Depression in the elderly, dementia or pseudodementia
Keywords:
aged, dementia, depression, feigned disordersAbstract
Introduction: depression in old age, if not properly diagnosed and treated, causes unnecessary suffering in the elderly and their family. In daily clinical practice, it is common to find a type of patient who gives the impression of suffering from primary dementia, when in reality they have an affective disorder, depression.
Objective: to describe the clinical characteristics that define the diagnosis of depression in older adults, dementia and depressive pseudodementia, differential diagnosis and treatment.
Methods: more than 70 sources were located from the national and international bibliography and 25 studies were selected that addressed the topic in greater depth, with updates between 2017 and 2020. In addition, the international classifications of the American Psychiatric Association in its 5th edition and the International Classification of Diseases, among other sources of information, were examined.
Development: depression is probably the psychiatric disorder most frequently confused with dementia. Clinical samples indicate that between 30 and 50 % of patients with cognitive impairment present depressive symptoms. Elderly patients with major depressive episodes without dementia usually present cognitive deficits that also worsen general functioning.
Conclusions: the similarity of symptoms between dementia and depressive pseudodementia leads to diagnostic difficulties. The early identification of depression in older adults from primary care and its relationship with cognitive impairment and dementia requires timely diagnosis and appropriate treatment to contribute to better resilience at this stage of life.
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