When you have a loved one with dementia, life can be devastating—and challenging. And what can make dementia particularly difficult is its unpredictable timeline. Although the most common form of dementia, Alzheimer’s disease, typically advances gradually and progression can be described in stages (there are different models—for example the three- [early, middle, and late] or seven-stage models), the speed with which symptoms progress can vary widely from person to person.
But if your loved one’s dementia symptoms start to worsen within days or weeks, it’s important to note what’s happening so you can immediately seek medical advice. “While dementia is a progressive illness, it’s important to rule out underlying medical causes that may be worsening the condition,” says Gary Small, MD, Chair of Psychiatry at Hackensack University Medical Center, in Hackensack, New Jersey, and a member of TheKey’s Scientific Advisory Board.
Other times, worsening symptoms may have been present for a while, but you only notice after your loved one begins to lose day-to-day function, adds Frank M. Longo, MD, PhD, Professor and Chair of the Department of Neurology and Neurological Sciences at Stanford University School of Medicine in Stanford, California. “For example, maybe your loved one used to prepare meals and now they can’t, or they lose their way in a familiar place. Knowing what’s happening helps determine what needs to come next in terms of treatment,” says Dr. Longo, who’s also a member of TheKey’s Scientific Advisory Board.
It’s always a good idea to consult with your loved one’s primary care doctor first. That said, here’s how to tell what might be going on when you become aware of worsening dementia symptoms as well as what to look out for.
Dementia can be caused by many different conditions that affect brain health. Different causes have different treatment approaches and outcomes, so it’s important to know which type your loved one has, Dr. Small says. This way, you’re in a better position to track symptoms and note if they are suddenly worsening.
Here are the most common types of dementia along with their symptoms:
The most common type of dementia, its symptoms initially present as short-term memory problems, Dr. Small says. “Alzheimer’s has a gradual onset and a gradual cognitive decline,” he explains.
In the early to middle stages, you may see your loved one having trouble handling money and paying bills, or show forgetfulness and mood and personality changes. In later stages, symptoms can include:
This is one of the most common forms of dementia and occurs due to blood vessel damage and/or injured brain tissue resulting from the brain not receiving enough blood, oxygen, or nutrients. It may cause symptoms of memory loss similar to Alzheimer’s disease, Dr. Small notes.
Other signs of vascular dementia can include:
Unlike other forms of dementia, vascular dementia can have a stepwise structure, says Shadi Gholizadeh, PhD, MPH, Director of Memory Care at TheKey. “The decline in functioning can be steep compared to other dementias, which have a much slower progression if the symptoms follow a stroke or transient ischemic attack (mini-stroke),” she notes.
Another form of dementia, it typically affects people at younger ages, such as those in their 40s, 50s, or early 60s. “We don’t see as many memory issues initially; it’s usually trouble with language and personality changes,” Dr. Small says.
In the advanced stages of frontotemporal dementia (FTD), patients can develop muscle weakness and coordination problems that can make it difficult to swallow, chew, move around, and control their bladder and bowels.
Like most other forms of dementia, the symptoms are subtle at first and become more pronounced over time. But unlike Alzheimer’s, for example, early-stage symptoms typically include:
Up to 80 percent of people with Parkinson’s disease will eventually develop dementia. Parkinson’s-related dementia symptoms are similar to those of Lewy body dementia and can include cognitive impairment, sleep disorders, and hallucinations.
This type of dementia is usually seen in people aged 80 or over. Most commonly, people have both the abnormal protein deposits associated with Alzheimer’s as well as the blood vessel problems linked to vascular dementia, according to the Alzheimer’s Association. As a result, they may have features of both diseases.
Dementia can manifest in a number of ways, but if you notice that your loved one suddenly seems more confused than usual, or is unexpectedly agitated, they may be experiencing delirium.
“Both delirium and dementia can cause cognitive impairment, but delirium is usually due to a more acute problem. There’s often an underlying physical cause–for example, an infection or dehydration,” explains Dr. Small.
Studies show that people with dementia are up to five times more likely to develop delirium. In fact, two-thirds of delirium cases occur in people who already have dementia, according to the American Geriatrics Society.
If you notice any of these seven signs suddenly cropping up, have your loved one checked by a medical professional as soon as possible.
This symptom is common in middle- and late-stage dementia. If it pops up out of the blue, it could indicate another issue, such as an untreated urinary tract infection.
Your loved one is unable to find the right word, or forgets what they are saying mid-sentence much more frequently than they did in the recent past.
They seem restless and pace or seem unable to sit still, or they shout or scream, whereas they didn’t before.
Your loved one starts saying or doing inappropriate things that are out of character for them.
They get confused about the time of day or suddenly appear perplexed about where they are.
Your loved one may suddenly worry that others will harm them or can’t be trusted.
They see and hear things that aren’t there, whereas this hasn’t been an issue previously.
If you suddenly see any of the above symptoms in your loved one, your first step should be to make an appointment with their neurologist, or, if you can’t get in quickly, their primary care physician, advises Dr. Small.
While it’s important to notice worsening dementia symptoms, it’s just as essential to keep your loved one as happy and comfortable as possible. Maintaining a stable environment is extremely helpful in protecting and caring for your loved one, as change can sometimes exacerbate dementia symptoms.
Working with home-based care service can help you develop and maintain a long-term care plan—and help your loved one stay in a familiar environment for as long as possible. A professional caregiver may be the most beneficial option, says Dr. Gholizadeh. “For adults living with dementia who don’t have access to regular social interaction, a professional caregiver can provide an important source of companionship and engagement,” she explains.
“The longer people can be in a home that’s functional and safe, the better,” adds Dr. Longo. And remember that you don’t have to go it alone. There are plenty of options to support you and your loved one with dementia to help them receive the best possible care.
Additional reporting by Hallie Levine.
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