Businessman at 52 Feared Dementia; CMC Vellore Doctor Uncovers Clue to Reverse Memory Loss

A 52-year-old businessman from Bellari, Karnataka, got excessively stressed when he started identifying his struggle with remembering things. When he visited the clinic for medical consultation, he explained his situation, pointing out the symptoms such as missing appointments, fumbling with calculations, and losing the sharpness with numbers that once defined his success. Not only a mere personal observation, his doctor Mr. Sudhir Kumar explained on his personal LinkedIn post, “His family had noticed that even before the memory issues began, he had slowly become withdrawn and disinterested in his work. Yet, his sleep was sound, and there were no obvious stressors such as financial or family problems.”
When people often label forgetfulness as dementia, this case does not check all the boxes of dementia, yet the patient was suffering with certain symptoms, making it more complicated to decode. While taking a deeper look, another medical condition came into the centre stage, known as ‘Pseudo dementia.’ Take a closer look...

What is Pseudodementia

Pseudodementia is a condition where people show memory loss and difficulties with thinking-much like dementia,-but these problems are actually caused by mental health issues, mainly severe depression, rather than permanent brain damage. Unlike true dementia, such as Alzheimer’s, pseudodementia doesn’t involve irreversible changes in the brain and can often be reversed with treatment.

Research found out that the main cause of pseudodementia is severe depression, which affects brain areas responsible for thinking and memory but does so in a way that can improve once the depression is treated. Other mental health problems, such as anxiety or schizophrenia, may also cause symptoms that look like dementia.
Often, pseudodementia is confused with real dementia because the symptoms overlap, but this distinction is crucial since treatments differ greatly. Diagnosis usually involves careful assessment to rule out neurodegenerative diseases.

Signs you should look for:

The major symptoms of Pseudodementia includes:

• The affected person often feels difficulties with memory, including trouble recalling words or remembering general information.
• When someone feels impairments in speech, such as significant fluency decrease, slowed speech, or trouble finding words, that can be a sign .
• One may feel significant problems with attention and concentration, finding it hard to focus or switch between tasks.
• One serious concern takes place if suddenly one sees the deficits in executive functions like decision-making, planning, organizing, and completing tasks. It instantly leads to more stress and self-doubt.
• Emotional symptoms of depression commonly coexist, including persistent sadness, loss of interest in activities, social withdrawal, fatigue, changes in appetite and sleep patterns, and feelings of guilt or worthlessness.
• During cognitive testing, they may say “I don’t know” rather than guessing answers, which is different from dementia patients who often guess wrong.
• Here the person’s cognitive performance can fluctuate depending on mood and psychological state, instead of showing steady decline as seen in organic dementia.

How we get it wrong

Pseudodementia is frequently misdiagnosed as true dementia because of overlapping symptoms. However, distinguishing between the two is essential as their treatments differ dramatically. Patients with organic dementia typically exhibit gradual and progressive cognitive decline along with poor attention and a lack of awareness or concern about their deficits. In contrast, pseudodementia often presents with sudden fluctuating symptoms, intact attention, and a high degree of awareness and distress about cognitive difficulties. Here the person is aware of the fact that they are losing what it used to be different before

How early medication and treatment can save you:

Early stage identification of Pseudodementia showcases higher chances of getting back what looks like ‘lost’ as it’s a reversible condition . Effective treatment of pseudodementia centers on addressing the underlying psychiatric condition, primarily depression. Pharmacologic therapies such as selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants (TCAs), and newer agents like vortioxetine have shown improvements in both mood symptoms and cognitive dysfunction. Non-pharmacological interventions including cognitive behavioral therapy, lifestyle modifications, and psychosocial support form an integral part of treatment and patients see a significant improvement on their mental health related issues as well. Early initiation of these therapies can lead to cognitive recovery and often full reversal of pseudodementia symptoms. Careful monitoring is recommended to identify any progression toward organic dementia, especially in elderly patients.