Can a severe fall trigger dementia?

Yes

One useful piece of information I got when my mom fell was that sometimes, something CAUSES the fall. The hip beaks and then you fall. You have a TIA or small stroke and then you fall. Not the other way around. Did they do any brain imaging?

UTIs can cause severe and sudden behavioral changes in elders. So can imbalanced electrolytes.

You need to make sure that the rehab docs and PAs know that this is a change in mental staus for your dad. That always needs to he investigated. Remember that they didn't know him before.

A lot of factors can be involved when someone starts with multiple symptoms, but, I agree about how sometimes, the brain problem happens first and causes the fall. It's the fall that gets 911 called and a lot of the attention. Did they do a head scan at the hospital after he fell?

I know that my LO went downhill pretty fast after she fell and fractured her wrist. She was never able to explain how it happened and within a few weeks, her Primary diagnosed her with significant dementia. Before this, she had been maintaining her own household. I later found out that she had been having some struggles before and since the incident, but, it really got bad afterwards. Once we got more eyes on her, we were able to see that she had INCREDIBLY poor balance. She would fall down for no reason, except poor balance. It wasn't like she tripped on something. The poor balance was likely due to her dementia. Her MRI showed multiple strokes.

There is evidence that a TBI (traumatic brain injury) can cause dementia but it would not happen so quickly. It happens after years of multiple injuries like the ones football players, boxers and other athletes get.
This is not to say your dads dementia is not caused by a TBI you do not know what happened to him this time or 5, 10, 15, 20 or more years ago.
There are some TBI's that can accelerate dementia that was in progress already.
Getting a proper diagnosis is important. And if he is a Veteran possibly get the VA involved as this also could be a result of military service.

My Mom was showing signs of Dementia before her fall, caused by neuropathy in her ankles. She really hit her head needing stitches. From that point on started her decline. That was 2011 to 2017.

Was he checked for a stroke that could have caused the fall. Was he checked for a concusion or brain bleed?

I agree to check for other conditions that might have caused the fall but could also be hospital-induced delirium or sundowning?

Grandma did something similar after her fall. She went into rehab her normally chatty self after a couple of days in the hospital. After 2 weeks in rehab she was a zombie. Quiet, incontinent(she was completely continent before) and pretty non-responsive. The doctors at rehab diagnosed her with dementia. When I responded that she was pretty independent before the fall, they brushed it off as she was hiding how bad she was. They ordered hospice house.

I decided to bring her home instead. 2 weeks after I had her home, she was basically back to herself. Chatty as always and we had to go through weeks to train her to just go in her diaper. She would hold it and yell at me to take her to the toilet.

For grandma, the problem was rehab. I don't know if it was the environment or maybe medication, but something was making her not herself. Once she was out of that environment and back on her normal meds, she was back to herself.

This is exactly what happened in a family member of ours. He went from driving his car and remembering everything to not recognizing his wife and thinking he was in the army in one weekend after a bad fall.

We hoped it was a UTI or something we could fix. But it wasn't. He's in memory care now.

If you get a choice, try to get a memory care facility that feeds into a good nursing home. Getting into a good nursing home takes some planning. Unless you have lots of money, you don't just walk in.

When he sees the neurologist, someone needs to be present to provide correct info on the symptoms and provide the full picture. If alone, he could give the doctor erroneous information.

You could be dealing with a delirium which mimics dementia but onset is very rapid. Med changes, changes to routine, there are lots of causes and once that trigger is dealt with symptoms improve. You also mention you’ve noticed some memory issues before the fall This could indicate a possible dementia. The brain will sometimes “compensate” for the deterioration in dementia and as long as a person is in familiar setting with long-held routines they can appear to function normally. Once the dementia progresses to a point that the brain cant compensate or a trauma or injury occurs, the dementia becomes very apparent. The decline seems rapid but the pathology has been present for a long time. An evaluation is a good step, but should include MRI and other more comprehensive knowledge gathering and cognitive testing to help see if there is damage/degeneration of the tissue in the brain. Good luck!!

It seems like what you are seeing, such an apparently dramatic change, is probably a combination of factors rather than a single cause. Hospital delirium is very real. You also mentioned he had been suffering from UTIs, which can cause or worsen dementia type symptoms. And then the fall with the strike to his head. Just seems like a “perfect storm.” I would recommend advocating that the docs treat you dad as a whole person. Specialists, for the most part, only look at their own area without considering interactions with the rest of the body. If you can find one, a geriatric general practitioner would do this. Tests may be ordered from specialists, but the GP would put all the pieces of the puzzle together.
My own father experienced very serious hospital delirium. After that he declined slowly for years. Then he had three falls on his head in three days—he refused to drink water and the chronic dehydration left him with terrible balance. Two of those falls were serious, and he was dramatically worse afterward. He did have many other issues.
I’m so sorry you are going through this. It’s impossible to be prepared for such dramatic changes in our loved ones. I wish you wisdom and strength for the road ahead.

