Reversible Dementias & Pseudodementia

Did you know that not all dementias are terminal and progressive (irreversible)? The term "dementia", in general, is a broad umbrella term used to describe the general symptoms associated with several types of dementia.

There can be a lot of confusion surrounding what dementia truly is because when the term "dementia" is used, people are typically referring to the neurodegenerative forms of dementia (i.e., Alzheimer's disease, Lewy body dementia, vascular dementia, frontotemporal dementia). These are what we call "true dementias". However, these are technically not the only types of dementia. There are actually over 100 different types of dementia and some of them are considered reversible dementias or pseudodementia.

In this blog, we are going to talk about pseudodementia and reversible dementia. What are they and how do they differ from true dementia? 

Now, it's important to note that the words pseudodementia and reversible dementia are often used interchangeably. I admittedly have a tendency to do this as well because pseudodementia essentially means "fake dementia" and it's easy to get carried away and generalize that, right? But, it is important to know that pseudodementia is technically a specific type of reversible dementia. In most cases, when you hear pseudodementia you want to think depression. This is most common application of the term. So, pseudodementia is typically referring to cognitive impairment due to depression that is mimicking the symptoms of dementia.   

Now, as just mentioned, pseudodementia is a type of reversible dementia and the thing that is most important to know is that the word reversible is not "set in stone", per say. Honestly, it would be more accurate to say "potentially reversible", as treating whatever the cause is can still be difficult and early diagnosis and intervention does matter.

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The way potentially reversible dementias differ from true dementia is that true dementia is irreversible and degenerative in nature. With potentially reversible dementias, the underlying cause is not degenerative in nature, its root cause is not in neurological degeneration.  

So, we talked about depression as a cause of a potentially reversible dementia, but what could be some others? 

• Insomnia or sleep deprivation
• Sleep apnea
• Thyroid disorders
• Nutritional or vitamin deficiencies (such as folate or vitamin B12)
• Medication side effects or interactions
• Certain infections
• Head injuries
• Normal pressure hydrocephalus
• Brain tumors
• Drug and Alcohol abuse

And, there are many others.  

Now, knowing the cause of dementia, whether reversible or irreversible, is difficult and knowing whether the dementia is reversible or irreversible is tricky as well. For this reason, misdiagnosis is pretty prevalent and thorough testing is absolutely necessary. It really is a rule out process and so the testing can be rather extensive, if the physician(s) are thorough.  

So, what's the lesson in this? Why am I telling you this.  

The lesson is, if you notice any of the common symptoms of dementia: 

Memory loss, increased confusion, impaired judgment, difficulty performing familiar tasks, difficulty with social interactions, mood changes, etc.  

1) Don't automatically assume that it's irreversible and by default degenerative in nature

2) Get yourself or the person you are concerned about checked out by a doctor

You want to catch these types of things as early as possible so that the root cause can be potentially identified and the appropriate interventions can be implemented. 

When you present to the doctor with dementia-like symptoms, they SHOULD be ruling out reversible causes for the presenting symptoms. This involves ruling out infections, autoimmune issues, malignancies, vascular causes, toxic and metabolic causes, etc. It should NEVER be assumed that the symptoms are irreversible.

So, again I say, if you are someone reading this blog and you or someone you know has not gotten an official diagnosis, but you are continuing to present with dementia-like symptoms, please, please go ahead and schedule a doctor appointment. 

Remember, everything that looks like dementia may not actually be "true dementia". Therefore, it's important to act on the things you notice, because whatever symptoms are being experienced may be reversible or at least treatable to some degree.  

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