Understanding The Paranoia-Dementia Connection
When you think about dementia, a condition that affects thinking and behavior, you might picture symptoms like memory loss and confusion. However, dementia can also affect a person’s beliefs, leading to symptoms like delusions and paranoia. Having a better understanding of paranoia—and what this symptom can look like in someone with dementia—may make it easier to spot and seek treatment.
Understanding dementia
An estimated 55 million people worldwide are living with some form of dementia, a group of illnesses that affect how a person thinks, behaves, and communicates. Dementia is a progressive condition, meaning symptoms often start out mild and gradually worsen over time. As the illness progresses, people with dementia may increasingly struggle to remember information, take care of themselves, and complete daily tasks. By the later stages of the illness, patients typically need ongoing care. Dementia often leads to the end of one’s life.
Do all people with dementia have Alzheimer’s disease?
When you hear the word “dementia,” you might immediately think of Alzheimer’s disease. Alzheimer’s disease is a specific form of dementia caused by a buildup of proteins and plaques that disrupt brain function. Although the two terms are often used interchangeably (and Alzheimer’s is the most common type of dementia), not all cases of dementia are due to Alzheimer’s.
Beyond Alzheimer’s disease: Other types of dementia
In addition to Alzheimer’s disease, there are several other types of dementia that you may make yourself aware of, each with its own effects on the brain. These other forms of dementia include the following:
- Vascular dementia: Vascular dementia is caused by issues that affect the flow of blood to the brain, such as blood clots and strokes.
- Frontotemporal dementia: Like Alzheimer’s, frontotemporal dementia is caused by an abnormal buildup of proteins in the brain—specifically in the frontal and temporal lobes.
- Lewy body dementia: Lewy body dementia is caused by protein deposits (called “Lewy bodies”) that disrupt the balance of chemicals in the brain.
- Mixed dementia: Mixed dementia is when a person has multiple forms of dementia—for example, Alzheimer’s disease and Lewy body dementia—at the same time.
Causes of dementia
While the exact cause of dementia is still being studied, several risk factors have been identified. Age is one of the biggest risk factors, while genetics may also play a role. Other possible risk factors include the following:
- Alcohol use
- High cholesterol
- A history of brain injuries
- High blood pressure
- Smoking
- Depression
- Hearing loss
- A lack of physical exercise
Delusions, hallucinations, forgetfulness, and other common symptoms of dementia
Understanding the different ways dementia symptoms can manifest may be helpful as you explore the paranoia-dementia connection. While different people may show different symptoms, common signs of dementia may include the following.
Forgetfulness
Memory loss is a common symptom of dementia. Minor memory troubles can be a part of normal aging, but people with dementia may show more severe forgetfulness, such as:
- Forgetting the date or year
- Frequently misplacing items and being unable to find them
- Frequently forgetting to do routine tasks
- Forgetting the names of loved ones or close friends
Behavior and personality changes
People with dementia may also show changes in their behavior, communication, and habits. For example, they may become more socially withdrawn or aggressive or struggle to be considerate of other people’s emotions. Dementia-related behavior changes may also include:
- Mood swings
- Changes in grooming and personal hygiene
- Trouble planning and making decisions
- Trouble following conversations
- Inappropriate or impulsive comments and actions
- A loss of interest in relationships and hobbies
- Wandering off or getting lost in familiar places
Delusions
Delusions are untrue beliefs that are firmly held and persist despite attempts to persuade an individual otherwise. A person experiencing delusions might, for example, believe they are friends with a celebrity, that the government is spying on them, or that they have magical powers. Studies have found that up to 70% of people with Alzheimer’s disease experience delusions at some point during their illness.
Hallucinations
Hallucinating is experiencing sensory stimuli that aren’t truly occurring. Hallucinations can involve any of the five senses (seeing, hearing, smelling, tasting, or touching) and can be common with certain types of dementia, such as Lewy body dementia. Hallucinations may accompany delusions and paranoia.
