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  • Print publication year: 2000
  • Online publication date: January 2010

12 - Depressive pseudodementia

from Part II

Summary

The memory lapses often recorded in elderly depressed patients with depressive pseudodementia reflect true cognitive difficulties. Sometimes associated with soft signs, and sometimes contrasted with cognitive impediments seen in patients whose 'subcortical' disease (e.g. progressive supranuclear palsy) primarily affects frontostriatal systems,this reversible dementia is thought to compromise memory primarily by disrupting accessory behaviours (e.g. attention) that are necessary to engage/maintain mnestic activity. Directly relevant to the question of pseudodementia is the research seeking to plot normal cognitive ageing in terms of functional competence, neuropsychological performance, neuroradiological correlates, etc. and how 'non-harbiger' conditions of age-related cognitive decline (DSM4) or age-associated memory impairment (AAMI) differ from dementia. It is still unclear how profiles on cognitive diagnostics can be shown to reliably distinguish between reversible and irreversible patients, and whether such profiles can be used to avoid misclassifying other depressed patients in preclinical stages of Alzheimer's disease (AD).