Mad relatives
March 12, 2007 3:32 AM   Subscribe

My mother is going senile (approx. age 65) and is losing inhibition and ability to think rationally about her finances. She has trouble forming sentences, slurs a lot to begin with, has trouble recognizing relatives for the first five minutes of a conversation, and is developing lack of balance, and a stooped gait. Her younger sister (approx. 63) is having paranoid delusions. Family discussion reveals possible similar problems in previous generations (both males and females) historically classified as schizophrenia or "he went funny after a car accident". How concerned should I be that I or my kids could inherit / develop a similar condition and what should be done to pro-actively investigate?
posted by anonymous to Health & Fitness (17 answers total) 4 users marked this as a favorite
To state the fairly obvious, this is something that you really need to discuss with your local doctor. They will need to take a more thorough history than you have provided here and maybe they'll need to speak with your mother's and aunt's doctors for more information. You can ask your local doctor what tests are available/recommended for your family members and perhaps obtain a referral to see a genetic counsellor. I'm sure I couldn't/wouldn't want to speculate as to the chances that this is truly a familial condition and/or whether it's likely that it will be passed on.
posted by peacay at 4:38 AM on March 12, 2007 [1 favorite]

Discuss it with your doctor.

Also, your post mentions several things that might not be related. Schizophrenia is not the same as going senile, and a stooped gait and lack of balace could each have their own causes.
posted by yohko at 6:35 AM on March 12, 2007

I wonder if your mother has had her mental condition evaluated by a doctor? Depending upon what is causing the symptoms you describe, there may be treatment or at least cognitive therapies can help slow the progress of dementia. If she has had a stroke, she can receive treatment to lessen the chance of having another one.

Your family members may have had a variety of different conditions, diagnosed and undiagnosed. From personal experience, I can say that my family has a tendency to produce broad diagnoses of "how we are" and "what (diseases) we get." A lot of it has turned out to be a big case of confirmation bias and self-fulfilling prophesy.
posted by desuetude at 6:40 AM on March 12, 2007

You need her to see a good neurologist, sooner than later.
posted by docpops at 8:16 AM on March 12, 2007

She needs to go to a doctor. These are a range of symptoms that could be related to familial Alzheimer's, but not all of them line up. The confusion combined with other factors could also be related to a thyroid issue, an untreated stroke, or a number of other things. "Historically classified" doesn't mean much.
posted by mikeh at 8:28 AM on March 12, 2007

The first step is for the affected people, your mom and her sister, to visit a neurologist; ideally, the same neurologist. Diagnosis of this kind of problem is not particularly trivial and if you suspect a family predisposition it becomes more important that the diagnosis be correct.
posted by ikkyu2 at 9:01 AM on March 12, 2007

re: ability to think rationally about her finances

After the doctor's office, visit an attorney specializing in elder care (an exploding field, as you might imagine.) Explore your options regarding guardianship before she writes a check to some scam artist.
posted by Saucy Intruder at 11:41 AM on March 12, 2007

Although your mother's condition does not sound like schizophrenia (which normally first appears in young adulthood), if it does indeed run in your family the best thing you/your kids can do is get treatment as soon as symptoms manifest. There is a correlation between time between how soon after the first psychotic break the patient gets treated and the sucess of treatment/delay of disease escalation. You should meet with a genetic counselor or try to find out more about your family history - there were a lot of mental health disorders that were once classified as schizophrenia that do not fit into the modern DSM-IV deffinition.

And definitely Nth-ing the recommendations to get your mother and aunt to a neurologist for a thorough checkup and diagnosis.
posted by twoporedomain at 12:43 PM on March 12, 2007

In case anonymous doesn't know this: docpops is a physician and ikkyu2 is a neurologist. Please listen to their advice.
posted by mbrubeck at 4:17 PM on March 12, 2007

This is a scary subject. You Mom and aunt are ill, and you must be pretty worried. Get a handle on things 1 at a time. In 65 years we may have a much better understanding of mental illness, and hopefully, much better treatment, as we are so much further than we were a 65 years ago. Good luck.
posted by theora55 at 5:05 PM on March 12, 2007

I watched my grandmother's mental health deteriorate considerably over 6 months due to Alzheimer's and it was not pleasant. She had many of the same signs you talk about, and some of them such as memory loss seemed to be a part of her personality her whole life. Unfortunately, we always wrote them off as being "Grandma disease" until things got really bad.

From my experience, I would recommend two things:
1) Talk to a neurologist (not just the local doctor) about your mother and yourself/kids. You'll immediately recognize those who would rather medicate her into a stupor than those who will actually diagnose and treat her.
2) Talk to your mother. Have conversations that you might not be able to have in a year or two. I know this is off-topic, but I really wish someone would have pointed it out to me at some point.
posted by jivesoul at 5:26 PM on March 12, 2007

As far as dementias.....

1. Alzheimer's -- perhaps 7% of it is familial -- although I'm not sure how well you could be tested for it (again, ask a doctor who specializes in this field). Although even if you have a mutation its not guaranteed you get it (the ApoE mutation -- E4 variant), so a definite "you got this gene", "you're going to get dementia" link has not been established. The wiki link on Familial Alzheimer's feels pretty accurate to me.

Other causes of dementia:

1. Frontotemporal dementia (dementia plus really noticeable personality change -- the familial (inherited) variant here is FTDP-17 and has some Parkinson like features

2. Dementia + diffuse Lewy body disease (more likely if she's having visual types of hallucinations, fluctuations in consciousness) -- not too many familial links here it seems.

3. Vascular dementia (likely if she's had stroke in the past), or even normal pressure hydrocephalus (where your body's spinal fluid builds up and affects your neurons). Here, gait disturbance is common as well as dementia -- and even more likely if she's been not able to hold her urine/feces in (incontinence) -- not as many familial links here either....

Other causes can even be Crutzfeld-Jakob (Mad Cow) disease -- although it's VERY VERY rare.....(although 5-10% is familial here too). Think about it if her dementia is getting worse fast though.

So, that's a poor man's (i.e. not too comprehensive) guide to some common causes of dementia. At her age, it really does not seem like schizophrenia although anti-psychotic medications might help stabilize any psychotic aspects of what might be at their basis dementia/brain atrophy/brain neuron structural

My larger point is that, yes, some forms of dementia do have familial links, but not that many and identifying guaranteed genes might be tough and also not even indicate that you're going to get the disease.

At any rate, go to a neurological specialist soon. Best of luck to your mother and your family. Disease of the brain attacks the very essence of who we are, our soul that is, and that might be the most difficult aspect of neurological illness.
posted by skepticallypleased at 9:10 PM on March 12, 2007

Keep your mind and body as active as possible, even as you age. Read challenging books. Take classes. Get regular exercise. Eat foods that are rich in antioxidants (blueberries are a good source). Try new ways of doing things. Maintain a social life.

Alzheimers runs in my mother's side of the family, with early onset, so I'm also trying to do what I can to take care of myself.
posted by pluckysparrow at 9:11 PM on March 12, 2007

Other causes can even be Crutzfeld-Jakob (Mad Cow) disease -- although it's VERY VERY rare.....(although 5-10% is familial here too). Think about it if her dementia is getting worse fast though.

Just a clarification: "Mad Cow" is variant Creutzfeldt-Jakob Disease. Creutzfeldt-Jakob Disease may or may not be hereditary, but is not caused by eating infected meat. It's incredibly fast (weeks or a few months, tops) and almost too heartbreaking to describe.

If you're having trouble getting your mom and/or aunt to a doctor, it may help you to know that her physician will undoubtably be also checking for nutritional deficiencies, depression, adverse reaction from combination of medications, etc.
posted by desuetude at 8:05 AM on March 13, 2007

DISCLAIMER: I'm not a doctor. I know nothing. The first thing you should do is follow the smart people's advice and get them to a neurologist.

You should also look up Huntington's disease. The paranoia and the strong hereditary nature make me think of that.

It's genetic and there is a definitive DNA test to detect it.

I'm no expert, just had a grandmother with Huntington's.
posted by mmoncur at 7:21 PM on March 13, 2007

Desuetude -- thanks for clearing that up. If you're in the USA, it's probably even less likely Mad Cow as there have been only a handful (or possibly just one case) of it reported here.
posted by skepticallypleased at 10:46 PM on March 13, 2007

Desuetude -- thanks for clearing that up. If you're in the USA, it's probably even less likely Mad Cow as there have been only a handful (or possibly just one case) of it reported here.

A long time family friend (who was like an uncle to me) died of CJD. I don't even know anyone else who has known someone who had's brutal. He went from forgetful to delusional to completely incapacitated in a matter of weeks.

posted by desuetude at 6:31 AM on March 14, 2007

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