Sudden Worsening Of Dementia Symptoms
Whether youve been diagnosed with dementia yourself or are caring for someone who has, a sudden change in symptoms, such acute confusion, memory loss, or delirium can be really worrying. In this guide we talk about some of the lesser known reasons why symptoms can get worse in a short space of time, and what to do about it.
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According to Alzheimers Research UK, one in every two people will know someone affected by dementia, and you dont have to personally receive a diagnosis for it to have a big impact on your daily life. Seeing a loved one go through cognitive decline is never easy, especially if they seem to be progressing fairly quickly through the different stages of dementia.
Its important to remember that while there are three recognised stages of dementia, symptoms will vary from person to person, which can sometimes give the impression that the condition is progressing faster than it actually is. For example, some common symptoms may occur earlier than expected, while others will fail to occur at all. Some behaviours, such as emotional outbursts, or feeling depressed can come and go too.
And, while dementia is progressive, a sudden or unexpected change in behaviour, mood or memory wont always mean that its the condition itself getting worse. There are a number of other health conditions that can make symptoms worse, which well cover in this guide too.
Common Forms Of Dementia
There are many different forms of dementia. Alzheimer’s disease is the most common form and may contribute to 60-70% of cases. Other major forms include vascular dementia, dementia with Lewy bodies , and a group of diseases that contribute to frontotemporal dementia . Dementia may also develop after a stroke or in the context of certain infections such as HIV, harmful use of alcohol, repetitivephysical injuries to the brain or nutritional deficiencies. The boundaries between different forms of dementia are indistinct and mixed forms often co-exist.
Rapid And Unexplained Mood Swings And/or Depression
Mood and personality changes can be associated with early signs of dementia. This could include becoming confused, suspicious, depressed, fearful or anxious, and your parent may find themselves getting easily upset in places they feel unsure about.
Some of the dementia symptoms NHS lists include:
- Increased anxiety
- Depression
- Violent Mood Swings
For example, your parent may appear calm, then visibly upset, and then very angry in a matter of minutes. This is a significant sign of dementia anger and frustration specifically if its unprovoked.
Other physical signs include pacing, obsessing over minor details, agitation, fear, confusion, rage and feeling overwhelmed because theyre trying to make sense of a world thats now confusing to them.
This is different to: more typical age-related behaviours such as becoming irritable when a routine is disrupted.
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Decreased Or Poor Judgement
Changes in decision-making or judgement might include dealing with money or paying less attention to keeping clean and groomed. This can be one of the more obvious parts of your observation list for early signs of dementia.
Look out for signs that your parent might not be looking after themselves the way they used to. They may forget to wash regularly, wear the same clothes continuously throughout the week, forget to brush their teeth, forget to brush their hair, shave or to visit the toilet.
Its vital to make sure your parent is keeping up with any regular appointments they may have. Make sure theyre keeping up with their health and hygiene routines with our guide to Keeping Healthy.
This is differentto: making a bad decision once in a while.
Changes In Behaviour Judgement And Moods
Becoming quiet, withdrawn or restless or frustrated or angry can be early signs of dementia. Someone may develop repetitive behaviour for example, they ask the same question over and over again, do the same thing repeatedly or make multiple phone calls to the same person. They may become insecure and anxious or start hiding and losing items. They may withdraw from social activities or give up hobbies and interests they have enjoyed.
They may show poor judgement, for example putting summer clothes on in cold winter months, not knowing when a kettle is full or overfilling cups when making cold and hot drinks, putting a kettle on the hob or leaving a cooker on or tap running. Someone with dementia may become very emotional and experience rapid mood swings or become quieter and less emotional than usual.
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Conditions With Symptoms Similar To Dementia
Remember that many conditions have symptoms similar to dementia, so it is important not to assume that someone has dementia just because some of the above symptoms are present. Strokes, depression, excessive long-term alcohol consumption, infections, hormonal disorders, nutritional deficiencies and brain tumours can all cause dementia-like symptoms. Many of these conditions can be treated.
How Is Dementia Diagnosed
To diagnose dementia, doctors first assess whether a person has an underlying, potentially treatable, condition that may relate to cognitive difficulties. A physical exam to measure blood pressure and other vital signs, as well as laboratory tests of blood and other fluids to check levels of various chemicals, hormones, and vitamins, can help uncover or rule out possible causes of symptoms.
A review of a persons medical and family history can provide important clues about risk for dementia. Typical questions might include asking about whether dementia runs in the family, how and when symptoms began, changes in behavior and personality, and if the person is taking certain medications that might cause or worsen symptoms.
The following procedures also may be used to diagnose dementia:
Early detection of symptoms is important, as some causes can be treated. However, in many cases, the cause of dementia is unknown and cannot be treated. Still, obtaining an early diagnosis can help with managing the condition and planning ahead.
