Is it dementia? Understanding 'pseudo-dementia' in the elderly

Yeongcheol, an 80-year-old man living with his wife, began experiencing a decline in his well-being. He lost his appetite, felt listless, and found his daily walks burdensome. A particularly distressing incident occurred when he greeted a neighbor he had known for decades but couldn't recall the person's name, leading to significant discomfort and a growing reluctance to engage socially.

“

Perhaps the father has dementia?

His children, intending to gift him a modern lifestyle, replaced his old flip phone with a smartphone and upgraded their home appliances to the latest models, including a smart TV, robot vacuum, and dishwasher. Yeongcheol found these new devices overwhelmingly complex. He struggled to make a simple phone call and was intimidated by the multiple remote controls for the television. An accidental press of a button activated the robot vacuum, which startled him, and another remote initiated the dishwasher, causing him further anxiety. He felt trapped in his own home, surrounded by unfamiliar technology.

When his children and wife returned, Yeongcheol reacted with anger, expressing frustration with the new devices and a preference for his old, simpler belongings. His children were confused, having intended the gifts as a gesture of care. His wife, however, recognized a pattern in his recent behavior, recalling his loss of energy, appetite, and his distress over forgetting names. This led the family to seek medical advice, fearing he might have dementia.

“

Cognitive flexibility is the brain's ability to quickly and flexibly switch one's thoughts and actions according to changes in situation or environment.

Diagnostic tests revealed that Yeongcheol's overall cognitive functions, including memory, calculation, and language abilities, were within the normal range for his age. He was not suffering from dementia. Instead, the diagnosis pointed to "pseudo-dementia," a condition where symptoms mimic dementia but are caused by underlying issues like geriatric depression, resulting in a decrease in "cognitive flexibility." This is the brain's ability to adapt thoughts and behaviors to changing situations.

“

Pseudo-dementia refers to a state where cognitive function impairments, such as memory loss, are observed, similar to actual dementia, but without structural damage to the brain.

To help Yeongcheol overcome pseudo-dementia and geriatric depression, the focus is on restoring his sense of control and self-esteem. This involves gradually introducing new technology, starting with simple functions like making calls on the smartphone and using a single, large-button TV remote. Re-establishing his confidence in managing his environment is paramount. Additionally, medical treatment for his depression and efforts to regain physical vitality are crucial. This includes a nutritious diet and exposure to sunlight to regulate his biological rhythms. Family support is also vital, with loved ones accompanying him on walks to help him reconnect with neighbors and ease his social anxieties.

“

It is important to restore the self-esteem that allows the elderly to feel in control of things with their own hands, starting with simple tasks.