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Dementia Expert Series, Normal Aging or Dementia? Dementia Expert series

Are you having trouble telling the difference between normal aging and dementia?  Ask our expert Sarah Lock.  She is Senior Vice President for Policy and Brain Health in AARP’s Policy, Research and International. She leads policy initiatives on brain health and care for people living with dementia and is Executive Director of the Global Council on Brain Health, an independent collaborative of scientists, doctors and policy experts convened by AARP to provide trusted information on brain health.

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My 85 year old Mother-in-law’s stories are continuing to escalate. I have known her for 25 years and she has always been a creative story-teller, frequently embellishing, but with a core of truth. Now her stories are more outlandish every day. This week she told me she had written documentation that proved her husband had portions of his brain missing. She described detailed medical write-ups and proceeded to tell me that they were specific to driving and navigating in a car. I’m am the caretaker for both and know this is both impossible and untrue. Does this sound like dementia? 

 

 

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@RobyneR472196 wrote:

My 85 year old Mother-in-law’s stories are continuing to escalate. I have known her for 25 years and she has always been a creative story-teller, frequently embellishing, but with a core of truth. Now her stories are more outlandish every day. This week she told me she had written documentation that proved her husband had portions of his brain missing. She described detailed medical write-ups and proceeded to tell me that they were specific to driving and navigating in a car. I’m am the caretaker for both and know this is both impossible and untrue. Does this sound like dementia? 

 

 

Hi RobyneR,

Sounds a bit like delusions. As in, making up stuff that's untrue, and why... that would be the question. One of the odd things about being old is that a simple thing like a urinary tract infection can have serious mental health effects, weirdly. The UTI is cleared away by antibiotics and whoosh, back to normal. Is she making up stories about her husband because she's afraid to be in the car while he's driving? 

 

You could take her to the doctor and tell her/him before hand (drop off a note a couple of days before the appointment, say) that she's making up wild stories, and the doctor can then be on the lookout for strange cognition, and maybe do a simple test during the visit called a mini mental status exam. That test would show cognitive decline. But it won't show delusion, which is a psychiatric issue. 

 

Are there other stories and behaviors that are disturbing and out of the usual? She certainly has a creative mind! Tell us more?

Jane


 

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Hello-My MIL I highly educated and intelligent. However she has always ‘embroidered’ her tales about (but I’ve found the nugget of truth in them’. Here are some Examples:

 

1. An overweight student teacher she knows was required to weigh in before class (the school 

     told him he was too large to teach)

2. One of the Universities here requires students to order their food using only sign language.

3. The Duchess of Sussex’ father wn]ent to London. Knocked on the door of Buckingham Palace

     and demanded to see the queen. 

4. A couple she knows was refused a divorce ( in court) by the judge. He told them they must stay 

     together (the woman has been physically abused by the man). 

5. She has a multitude of physical maladies (they are truly the sort of thing that eveyone has, arthritis 

     in the knees, deteriorated hearing, dry skin etc) they are all elevated into unique illnesses that are 

      rare. (I take her to her Medi-Cal a;point,ents and she’s actually very sturdy). 

6. She had a growth removed from inside her nasal cavity, she refers to it as her brain tumor. 

It’s my belief she needs much more attention than she receives somresorts to the embellished takes to create more interest. Last week she told me her bank manager was extremely rude to her over the phone. It didn’t happen. 

Im just trying tune it out. She is a lovely and generous, kind person. 

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@RobyneR472196  As @JaneCares mentioned -there could by numerous reasons for this behavior - but it sounds like something could be amiss. I have had family members who are really good at telling stories - my sister was so funny - she could make us believe just about anything. Some of the examples you've given us sound like they could be a step beyond storytelling and attention-grabbing. Consider a thorough evaluation by her doctor. She may need an evaluation from a neurologist and/or geriatric psychiatrist. If nothing else, it helps to have a baseline cognitive evaluation. 

 

IF (and I do mean if - don't assume anything) she does have a health condition causing this behavior (whether it is dementia or another cognitive or brain impairment, depression, isolation etc.), it's very important to get an early evaluation. There are things that can be done to manage situations and symptoms and to be better prepared for future care. 

