Mimicking Dementia

Helpful Highlights

• There are many conditions that can impact cognition (mental processes). Symptoms are not always a sign of dementia.

• Before diagnosing dementia, a provider will rule out other possible causes of cognitive problems.

• If there is an underlying cause that can be resolved, then the cognitive symptoms may disappear, as well.

• If you suspect dementia, don't guess or self-diagnose, consult a provider.

Dementia is a chronic condition that brings about progressive loss in thinking, remembering, and reasoning. As it progresses, various odd and even irrational beliefs and behaviors can appear. Some are confusing, some repetitive, and some are completely opposite of who we know our loved one to be. Additionally, dementia causes changes in sleeping, eating, toileting, and communication.

So, can signs and symptoms commonly associated with dementia be caused by conditions other than dementia? Most certainly.

Infection

Aging and decreased activity can weaken the immune system, making older adults more vulnerable to infections like urinary tract and pneumonia. Because these can go undetected for several days, symptoms can be severe when they appear - lethargy, confusion, irritability, and an inability to care for oneself. Oftentimes, when the infection is resolved, the mental and behavioral symptoms also disappear.

Malnutrition or dehydration

Without a proper diet and plenty of fluids, the body is unable to produce the necessary cells to maintain health, which includes red blood cells that carry oxygen and nutrients to the organs and muscles. Likewise, electrolyte imbalances affect brain, heart, and kidney function. The resulting symptoms can be confusion and trouble communicating, tremors, and bladder and bowel difficulties. These poor conditions can also make the body a haven for infection.

Hypoxemia

This is the medical term for a lack of oxygen. Oxygen is essential for all body functions, and the brain uses most of it. Cardiovascular issues and shallow breathing common in the elderly can reduce available oxygen, and not enough oxygen to the brain can produce difficulty concentrating, forgetfulness, and agitation.

Medications

Older adults metabolize some medications much slower, which can result in a build-up of drugs in their system. An excess of pain medications, psychotropic drugs, or anti-anxiety agents can cause symptoms such as hallucinations and delirium.

Depression

Untreated depression can become severe and result in restlessness and wandering, confusion and irritability, and even paranoia. It definitely affects eating, sleeping, and socialization.

Other conditions

Other conditions that can mimic dementia symptoms are lack of sleep, transient ischemic attacks (mini-strokes), and head injury. We think we would certainly know if these things happened, though they go undetected all the time, even with the most involved caregivers.

See a provider

If you suspect that your loved one may be developing dementia, and the symptoms aren’t emergent, make an appointment for you both to talk to their primary care provider as soon as possible. Their provider will help you determine if it’s dementia or possibly something else. If the symptoms require immediate attention, say if your loved one seems very sick or is at risk of hurting themselves, consider going to the emergency department for evaluation.