Dementia

April 8, 2011 6:30 AM

Is it possible for dementia or Alzheimer's symptoms to come and go?

My father is 77 and at times displays very prominent symptoms of dementia and or alzheimer's. He searches for words, can't remember what's going on, who people are or what he's been doing.

But some days he's sharp as a tack. For the most part he shows mild symptoms day to day but some days are worse or better than others.

Any thoughts?

posted by Scoops to health & fitness (16 answers total)

I'm not a doctor, and specifically not your dad's, but my limited experience with Alzheimer's is that it fades in and out, getting progressively worse over time.
posted by mhoye at 6:37 AM on April 8, 2011

This sort of thing happens w/ an elderly family member of mine and seems to be related to
a disturbance in sleep. For example, not sleeping well -if at all, on a given night and then becoming disoriented the following day and experiencing waking-dreams (which appear to be hallucinations). (possible hypnagogic and/or hypnopompic sleep hallucinations)
(Not implying your dad is having this problem, but just describing my own experience w/ family member.)
posted by The_Auditor at 6:48 AM on April 8, 2011 [1 favorite]

IANAD as well. The reason those with Alzheimer's fade in and out is due to the brain constantly re-arranging connections to work around the disease. It's a tough disease, and I would recommend having him checked out by a doctor for a proper diagnosis. While there is no cure, there are treatments that can help lessen the symptoms.
posted by samsara at 6:48 AM on April 8, 2011 [1 favorite]

My personal experience is that this is fairly common, but good days fade over time.
posted by te1contar at 6:49 AM on April 8, 2011

Has he been to a doctor? Things like "who people are" is obviously VERY bad if you're saying he can't remember you, or your mother (whether she's living or not), etc.

But some mild memory issues like searching for words, the name of your mailman, etc. - that's normal aging or could be another issue, as has been suggested. Hell, give me 4 hours sleep and 3 things too many at work, and that's ME, at age 40-mumble. You really need to talk to a doctor. They can do more with drugs these days to at least control or delay the worst of Alzheimers or other dementia. He really needs a proper diagnosis.
posted by randomkeystrike at 6:54 AM on April 8, 2011

That would be delirium rather than dementia. Aging people can have both, which gets confusing. Dementia is mostly consistent; it doesn't really get better. Delirium comes and goes. If he's sick or otherwise impaired, it can make the delirium worse.

Full disclosure: I'm not a doctor, but I work with a bunch. This should at least give you the right terminology to use to talk to your dad's doctor.
posted by echo target at 7:04 AM on April 8, 2011

My grandmother is around your father's age, and she is in the early stages of dementia/Alzheimer's/senility (I'm honestly not involved enough with her medical stuff to know that she specifically has Alzheimer's).

She has great days, and then she has terrible days. Certain things tend to really exacerbate her symptoms. Being out of her element or in an unfamiliar setting seems to especially affect her.

This has all been going on for a few years now. She used to have "sharp as a tack" days. Now her good days are more like "doing OK" days.
posted by Sara C. at 7:19 AM on April 8, 2011

Yeah, this sounds pretty normal. My grandfather is pretty far into dementia, but for months it was hard to know from one day to the next how he was going to be. Sometimes he'd be completely lucid. Others he'd be incapable of conversation. It can be a real crap shoot.

It may not even be the brain rearranging itself either. All of us have days where we're just "off," but most of us have enough intellectual capacity to be able to keep functioning more or less normally. If you're already pretty impaired, even something as simple as not sleeping all that well the previous evening or having unrelated physical symptoms can really throw you off your stride.
posted by valkyryn at 7:21 AM on April 8, 2011

Everyone has days when they are sharper than others. As mental facilities deteriorate, the bad days seem worse because there is less mental capacity/resiliance available.

And so yes, it is very common to see that.

It is also sadly too common for these issues to be caused by various medications and in some cases how the person is treated. An anti-histamine that makes a younger person a little dull for a few hours might hit an older person a lot worse, and for a lot longer. Dosing levels that worked fine when grandpa was 75 might be too much when he is 85.

Another issue is depression/bipolar. In an older person, they can manifest and look like dementia. And being treated like a feeb can trigger depression. A week in the hospital being talked about across the bed and treated in the weird infantile way that too often happens "DO YOU NEED A SIPPY-CUP, SEYMORE?" is enough to take even the strongest people down.

Definitely get him checked out! Some of these things are easily correctable, and if it is truly dementia, there are drugs that slow the progression.

(For the definition specific folks, dementia is physical deterioration of the brain that usually manifests in memory loss. I don't think there is as bright a line between it and delirium as echo target suggests.)
posted by gjc at 7:24 AM on April 8, 2011

Not a doctor, but have cared (and am caring) for several aging family members, so this is just from what I have seen. Yes, symptoms do seem to come and go with dementia.

