Ask a doctor on the topic of Neurology

Pseudo-dementia

June 27, 2012 | 15,00 EUR | answered by Dr. med. Ive Dr. Schaaf

My mother (70) has been confused for about 3-4 years. She had atrial fibrillation for years (since 2001) and would receive infusions. Most of the time she could leave the hospital the next day. It was noticeable that after these infusions she was particularly confused and this condition worsened each time. Three years ago she had a thrombosis in her eye, which was treated with blood thinners intravenously for a whole week. Since then, she has been psychotic, completely confused, and suffers from paranoia. Sometimes it's better, sometimes it's very bad.

However, she is so forgetful that she no longer recognizes her own home when she wakes up. When she is in my apartment, she thinks it is hers. Sometimes she doesn't remember who I am and thinks I'm her sister, searching for her little daughter. She no longer knows my date of birth. She constantly asks what day it is and when her caregiver (for almost 2 years) will come back and bring her money. She complains that she has been declared incompetent. However, she went to the doctor herself and asked for help because she is so confused that she can no longer manage on her own. She can't remember what she ate 5 minutes ago, but she holds on to things that never happened. Unfortunately, she also tells others about these things and makes me look bad. However, she can still articulate well and if asked to draw a clock, she does it perfectly in no time.

Now my question is: The treating psychiatrist believes that my mother "... has a serious mental problem." It is not dementia, it is a pseudo-dementia. However, the confusion and forgetfulness seem very pronounced to me, to be explained with pseudo-dementia.

The caregiver is unfortunately not much help, she is rude and short. When my mother at the beginning of the care told nonsense and claimed that I was using her account, she threatened me with involving the district court. It should be noted that she left this message on my voicemail, without introducing herself and asking me if this was even true.

My mother wants to go to a nursing home. However, with the diagnosis of pseudo-dementia, according to the caregiver, she is not eligible for social welfare contributions regarding the nursing home costs.

Could it actually be pseudo-dementia, a psychosis as part of a severe depression?

Thank you in advance and best regards
A.Z.

Dr. med. Ive Dr. Schaaf

Hello,

First of all, here is an explanation of what is understood by pseudodementia.
http://www.neuro24.de/show_glossar.php?id=1386

It is not denied that dementia exists, but it is not seen as the sole problem, which seems to be correct based on your description. It sounds like not only dementia, but also psychosis, indicating a personality disorder.
Ultimately, it doesn't really matter what the illness is called, as long as it is treated correctly. In this case, it is more favorable if it is not just dementia, as dementia is difficult to treat with medication. It can slow down the progression, but not reverse it. Psychoses, on the other hand, can be effectively treated with medication, giving hope for improvement in this case.
It seems like you are not comfortable with the psychiatrist you are seeing. Since you have the right to a second opinion, why not consider seeing a neurologist with your mother? That would be the appropriate specialist to consult.

Is everything clear or do you have any questions?

All the best, Dr. Schaaf