 

Hopefully, she's just a good story teller! But if it's a health condition that is affecting her cognition, it is always better to understand what is happening. This article, 8 Treatable Conditions that can be Mistaken for Alzheimer's Disease, has very helpful information too - often there are other health conditions that mimic dementia. 

 

Please keep us all posted! 

 

Take care,

Amy Goyer, AARP Family & Caregiving Expert

Author, Juggling Life, Work and Caregiving and

Color Your Way Content When Caring for Loved Ones

 

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My husband seemed to show symptoms of memory loss.  I took him in to be checked for dementia or alzheimer,  but due to his severe dyslexia they  were unable to give me a definitive answer. it is very hard to test when he can not read and write beyond a third grader.  I have located a tutor to work with him on improving his reading.  social worker who did the testing said no.  But our doctor said maybe.

he works full time at work with no problems.  I feel like he demonstrates some type of a mental disfunction.  unsure whether it is dementia.  can you give me some advice.

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@cw47629412 wrote:

My husband seemed to show symptoms of memory loss.  I took him in to be checked for dementia or alzheimer,  but due to his severe dyslexia they  were unable to give me a definitive answer. it is very hard to test when he can not read and write beyond a third grader.  I have located a tutor to work with him on improving his reading.  social worker who did the testing said no.  But our doctor said maybe.

he works full time at work with no problems.  I feel like he demonstrates some type of a mental disfunction.  unsure whether it is dementia.  can you give me some advice.


Hi there, CW. Goodness. I'm thinking that there are other ways to test for dementia besides reading. There's a Literacy Independent Cognitive Assessment that i found out about just by googline 'test for dementia literacy.'  Here's the link: 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4504916/.   Print out this article. Give it to the doctor AND the social worker. And make them get on this thing. Jeeeez. 

 

On the other hand... if he's doing his job well, what makes you think he has dementia? or, rather, memory loss? might be normal aging...

 

While you two are trying to figure this out, go for a walk together? Exercise helps prevent dementia...

 

Please write back and tell us what happened next...

 

Jane

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My 97 year old dad has become confused and agitated in a fairly short period of time. Is this just a part of Dementia setting in?

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@lm20366758 wrote:

My 97 year old dad has become confused and agitated in a fairly short period of time. Is this just a part of Dementia setting in?


Something that comes on that suddenly might mean many things but the first piece of advice is to take him to his primary care provider. It might be a urinary tract infection, believe it or not. It could be any other kind of infection, too. It could be a new medication or an interaction, including a new supplement or herb that he decided to take. Could you tell us more? Especially about the agitation. That is worrisome.

 

Jane

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@lm20366758 @JaneCares 

 I totally agree with Jane -- my mom started getting urinary track infections in her mid 80s relatively frequently and her behavior would change to be confused and agitated, which would resolve as soon as she got the infection controlled with antibiotics.  Not saying that is your dad's issue, but getting him checked out for underlying cause in the change of behavior is important.  It is estimated that half of people 85 and older have some form of dementia symptoms so it's not unusual.  The sooner you get him checked out the better.  Sarah

Sarah Lenz Lock, AARP Expert Brain Health
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I seem to be experiencing a loss of comprehension in reading and in conversation.  Sound like demetia?

 

Frank

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@StuartR890144

Hi Frank,

 

If you are worried about your ability to comprehend information in reading and conversation, you should definitely talk to your family health care provider. But part of comprehension is focus and memory.  Lots of people as they age lose some of their ability to maintain focused attention, experience memory loss, or find that their ability to process information is not as fast as it was when they were younger. That is normal, and there are activities that can help to maintain these and other cognitive functions over time. I recommend taking a look at the Global Council on Brain Health's report, Engage Your Brain for strategies to help you improve focus.  Sometimes improving your sleep, fixing a vitamin deficiency, or simply paying more attention can help.  But if its starting to interfere with your life and you remain concerned, your doctor should evaluate whether it is nothing to worry about, something that is a simple fix, or something more serious like dementia.  Sarah

Sarah Lenz Lock, AARP Expert Brain Health
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My sister just turned 65 years old.  For the last two years she has been asking the same questions repeatedly.  She tells the same story over and over in the same conversation.  She spends a lot of time alone with no one to talk to while her husband works. They live in a one bedroom apartment in another state away from family.  She recently spent a week with me and it is getting worse. She is adamant about not going to the doctor because she says they don’t listen to her.  I don’t know what to do.