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Are Early Signs Of Dementia Obvious
Changes in a person in the early stages of dementia can be so gradual they can often be mistaken for normal ageing. Because dementia affects people in different ways, symptoms may not always be obvious. In fact, failure to recognise early signs often leads to people not being diagnosed for several years.
So what to look for? Perhaps someone you care for is struggling to remember what they did yesterday and forgets the names of friends or everyday objects. They may have difficulty following conversations or TV programmes, repeat things over and over, or have problems thinking or reasoning. They may feel angry, anxious or depressed about memory loss or feel confused even in a familiar environment.
The healthtalk website presents a range of carers experiences of identifying the early signs of dementia. One carer put it this way.
The first stage is not recognisable I think, or certainly wasnt recognisable as far as I was concerned initially . I was certainly not understanding… the fact that my wife was at the beginning of a serious problem, a serious mental health problem. Because I was with my wife continuously, I think I was less likely to recognise some of the changes that were taking place than people who saw her less regularly.
Psychological Changes For Dementia Patients
- Changes in mood: Frequent mood swings, increased sensitivity to change, and increased anxiety and agitation.
- Personality changes: Loss of interest in previously enjoyed activities and sometimes completely changed personality and behaviors.
- Hallucinations or paranoia: In later stages of dementia, sufferers may believe that even close friends or family are dangerous or “out to get them”.
- Neglecting safety, personal hygiene, exercise, or nutrition. May display decreased judgement skills involving money, like careless purchases or giving away large sums of money.
- Socially inappropriate behavior: Making rude or explicit sexual comments publicly or to strangers.
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Dementia Symptoms To Watch For
Here are some of the warning signs identified by dementia experts and mental health organizations:
Difficulty with everyday tasks. Everyone makes mistakes, but people with dementia may find it increasingly difficult to do things like keep track of monthly bills or follow a recipe while cooking, the Alzheimers Association says. They also may find it hard to concentrate on tasks, take much longer to do them or have trouble finishing them.
Repetition. Asking a question over and over or telling the same story about a recent event multiple times are common indicators of mild or moderate Alzheimer’s, according to the Cleveland Clinic.
Communication problems. Observe if a loved one has trouble joining in conversations or following along with them, stops abruptly in the middle of a thought or struggles to think of words or the name of objects.
Getting lost. People with dementia may have difficulty with visual and spatial abilities. That can manifest itself in problems like getting lost while driving, according to the Mayo Clinic.
Personality changes. A loved one who begins acting unusually anxious, confused, fearful or suspicious becomes upset easily or loses interest in activities and seems depressed is cause for concern.
Troubling behavior. If your family member seems to have increasingly poor judgment when handling money or neglects grooming and cleanliness, pay attention.
People with mild cognitive impairment are at an increased risk of developing dementia.
What Should I Do If I Think My Parent Has Dementia
If you think your parent or another relative has dementia, follow these steps to help improve their health and well-being.
- Trust your instincts. If youre seeing unusual behaviors in your family member, jot down the symptoms, when they present, and how often they occur. Think about changes youve noticed over the past few years.
- Learn the signs of dementia. Educating yourself about various symptoms will help you know what to look for. It can also help rule out reversible conditions sometimes mistaken for dementia, such as delirium.
- Talk to your parent. Its important to share concerns with them before more symptoms occur. Decide how youll begin the conversation. Recognize that it might not go as planned. Above all, be respectful and offer your support.
- Talk to a doctor. Reaching an earlier diagnosis will set your loved one on a path to better care and treatment options. Be honest and upfront with the doctor about the symptoms youve noticed.
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Other Types Of Dementia
Other progressive forms of dementia include frontotemporal dementia, Lewy body dementia, and vascular dementiaand it’s also possible to have a combination of dementia types.
Frontotemporal Dementia
With frontotemporal dementia, nerve cells in the parts of the brain involved in behavior, communication, and personality begin to degenerate. Thus, people with this condition typically have symptoms that impact their behavior, reasoning, communication, and/or movement.
Lewy Body Dementia
In Lewy body dementia, wads of protein accumulate in the brain. These proteins can also be found in patients with Parkinson’s and Alzheimer’s diseases. People with this form of dementia might hallucinate, have trouble concentrating, or experience physical coordination and movement difficulties.
Vascular Dementia
Vascular dementia is second only to Alzheimer’s in its prevalence in people with dementia. It occurs due to problems with the blood vessels that involve the brain. While people with this form of dementia may have difficulty recalling, their most obvious symptoms are likely to be trouble with organization, reasoning, concentration, and thinking quickly.