However, it's also possible (as is happening with one of my family members) that he may be experiencing strokes. So do get him checked out. Blood pressure meds or other treatment may be able to help.
posted by The Deej at 7:44 AM on April 8, 2011

My grandmother lived with dementia for at least five years. The symptoms came and went. Some of her heart medication (blood thinners) also affected her moods and cognitive ability. Towards the end of her life, she would remain in a fog mostly, and then her personality would rise up out of it, and then she would go back down. The quality of the "peaks", though, deteriorated over time. For the last month of her life she did not rise out of the fog. She was 94 when she died, and lived, like I said, for at least 5 years with dementia, although she must have been affected for about 10 years.
posted by KokuRyu at 8:16 AM on April 8, 2011

Ah, yes, my grandmother also experienced strokes.
posted by KokuRyu at 8:17 AM on April 8, 2011

My step-grandmother used to be much better when she tried - normally when she had guests or was meeting someone unfamiliar. When she was really quite noticeably affected by Alzheimer's she still managed to convince her doctor she was compos mentis enough to drive.

Even though she was doing things like putting the telephone in the dishwasher, very forgetful and so on at the time.

In fact, with the benefit of hindsight, what we first interpreted as delightfully scatty only became apparent as something more pervasive 5 years later. For those first five years she could comfortably hold her own when she wanted and paper over any cracks when her memory failed her.

Over time she got worse, but even until quite late on she still had good and bad patches (hours, not days). It was much worse when she was tired, had drunk, or both. Breaking routine was not good. After some fairly major plumbing work my folks switched a bathroom and a bedroom round in their house between her visits and, er, a vanity stool came off somewhat the worse for wear.
posted by MuffinMan at 8:30 AM on April 8, 2011

As the others have said, yes. My late grandmother, who died with very advanced Alzheimer's, would have sudden moments of remission--starting to talk, for example, years after she had apparently forgotten how. In earlier stages, too, her dementia was very subject-dependent: she would be very inarticulate and repetitious about things going on in the present, but suddenly became very coherent and witty when I asked her about something that went on thirty years ago, or when the subject turned to art (she painted).
posted by thomas j wise at 10:39 AM on April 8, 2011

The best thing to do, of course, is to have a doctor evaluate your dad. That said, here are my personal experiences with Alzheimer's/dementia....my beloved Mother-in-Law was diagnosed with early onset Alzheimer's disease when she was in her early 60s (the diagnosis was later changed to Lewy-Body Dementia about five years later). Whatever the experts wanted to call it, her memory loss/odd behavior was on a fairly consistent downward spiral. There were plateau periods where she didn't seem to get any worse, but she never had days of sudden clarity or bursts of lucidity.

My Dad is 87 and his health is failing at the moment. He had what turned out to be a heart attack shortly before Thanksgiving 2010 (his only symptom was coughing and gasping for breath, so when Mom called for an ambulance, she'd thought it was pneumonia). Dad was put on a breathing tube in the ICU and the doctors consulted us family members regarding the "do not resuscitate" issue. Dad somehow rallied and was moved to a rehab floor, despite only having 15% heart function. Some months prior to this heart episode Dad complained to his doctor that he couldn't remember things anymore (Dad has always been very impatient and cranky and even when he was in his 40s and couldn't immediately recall a name or pinpoint the word he wanted he'd have a burst of temper and insist something was "wrong" with his brain....) Anyway, his GP sent him to a neurologist who gave him an Alzheimer's assessment. Dad apparently kinda sorta passed but was iffy (according to the way the GP explained it to Mom) and he put Dad on Aricept "as a precaution". During this time he remembered all of us immediate family members and also what time his favorite TV shows were on, but there were little things he didn't remember - for example, he told me he'd never been to Florida, and I had to gently remind him that he'd been there a couple of times, and had helped his brother move there in the late 1980s.

Anyway, Dad's mind/memory seemed sharp enough when we brought him back home on December 23, 2010. He even caught on to jokes Mr. Adams and I bantered with each other as we helped Mom settle Dad in. Dad is now in an extended care facility, after another hospitalization in early February. It's a Catch-22 sort of situation - because of his limited heart function, he tires easily and doesn't want to get out of bed or sit up and do his exercises. As a result of his inactivity he has no appetite and stops eating outside of the occasional bottle of Ensure. Lately his memory has been all over the place - when I went to visit him the other day, the aide asked him "Do you know who this is?" and he replied "Yeah, that's my wife." I said "No, I'm Oriole" and he said "Well, you look just like your mother." (I didn't say "I'm your daughter" but he apparently made the connection nevertheless.) Two months ago he not only never confused me for my Mom, he also would ask about my husband by name if he hadn't come to visit. The various doctors tell us that it's possible that one cause of his sudden mental deterioration is because he isn't eating enough. Right now he fluctuates on a daily basis between not remembering that we were there to visit him yesterday to seeing a motorcycle commercial on the TV in his room and griping about Japanese imports and how they'll never build a bike as good as a Harley-Davidson or an Indian.

So, to summarize this tl;dr response: please do have your father checked out by professionals. His symptoms might indicated the onset of mild dementia, but there could also be an organic reason behind his confusion - some sort of dietary deficiency, for example. Best of luck to you.
posted by Oriole Adams at 10:48 AM on April 8, 2011

My mother showed these symptoms and it turned out she was having petite mal seizures in her brain due to a small stroke she never knew she had years ago. No outward signs, just temporary bouts of dementia. She got on meds and is fine now. Go to a doctor.
posted by PSB at 2:37 PM on April 8, 2011