Paranoia in people with dementia
Paranoia occurs when one believes someone else or a group of people are conspiring against them, lying to them, or “out to get them” in some way. A person experiencing paranoia might seem defensive, fearful, or overly suspicious of others. They may also find relaxing around others difficult, react badly to criticism, or perceive negative intentions in innocent comments.
Paranoia can be common among people with dementia, either as its own symptom or because of other symptoms, like memory loss and confusion. For example, if a person with dementia keeps forgetting where they’ve put an important item, they may become paranoid that they are being robbed. As a result, they might start hiding things in specific places, only to forget where they put them, leading to more paranoia.
When a person with dementia becomes paranoid, is schizophrenia the cause?
Symptoms like false beliefs, hallucinations, and paranoia can sometimes look similar to other disorders, like schizophrenia. Schizophrenia is a mental illness that can cause severe delusions, hallucinations, behavior changes, and challenges functioning in daily life. While these two mental illnesses may share overlapping symptoms, schizophrenia usually starts earlier in life—often in the late teens to early 30s—while dementia frequently arises after age 60.
Signs of paranoia in a person with dementia
If you have a friend or family member with dementia, being aware of what paranoia can look like may make the symptoms easier to identify. While dementia-related paranoia can be a distressing symptom, it can often be managed with treatment, so you may want to seek help if your loved one:
- Shows a sudden change in their level of trust toward others
- Struggles to let their guard down around other people
- Seems preoccupied with other people’s motives
- Believes other people are making fun of them, gossiping about them, or plotting against them with no evidence
- Makes false accusations against close friends, family members, or peers
- Often misinterprets innocent comments
- Isolates themselves from their relationships out of suspicion or fear
Getting professional help
Dementia can be challenging, whether you’re living with the condition yourself or you have a loved one who is. While dementia cannot be cured, improving symptoms like paranoia and boosting your (or your loved one’s) overall quality of life may be possible with proper treatment. If you have concerns about dementia or paranoia, consider going in for a medical evaluation or talking to your doctor about starting treatment. Medications are available that may slow the progression of dementia, reduce symptoms, and make the illness more manageable. Examples can include:
- Antipsychotics: For people experiencing hallucinations, delusions, or paranoia due to dementia, a doctor might prescribe antipsychotic medications. These medications work by blocking the effects of brain chemicals like dopamine, which may contribute to these symptoms.
- Antidepressants: Symptoms of depression can be common in people with dementia, which is why some doctors may prescribe antidepressant medications. These medications alter levels of brain chemicals that affect mood.
- Cholinesterase inhibitors: Cholinesterase inhibitors work by boosting levels of brain chemicals that contribute to learning and memory. These medications may help slow the progress of dementia.
In addition to medication, some forms of therapy may also be helpful for people with dementia. For example, cognitive stimulation therapy uses activities like puzzles and games to practice problem-solving, memory, and other mental skills. Cognitive-behavioral therapy (CBT) may also help people with dementia reduce mood-related symptoms and shift unhelpful beliefs related to their illness.
The BetterHelp platform is not intended to provide any information regarding which drugs, medication, or medical treatment may be appropriate for you. The content provides generalized information that is not specific to one individual. You should not take any action without consulting a qualified medical professional.
Accessible support options
Even with insurance, mental health treatments like therapy may not be affordable. According to a 2022 White House report, only half of those with insurance report having adequate mental health coverage. With online therapy through a platform like BetterHelp, you can see a licensed therapist from the comfort of your home, often for under $100 a week, which may be more affordable than in-person treatment without insurance. In addition, online platforms can offer access to support groups.
Research shows that online therapy is as effective as in-person therapy at treating depression, which can be common among people with dementia. In a study from 2023, 108 people with depression attended therapy for 12 weeks, either in person or online. Both groups experienced significant improvements in their symptoms and quality of life.
Takeaway
Paranoia, an intense mistrust of others, can make a person suspicious, defensive, and fearful. In people with dementia, symptoms like memory loss may make behaviors worse. If you’re concerned about dementia symptoms, consider talking to your doctor. Symptoms of dementia (including paranoia) can often be managed with medication and therapy.
- Previous Article
- Next Article