Signs Of Mild Alzheimers Disease
In mild Alzheimers disease, a person may seem to be healthy but has more and more trouble making sense of the world around him or her. The realization that something is wrong often comes gradually to the person and his or her family. Problems can include:
- Memory loss
- Poor judgment leading to bad decisions
- Loss of spontaneity and sense of initiative
- Taking longer to complete normal daily tasks
- Repeating questions
- Increased sleeping
- Loss of bowel and bladder control
A common cause of death for people with Alzheimers disease is aspiration pneumonia. This type of pneumonia develops when a person cannot swallow properly and takes food or liquids into the lungs instead of air.
There is currently no cure for Alzheimers, though there are medicines that can treat the symptoms of the disease.
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Forgetting How To Do Everyday Tasts
Your parent may start to find it hard to complete daily tasks, these might include the setting of a table, driving to a familiar location or remembering the rules of their favourite game.
Forgetting how to do everyday tasks or memory loss can be spotted in-person or by completing a Self-Administered Gerocognitive Exam an early signs of dementia test which can be taken online.
However, this shouldnt be used as an official diagnostic tool you should always seek the advice of a GP. Other examples of forgetting how to do simple everyday tasks can include:
- Closing the fridge door
- Making a cup of tea or coffee
- Locking / closing the front door
- Managing a budget
Your parent may start to find it difficult to complete tasks they used to be able to do with ease. For example, if they used to be a fantastic baker, they may now find it hard to bake the sponge cake theyve made over and over again.
This is different to: more typical age-related forgetfulness such as needing help to record a tv programme or how to use the settings on a microwave oven.
What Can I Expect If I Have Dementia
Getting a diagnosis of dementia is certainly difficult to hear. Several types of dementia arent reversible. Others are a side effect of other serious diseases. Some dementia-like symptoms are due to conditions that can be treated and reversed.
Your healthcare team, which will probably include a neurologist and/or a geriatric-psychiatrist or a geriatrician, will order the needed tests to make the correct diagnosis. The medications available today focus on slowing the decline.
The goal is to maintain your or your loved ones quality of life. Some people with Alzheimers dementia can live up to two decades, but each person has their own unique course. Researchers continue learning about the mechanisms that cause dementia and testing different methods to slow, and someday, hopefully, cure this disease.
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What Happens In The Early Stage Of Dementia
Dementia affects everyone differently and early symptoms are often relatively mild and not always easy to notice.
Many people at the early stage of dementia stay largely independent and only need a bit of assistance with daily living. It is important to focus on what the person can do and not to take over and do things for them. Instead, try doing things with them, for example helping the person develop a routine, reminder lists and prompts, and use technology.
For more information for people living with dementia, see the ‘Keeping active and involved‘ page.
The early stage of dementia is when many people choose to make plans for the future, while they still have the ability to do so. This includes making a Lasting power of attorney , and advance decisions and advance statements to ensure their wishes and preferences are made clear.
Loss Of Daily Life Skills
A home that may not be as well kept as usual may be a sign that the person living there has dementia. They may lose the ability to do many of the things they normally do themselves, such as preparing meals, household chores and eating and drinking properly.
They may also struggle to maintain their personal hygiene and getting dressed. Deciding what to wear, how to put things on and in the right order may become increasingly difficult. Getting around the house without walking into furniture and other items may also be a problem.
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What Are Lewy Body Creutzfeldt
- Lewy body dementia/Lewy body disease is caused by Lewy bodies, which are abnormal clumps of certain proteins, accumulating inside of neurons. Forgetfulness and other signs of cognitive decline are the primary features of this condition, but patients can also develop prominent hallucinations which seem very real to them. Some patients with Lewy body disease develop symptoms that look like Parkinson’s disease, such as tremors and slowness.
- Creutzfeldt-Jakob diseaseis a rare condition where an abnormal protein leads to the destruction of brain cells and dementia. While most cases occur without an underlying cause, in some patients there is a family history of this disorder. Even less often, patients might be exposed to the abnormal protein. Mad cow disease is one example of external exposure. This condition tends to progress rapidly, over only a few years and is often associated with abnormal muscle movements.
- Mixed dementia refers to patients who have evidence of two types of dementia. They are often described as having mixed dementia. Alzheimer’s disease and vascular dementia are the most common causes of mixed dementia.
What Are The Signs And Symptoms Of Dementia
Signs and symptoms of dementia result when once-healthy neurons, or nerve cells, in the brain stop working, lose connections with other brain cells, and die. While everyone loses some neurons as they age, people with dementia experience far greater loss.
The symptoms of dementia can vary and may include:
- Experiencing memory loss, poor judgment, and confusion
- Difficulty speaking, understanding and expressing thoughts, or reading and writing
- Wandering and getting lost in a familiar neighborhood
- Trouble handling money responsibly and paying bills
- Repeating questions
- Not caring about other peoples feelings
- Losing balance and problems with movement
People with intellectual and developmental disabilities can also develop dementia as they age, and recognizing their symptoms can be particularly difficult. Its important to consider a persons current abilities and to monitor for changes over time that could signal dementia.
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