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recommedation : seek medical treatment ASAP  froma a local MD certified Gerentologist  !!

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@Brooklyn1153

 

As you probably know, loneliness can pose serious physcial and mental health problems for people as they age.  In these times with families spread apart in different places, it can be hard to know how to help. People who lack social connections can be reluctant to reach out to others. Volunteering in the community can provide a reason for making social connections, and it benefits both your own brain health as well as whomever else you are helping. Studies have demonstrated that feeling purpose in life is associated with a 20% reduction in the risk for dementia! Try not to push a particular solution but ask questions to determine what is of interest to your sister. Are your other family members willing to arrange to make regular calls to your sister? The Brain and Social Connectedness Report provides lots of tips at https://bit.ly/2KS9nOQ. If your sister's doctor refuses to listen to her concerns, then maybe it’s time to look for another one who will!

Sarah Lenz Lock, AARP Expert Brain Health
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Can we talk about forgetfulness or confusion in conversation?  What is in the range of normal versus what may be a sign of something else going on?  I'm thinking of examples like leaving the keys in the front door and mixing up names or events  when talking and not catching it.   These are things that any of us can do, especially if we're stressed or distracted, but how much of a pattern or repetition should we be aware of?

Amanda Singleton
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@AmandaSingleton  Hi Amanda,

Like I was mentioning to John, losing your keys several times in a week, mixing up names or events, and even forgetting the names of old friends in conversations is not a reason to run to the doctor.  Every lapse in memory does not necessarily mean that you have dementia.  Not paying attention to what we are doing can lead to absent-mindedness for all people and it may lead to forgetfulness such as you describe for many of us as we age. It's the nature of the changes in your thinking and behavior and the matter of degree that can help you decide whether you or a loved one needs to be evaluated. If you are becoming lost in familiar places, or you are repeating the same things over and over again without realizing it, and this is happening so frequently that you find it is interfering with your activities of daily living at work or home, then you need to get checked out by your health care provider as soon as you can. New troubles in managing your finances and sudden mood and personality changes are other symptoms that signal it’s time for a check-up. Some people may be reluctant to discuss memory issues with their doctor.  But there could be underlying medical conditions – other than dementia -- causing your memory problems. For example, side effects from medications or excessive alcohol use, or stress, anxiety or depression can cause memory problems which are reversible. There are even some forms of dementia that are treatable.  If the confusion and forgetfulness is severe enough to affect your quality of life, then there is reason to seek medical advice.    Sarah

 

Sarah Lenz Lock, AARP Expert Brain Health
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I asked my doctor about this topic citing minor occurances of forgetfulness.  She assured me that since I was aware of them and they were not bad enough to incite worry rather than minor concern I was within the normal range of aging effects and did not rate alarm or concern. 

The bottom line would seem to be don't worry until it becomes a real problem.

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@JohnS34751

Sounds like good advice!  Not being able to remember the name of an aquaintance is normal aging, but if you can't recognize a family member then that is a concern.  If you are ocasionally forgetting things or events, or if you are not able to find the right word sometimes, that is normal.  But if you are frequently forgetting things and regularly struggle with word choice, then you should get that checked out. One of my favorite examples is that forgetting where you put your keys  is normal, but not remembering whether you drove your car home or not last night is a reason to get evaluated.  Two rules of thumb to ask yourself:  1.  Is it serious enough that it is impacting my daily  life?  2.  Does everyone else who knows me well seemed alarmed, but not me?  Sarah

Sarah Lenz Lock, AARP Expert Brain Health