Serious memory loss is not a normal part of aging. It also may not be Alzheimer’s or dementia, but a reversible condition. If a loved one is having worrisome symptoms, a complete medical and neuropsychological evaluation needs to be made quickly. Many of these conditions can be treated. (Dementia is a series of symptoms which can have many causes. Alzheimer’s is a specific much-feared disease with dementia symptoms.)
1. Medication Reactions – Reactions to a specific drug, or combinations of several, can cause confusion and poor functioning. Many prescription drugs can cause these side effects, including drugs used for treating other diseases such as the following:
- Parkinson’s disease
- Irritable bowel syndrome
- Sleep difficulties
Over-the-counter drugs that could cause dementia-like symptoms include:
- Hay fever treatments
- Cold and flu medicines
- Sleeping pills
- Anti-diarrhea treatments
- Herbal and other alternative medicines
In addition, taking too much or too little of prescribed medications, or combining certain medications, can cause adverse side effects.
2. Brain Tumors – The first symptoms of slow-growing tumors frequently resemble dementia, especially in older people. Removal of the tumor may remove the problem. (Fast growing cancerous tumors are a different matter.)
3. Hydrocephalus (“water on the brain”) is an excess of cerebrospinal fluid around the brain, sometimes but not always, resulting from a blow to the head, brain hemorrhage, or meningitis (inflammation of the membrane covering the brain). However, most cases seem to occur spontaneously without an obvious preceding illness. In addition to appearing to develop dementia, people lose bladder control and walk in a slow, hesitant manner, as if their feet are stuck to the floor. Caught soon enough, a surgically implanted tube from the brain or the abdomen can bring rapid improvement.
4. Subdural hematoma – A blood clot in between the brain surface and the thin membrane that covers it. Most subdural hematomas are caused by severe head trauma sustained in automobile crashes. The effect often mimics aspects of Alzheimer’s. Untreated, they are life-threatening, causing coma and death.
5.Thyroid Issues – Hyperthyroidism is an overproduction of thyroid hormones and commonly caused by Graves’ disease, resulting in dementia-like symptoms. Surgically removing the thyroid or destroying it with radioactive iodine usually corrects the cognitive problems.
Hypothyroidism is a severe underproduction of thyroid hormones usually resulting from Hashimoto’s thyroiditis disease. Physicians usually recommend thyroid hormone replacement, but this treatment doesn’t always reverse the dementia in older people. It’s important to catch it early.
6. Dehydration. As they lose the ability to feel thirst, seniors are especially susceptible to dehydration which is very easily overlooked as a problem. Dehydration itself can cause confusion.
7. Vascular dementia – Tiny strokes which often go unnoticed, because each one damages just a small part of the brain and doesn’t cause long-term impairment. However, multiple strokes can cause cumulative damage which can lead eventually to large areas of dead brain tissue, and symptoms such as confusion, impaired thinking, slurred speech, and paralysis may arise.
8. Alcoholism – Excessive alcohol for a significant period of time can also cause impaired thinking that resembles Alzheimer’s disease including memory loss, disorientation, and attention deterioration, although verbal skills are not always severely affected. Abstaining from alcohol may partly or fully restore mental functioning.
9. Metabolic disturbances – Confusion and appetite, sleep and emotional changes can be caused by medical conditions including renal and liver failure, electrolyte imbalances (blood chemistry levels), hypoglycemia (low blood sugar), hyperglycemia (high blood sugar), and diseases of the liver and pancreas.
10. Depression – Life changes from retirement, loss of spouse, family or friends can cause apathy, inattention and lack of self care which appear dementia-like. Psychiatric treatment and medication can restore functioning.
11. Infections – Confusion, attentional deficits and generalized severe disorganization of behavior can be signs of infections originating elsewhere but affecting the brain. 10-20% of all hospitalized adults, and 30-40% of elderly hospitalized have infections. Urinary tract infections (UTIs, including upper and lower symptomatic) are the most common infections in nursing homes.
Pneumonia may also cause these symptoms. The unlikely Connection Between UTIs and Dementia How to Avoid The Urinary Tract Infection
Confusion can also result from fever or other side effects of the body’s attempt to fight off an infection. Examples include meningitis and encephalitis, untreated syphilis and Lyme disease. Some conditions cause a completely compromised immune system, such as leukemia. Great pain and consequent disorientation from tooth and mouth infections is fairly common in nursing homes. Dental issues and mouth hygiene are frequently ignored as part of patient care.
12. Nutritional Deficiencies – Deficiencies of B vitamins (folate, niacin, riboflavin and thiamine) can produce cognitive impairment.
Actual diagnosis of Alzheimer’s is quite uncertain at this point and treatment is limited so it’s very important to be sure it’s not another treatable condition instead. The more quickly another condition is identified and treated, the more quickly and likely the person can be restored to normal functioning.
Sources for additional information:
Genetic Health – Alzheimer’s
Comfort Keepers, Memory Loss: When Is It Normal? When Is It Not?
Mayo Clinic – Dementia Causes
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