Sudden Worsening Of Dementia And Its Symptoms
According to Alzheimer’s Disease International (ADI), someone develops dementia approximately every three seconds. As of 2020, the ADI estimates that 55 million people are living with dementia worldwide. Many families monitor their loved one’s condition closely, particularly if they notice their symptoms are becoming more severe, as this could be a sign of rapidly progressive dementia (RPD) or delirium. A sudden worsening of dementia symptoms can indicate the need to contact a person’s care team. In many cases, loved ones of those with dementia, as well as those living with the condition, may find it helpful to speak to a therapist about how to effectively cope with the situation.
How does dementia progress in different types of the disease?
The way dementia progresses can vary depending on its type. For example, the Alzheimer’s Association lists the three primary stages of Alzheimer’s as early, middle, and late. In medical contexts, these may also be referred to as mild, moderate, and severe levels of dementia.
Early-stage Alzheimer’s disease (Mild)
Alzheimer’s disease can begin subtly, with symptoms sometimes going unnoticed by the individual experiencing them and their loved ones. A person may struggle to remember specific words or recall the names of acquaintances and familiar objects. It may also be difficult for an individual with mild Alzheimer’s to remember information they have recently learned or perform tasks they had no trouble previously completing. Additionally, those with mild Alzheimer’s may have problems with organization and planning. This, in combination with other symptoms, may make it difficult to function in social or work settings.
Middle-stage Alzheimer’s (Moderate)
As Alzheimer’s progresses into its middle stage, an individual may experience a significant increase in symptoms. For example, an individual may start to become confused during conversations, become irritable or angry more frequently, or begin to struggle with self-care. Individuals experiencing moderate Alzheimer’s may find it difficult to remember personal information, such as their address, telephone number, or important events in their past. As symptoms worsen, a person may struggle with sleep disturbances, forget their current location or what day it is, and find it challenging to control their bowels and bladder.
Late-stage Alzheimer’s (Severe)
In the final stages of Alzheimer’s, an individual may not be able to communicate, react to their environment, or control their movements. At this point, a person will likely require constant care, as they will typically be unable to complete tasks on their own. Individuals experiencing late-stage Alzheimer’s may not have the ability to walk, sit, or swallow, and they may become more vulnerable to infection. Even though these individuals may not be able to discuss their symptoms with others, they could benefit from interaction and a comfortable environment, as these factors may improve their overall well-being.
While some individuals experiencing dementia may follow a standard progression through these phases, this is not always the case. In some situations, dementia symptoms may suddenly increase in severity.
What causes a sudden worsening of dementia?
Even if an individual is responding to treatments, certain events or conditions may precipitate a sudden worsening of dementia symptoms. Two examples of these conditions are rapidly progressive dementia and delirium.
Sudden worsening of dementia and rapidly progressive dementia
When a person experiences rapidly progressive dementia (RPD), their symptoms may worsen at a fast pace. This type of dementia may quickly become more severe in as little as a few weeks or months, although in some cases, RPD may occur over several years. How quickly RPD progresses may depend on its underlying cause, which can vary. Some potential RPD causes include those listed below:
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In some cases, treating the underlying cause may stop or reverse the progression of RPD. However, in some situations, the progression of symptoms may be irreversible.
Delirium in people with dementia
Delirium is a condition that may involve disorientation, confusion, difficulty communicating, memory challenges, behavior changes, and mood swings. These symptoms may be confused with those of dementia, potentially making it difficult for medical professionals to determine what is happening to a patient. In addition to dementia, there are a variety of risk factors that may increase a person’s chance of developing delirium, such as the following:
- Hospitalization
- Lack of proper nutrition or hydration
- Infection
- Taking medications with significant mental side effects
- Metabolic disease
The onset of delirium can cause dementia symptoms to worsen rapidly. If the underlying cause of dementia is identifiable and treatable, it may be possible to reverse this progression.
What to do if dementia symptoms worsen
To determine whether dementia symptoms are worsening, it can be important to look for certain signs. These signs may vary depending on their underlying cause. In many cases, an individual presents with the same symptoms as they had before, but with increasing severity. In other situations, new symptoms may occur. It may be helpful to keep track of which symptoms an individual is experiencing. This may make it easier to determine whether there have been any recent significant changes.
Consulting a medical professional for dementia, such as vascular dementia
How are different types of dementia treated?
A variety of treatments may help those experiencing dementia. The UK National Health Service (NHS) lists several medications that may be beneficial for those with dementia, all of which must be prescribed by a licensed medical professional:
Acetylcholinesterase inhibitors for different types of dementia
Acetylcholinesterase inhibitors generally work by slowing the process of breaking down the neurotransmitter acetylcholine. By doing so, they may facilitate communication between nerve cells.
Memantine for dementia symptoms
Memantine is often prescribed to individuals with more severe forms of dementia, such as late-stage cases of Alzheimer’s disease or dementia with Lewy bodies. Memantine usually works by blocking the excessive production of glutamate, a chemical that carries messages between nerve cells in the brain. In some cases, memantine may be prescribed for those who cannot take acetylcholinesterase inhibitors, and it may induce side effects like dizziness, constipation, and headaches.
Non-medication treatments for people with dementia
The NHS also recommends several types of therapy or non-medication treatments, such as reminiscence and life story work, cognitive rehabilitation, and cognitive stimulation therapy.
Reminiscence therapy for vascular dementia
Reminiscence therapy often works by stimulating an individual with visuals, sounds, or smells that may remind them of pleasant memories. For example, a therapist may play a person's favorite song, show them recordings of family events, or present them with a meal they enjoyed during their childhood. Research suggests that reminiscence therapy may have positive effects on a variety of outcomes, including quality of life, mood, communication, and cognition.
