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Memory Loss, Depression, Agitation, Confusion. Did She Have Dementia?

Posted on Sat, 29 Sep 2012

Question: My mom died in May. During the last 3 years or so she had terrible memory loss. She did not remember anything said to her just after it was said. While at home sometimes she would ask me where she was. When I told her she was at home she did not believe me. She was always depressed, agitated and confused. Sometimes she could not even remember her children names etc. I had to bathe her and may sure she was clean because she did not show any interest in this sort of thing. She talked of her dead relatives all the time. She said she dreamt about them. She was in an out of the hospital several times in the last 3 years and the Nurse said she had Dementia but it was not really confirmed. Do you think that is what she had and if so what stage? Was her brain functioning properly at this time

Answered by Dr. Michelle Gibson James (1 hour later)

Hi, I am sorry for your loss

It does sound like dementia though in the elderly depression can often be confused with dementia.

Dementia is a term used to describe loss of brain function that affects memory,thinking,judgement and behavior.It may be associated with loss of emotional and behavioral control.
It is not just loss of memory, it reduces your ability to learn,reason,retain or recall past experience with loss of pattern of thoughts and feelings.
There are different classifications for dementia and different causes. Alzheimer's is the most common type of dementia.
Some other causes and types are vascular dementia (occurs in persons who may have repeated small strokes) ,lewy body dementia, due to infections, medications, nutritional deficiency,brain bleed, lack of oxygen to the brain are just some of the other causes.

Dementia is diagnosed after at least 6 months of symptoms. Diagnosis requires history, examination to rule out any illnesses that could be contributing to the symptoms, mental state examination is performed on the person to check cognition is normally done to assess the stage so it would not possible to determine what stage she was at post mortem.Normally when the mental state tests are given the person is given a score to let you know how far along they are.
In addition blood tests should have been done to assess for any reversible causes of dementia.
A CT scan is also part of the normal investigations.

Depression is common in persons with dementia and depression can often be confused with dementia.
Diagnosis of depression requires the person to have a depressed mood most days or loss of interest in activities. In addition to one of these the person should have at least 4 of the following : loss of appetite(some persons have large increase in appetite when depressed), difficulty sleeping, fatigue or loss of energy, difficulty concentrating, intense guilt ,feeling worthless, slowing down of movements,suicidal thoughts.
Diagnosis of depression in a person with dementia is sometimes difficult because they cannot describe their feelings.

I hope this is helpful to you, feel free to ask any additional questions

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Michelle Gibson James (1 hour later)

Actually my mom had more than just memory loss though. I noticed changes in her memory as far back as 2009 after she had a hysterecompy for cancer of the uterus. After awhile she could not retain any memory at all. She kept asking me questions over and over and over again. She could not recall what day it was or what time of the day it was. I would write things down for her like what day it was etc. and she would confuse this with a grocery list. She stopped doing things in the home and would not go anywhere except to Church even though she could not remember how she got there or what was said in Church. She was never a greater eater so most of the time she did not eat that much. However, she kept saying to me she wanted something good to eat. I would ask her what she wanted and she said she did not know what it is. She would also complain about a funny feeling in the stomach/chest but could not tell me what kind of feeling it was. She also had very severe take the operation to replace the valve. She was hospitalised several time because of breathing difficulties due to this, last October she was actually put on a ventilator for almost a week because of this. She would also get very angry if a small child came to the house. Sometimes I would have to stop her because she would try and pounce on them. She could not stand anyone who would make noise around her. I had to watch TV with the sound on Mute becaue it disturbed her. If I told her I was taking her to the heart doctor she would actually go after putting up a fight but she would not go to any other Doctor. I had to cancel lots of appointments because she simply refused to go. In the last few weeks before she died all she wanted to do was to play with her wallet. She would sit for hours sometimes taking things out of her wallet and putting them back in again and again and again. I really wanted to get her tested for Dementia but was not able to becaue I know she hated going to the Doctor and she had to go so much due to the heart valve problems that I did not want to put her through any more stress.

Answered by Dr. Michelle Gibson James (50 minutes later)

Yes dementia is more than simply memory loss, it would affect a persons judgement, thinking and behavior.
From what you are describing there were definately changes in all these areas so it is likely that she did have dementia.
Receiving a definate diagnosis may or may not have affected the outcome. There is medication to help control behavior and medication that may slow progression for a short time but it is not a sure thing and the progression is slowed not stopped.

It sounds as though that as a caregiver it was stressful for you as well which is what normally occurs which is caregivers are advised to have respite ( temporary relief from duties ever so often)

Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar