MS, MEd


January 31, 2023

In making a diagnosis of AD, it is important to consider the overlap between this condition and depression. "Pseudodementia" refers to cognitive impairment that mimics dementia; although this phenomenon can be spurred on by various conditions, it is most commonly caused by depression.

In addition, up to 50% of patients with AD develop concurrent depression. Depression symptomology in these two clinical contexts may differ: patients with AD often exhibit depression as apathy, fatigue, and low motivation, whereas older patients without dementia typically experience depression through mood changes, suicidal thoughts, and sleep and appetite changes.

Unlike AD, the cognitive effects associated with pseudodementia can generally be targeted with effective depression management.

Considering that this patient takes SSRIs and still has a history of gradually worsening cognitive impairment that affects daily functioning, it is likely that she has preexisting depression in addition to a new diagnosis of AD, though depressive symptoms may have slightly delayed AD diagnosis.


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