My Grandmother Has Dementia And For The Past Couple Of

Posted on Sun, 19 Jan 2020

Question: My grandmother has dementia and for the past couple of days she has been acting unusual. She seems more altered. She’s been staring, drooling and is becoming more forgetful. She has also started to have difficulties standing, walking and climbing stairs. She also appears to be less expressive. A few days ago she was smiling and laughing but now she is mostly stoic and quiet. I know this could all be a consequence of the dementia but I’m concerned because it happened so suddenly (I.e. within 2 days). She is an 89 y.o. with diabetes mellitus type II, HTN, HLD and possible PVD. My question is: is this decline too sudden and should we seek further care or is this just normal?

Answered by Dr. Panagiotis Zografakis (1 hour later)

Brief Answer:
investigation is required

Detailed Answer:
Hello,

the progression of dementia is usually gradual. Sudden changes in a patient's status require investigation. Anemia, disturbed electrolyte balance, impaired renal functionality, fever and other causes have to be excluded. Fever is obviously the easiest to check. A complete blood count, urea, creatinine, sodium, potassium, calcium, blood sugar, C-reactive protein and TSH are appropriate first-line tests to exclude a multitude of disorders that may worsen her status. Clinical examination by a doctor is important as well to exclude a vascular event (stroke).

I hope I've answered your question. Please let me know if you need further assistance.

Kind Regards,
Dr Panagiotis Zografakis,
Internal Medicine Specialist

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

Follow up: Dr. Panagiotis Zografakis (1 hour later)

thank you! we took her temperature earlier and it was 99F so my mother wasnt too concerned. however, the household memebers have been sick, her roommate went to the hospital for the flu, and today, she had a wet yet non-productive cough. we also measured her blood glucose and it was in the 120s both times we measured it today. blood pressure was okay as well (120s/80s). i forgot to
mention that in those two days she urinated on herself 2x and today defected on herself. her inability to walk/stand is inhibiting her from getting to the bathroom as she used to and im inclined to think that the incontinence is due to that rather than rapidly declining mental status. again, all of these symptoms, i understand, are apart of the sequeale of alzheimers but my concern was with the rapid decline over two days. do you recommend an appointment with her PCP or is this something to send her to the ER for?

Answered by Dr. Panagiotis Zografakis (8 minutes later)

Brief Answer:
I'd suggest immediate assessment

Detailed Answer:
Thanks for the additional information!

99F is usually not normal and may indicate a low-grade fever. The cough is in favor of a respiratory tract infection. Since her roommate had the flu, it's possible that she got the flu as well. If you're talking about influenza then this can be serious because old individuals particularly those with comorbidities (like diabetes, etc) are prone to complications. She needs an immediate assessment with clinical examination, blood tests and a rapid test for influenza and perhaps also treatment - depending on the results of the assessment. I wouldn't recommend an appointment for another day...

Best wishes!

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