A 70-year-old retired teacher presents with a 3-month history of poor memory, inability to concentrate, loss of interest in activities, and weight loss. His Mini-Mental State Examination (MMSE) score is 22/30. He states he 'cannot remember anything' and makes no attempt during memory testing. Previous function was normal. His GDS-15 score is 12. What is the most likely diagnosis?
- A Depressive pseudodementia ✓
- B Alzheimer's dementia
- C Vascular dementia
- D Mild Cognitive Impairment (MCI)
Explanation
Depressive pseudodementia (more accurately termed 'Depression-related cognitive impairment') presents with apparent cognitive decline that is reversible with antidepressant treatment. Key differentiating features from true dementia include: rapid onset (weeks–months), prominent subjective distress about cognitive failures, 'don't know' responses (rather than near-misses), and diurnal variation. The high GDS-15 score (>5 is significant) strongly supports depression. MMSE may be mildly reduced, but improvement after 4–6 weeks of antidepressant therapy confirms the diagnosis. Alzheimer's typically shows a more insidious, progressive decline with preserved insight initially.
Reference: Kaplan & Sadock's Synopsis of Psychiatry, 11th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.