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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Early Signs Of Dementia With Diabetes

Hi there, my dad is 77 and has had type 2 diabetes for around 40 years, and has been on kidney dialysis for the last five years or so. Around 6 months ago, he contracted peritonitis and was very ill, in hospital for 4 weeks. Since then, his mobility has become much worse, and he is mostly incontinent. He is also noticeably cognitively impaired and has signs of early dementia. One of the major arteries in his neck is completely blocked. In the last three and a half months, he has had three separate incidents of something like a hypoglycemic attack or a TIA, but no-one seems to know what is wrong. His tongue lolls out of his mouth and he can't seem to understand what is being said to him, or be able to make up a coherent answer. He is clearly extremely confused. On all three occasions, he's been taken to hospital and kept in overnight, but the doctors just treat the symptoms acutely, and release him the next day. CT scans each time seem to be normal. After each attack, his cognition and mobility are noticeably worse. I don't think these attacks have been hypoglycemic ones because his episodes of confusion are not helped by ingestion (or even intravenous injection) of glucose... usually he starts feeling better within 30 minutes of eating sugar, but on these occasions, he's still confused hours later. Can anyone suggest what might be going on?
Mon, 1 Sep 2014
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Psychiatrist,  's  Response
Dementia patients with other medical conditions are prone to Delirium. This can be caused by a number of factors. Since his cognition is worse after each episode of delirium, the chances of it being stroke/TIA are high. CT Scans may not always pick up tiny lesions. Another common possibility is drug interaction or side effects. In my practice I often see elderly patients on multiple medications and who use 'sleeping pills' without doctors' advice.
Delirium in the elderly usually has multiple causes. Common conditions such as pain, constipation, infection, dehydration, electrolyte imbalance may precipitate delirium.
If your father has delirium again, make sure that you give detailed history along with information of all medications he may be taking.
I hope this has answered your question.
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Suggest Treatment For Early Signs Of Dementia With Diabetes

Dementia patients with other medical conditions are prone to Delirium. This can be caused by a number of factors. Since his cognition is worse after each episode of delirium, the chances of it being stroke/TIA are high. CT Scans may not always pick up tiny lesions. Another common possibility is drug interaction or side effects. In my practice I often see elderly patients on multiple medications and who use sleeping pills without doctors advice. Delirium in the elderly usually has multiple causes. Common conditions such as pain, constipation, infection, dehydration, electrolyte imbalance may precipitate delirium. If your father has delirium again, make sure that you give detailed history along with information of all medications he may be taking. I hope this has answered your question.