Cognitive rehabilitation therapy
Cognitive rehabilitation therapy may improve cognitive function in those with earlier stages of dementia. Sessions may focus on a variety of subjects, such as memory, attention span, and problem-solving skills. For those with dementia, it may be beneficial to try a form of cognitive rehabilitation therapy known as compensatory treatment. These treatments may help individuals learn how to live with their condition and work around the difficulties they are experiencing instead of trying to “fix” them.
Cognitive stimulation therapy
Cognitive stimulation therapy typically aims to address the social isolation common in those with dementia by offering stimulating group activities in which they can participate. CST sessions may be guided by a variety of professionals, including occupational therapists, speech-language pathologists, registered nurses, and social workers. Research suggests that CST may significantly improve cognitive functioning and quality of life while impacting language skills, such as overall comprehension, naming, and word-finding.
Online therapy for dementia
While therapy may benefit individuals living with dementia and their caretakers, in-person therapy may not be convenient or accessible to everyone. For some, finding the time to search for a specialist or schedule an appointment may be challenging. Others may struggle to find reliable transportation or prefer to use other types of communication, such as phone calls, video conferences, and online chat. In these situations, it may be beneficial to explore alternatives, such as online therapy.
Although more research on the efficacy of online therapy specifically for dementia may be needed, existing studies suggest that for many individuals, online therapy can be just as effective as in-person therapy. One 2022 study involving 931 patients and 12 separate trials looked to compare the efficacy of these types of therapy. Researchers found that there were no significant differences between therapy delivered online and in-person in a variety of categories, including symptom severity, working alliance, overall improvement, function, and client satisfaction.
Takeaway
Frequently asked questions
What causes sudden dementia to worsen?
A sudden worsening of dementia symptoms can stem from various triggers that affect a person's condition. Infections like pneumonia, dehydration, or even long term health problems such as cardiovascular issues may lead to a higher risk of sudden change in cognitive or physical functioning. For older adults, medication interactions or emotional distress might exacerbate symptoms. Addressing worsening symptoms promptly and seeking to seek medical attention can help manage your or your loved one's dementia symptoms and provide greater stability.
Can dementia suddenly progress quickly?
While dementia is usually progressive, it can sometimes advance at an unexpected pace. Factors such as a stroke, acute illnesses, or severe stress can trigger a rapid decline. People living with common types like vascular dementia or frontotemporal dementia, may face a greater risk of rapid progression compared to other forms of the disease. Consulting a doctor regarding diagnosis and learning to recognize dementia changes early and can offer a better idea of what steps to take next.
What stage is restlessness in dementia?
Restlessness is commonly observed in the middle to later stages of dementia. It often reflects new or worsening symptoms, where the individual might pace, fidget, or display unease during daily life. These behaviors can be particularly pronounced in people living with frontotemporal dementia or advanced Alzheimer's. Addressing this phase of a person's condition with comfort measures can make a meaningful difference.
What stage of dementia is shadowing?
Shadowing, or closely following a caregiver, tends to occur in the middle of the three stages of dementia. This behavior highlights significant short term memory challenges and is often paired with a sense of insecurity or fear. Shadowing may also indicate a progression toward late stage dementia. Support strategies such as creating predictable routines can ease stress for both the caregiver and the individual.
What are signs that dementia is getting worse?
Signs that dementia is progressing include heightened memory loss, increased confusion, and challenges with daily tasks. In later stages, individuals may have difficulty recognizing loved ones, experience muscle weakness, or lose the ability to communicate effectively. In rare cases, rapid declines, like new issues with swallowing or mobility, may signal a significant shift. If these symptoms occur, it’s crucial to seek medical advice promptly.
What can trigger dementia patients?
Triggers for people living with dementia can include environmental changes, loud noises, or overstimulation. People diagnosed with dementia may also feel heightened frustration during transitions, such as losing independence in daily living tasks. For older adults, physical discomfort or emotional distress can escalate confusion or agitation. Identifying and minimizing these triggers can promote a calmer atmosphere for both patients and caregivers.
What is the most aggressive form of dementia?
Frontotemporal dementia and certain rare diseases like Creutzfeldt-Jakob disease are considered highly aggressive forms of dementia. While aggressive forms of dementia make up only a small part of diagnosis, they tend to progress rapidly, causing profound personality shifts, and behavioral changes. Unlike Alzheimer’s, the most common type of dementia, these aggressive forms of the disease often affect younger people.
How to tell when the end is near with dementia?
In late stage dementia, signs of decline may include severe muscle weakness, inability to eat or drink, and susceptibility to infections. Communication becomes minimal, and individuals may rely entirely on caregivers for daily living tasks. These signs, combined with other worsening symptoms, often indicate the need for palliative or hospice care to ensure comfort in the final phase of the person's condition.
What is the number one food that fights dementia?
While there isn’t a guaranteed food to prevent dementia, certain nutrient-rich choices can support brain health. For example, leafy greens and foods rich with omega-3 are believed to improve cognition and reduce the risk of brain health changes in the long term. Additionally, these foods are thought to lower the risk of cognitive decline in older adults. However, a balanced diet is recommended for all ages.
What calms dementia patients?
Calming people living with dementia involves creating a supportive and peaceful environment. Gentle reassurance, soothing activities, or familiar objects can address their emotional needs. In later stages, sensory approaches like soft music or touch may be especially effective. Identifying and reducing sources of distress can help manage their living experience and improve their overall well-being.
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