You have to deal with his situation as it is. And it might continue to change. If he is wandering, you need to make sure he is in a place where his movements will be monitored. He might be better in an assisted living facility that can handle someone who is frail. Memory care facilities are locked and often put tracking devices on their residents and have alarms at the doors that are set off if the person gets near them. Falls can also be a symptom of dementia. This happened to my mother, who began falling when she would try to get out of bed and was falling sometimes when walking. It's as if she forgot how to walk or how to react to an unexpected situation. The aides are now putting her in a wheel chair to move her around. We got a hospital bed for her with bars so she wouldn't get out of bed on her own. She doesn't walk any more.

When they are in their normal environment that they have been in for years, it is easy for them to mask a lot of their cognitive decline.  There may be a lot going on that you are totally unaware of.   We typically don't ask someone we have known our entire lives a point blank question.  You might be surprised at his answers.  Ask him the name of his bank, how old he is, what he had for dinner lastnight.  When you start drilling down with the questions, its shocking.  The UTI's are also a problem for the elderly and can make them act bonkers, so stay on top of that for sure.   I think you're on the right trail getting him evaluated.  I'm sorry Expat.

Did he have a concussion, or does anyone even know either way?

Sounds like this is not uncommon, based on what others are reporting here.

My only thought was to suggest double checking that he didn't start any new meds in the hospital -- perhaps the confusion could be a new side effect? Worth checking out anyway.

Best of luck, it sounds like you are suddenly deep in the midst of this harsh disease :(

Sadly, yes, and it's a chicken-and-egg problem i.e. did the dementia trigger the fall or the other way around.

People with dementia often forget to urinate and hold it until they can't hold it anymore and experience incontinence. Sometimes they don't feel the urge to urinate. Either way, retaining urine promotes UTIs.

Being outside familiar surroundings makes matters worse for those with dementia. Until your father returns home, I would not draw any conclusions by what's happening at rehab. Once he's back home hopefully he will become more lucid.

No! Alzheimer's Dementia and Lewey Body Dementia does not start "suddenly". He is probably sleep-deprived while in the hospital: lots of people checking on you throughout the night, lost of lights, lots of noise... not to mention any medications that may have a sedating effect. I've seen plenty of seniors get confused in the hospital, especially on night shifts. They do better when returned to their normal environment and usual routines. It seems that your father may have has some underlying dementia for quite some time: the loss of weight from forgetting to eat, the generalized forgetfulness, UTIs may be from forgetting to drink enough fluids...

However, if he has increasing confusion, I am concerned about a contusion (brain bruise) or a subdural hematoma (slow forming pool of blood under the skull). Both can make him a bit confused. The contusion gets better with time. The subdural hematoma gets worse with time. Usually, you don't get confusion from a subdural hematoma right away but months later.

In any of these cases, a neurological evaluation is your best option. The doctor can then address treatment options for dad.

Being in a different environment for an extended period of time and having one's routine disrupted is hard for anyone...but you've got a lot of other things in the pot...the possibility of alzheimer's or dementia brewing long before...and then this event which was traumatic. Medications that aren't metabolized the same as a younger person, or dosing that is not adjusted for an older person. Any surgery? Anesthesia can impact. And of course you can't rule out a flare up of the UTI if it hasn't resolved or if there is a new one. It was all similar for my mother who had an emergency appendectomy about 4 years ago. There had been little signs...but that seemed to be a trigger point. It was developing right under our noses. And it was nearly a year till it hit us in the face when they went on a trip to visit my sister. The travel went fine, but within hours I got a call from my sister who couldn't believe I thought mom could do this. I was shocked...and then I began to do a little refresh of the signs and was further shocked that mom had 9 or 10 out of 10. Do check out something called SAIDO. I wish I had remembered about it at the time. There is no program close to us, but I would have pursued it had I known at the time. Good luck...PS SAIDO is a program that works one on one to get people to use their brains...I'm not remembering all the details, but I do remember the article and the story of a person who came back to being himself again...

I read an article in the New England Journal of Medicine several years ago that studied the fact that a stay in ICU can sometimes result in dementia (or maybe trigger dementia or make it more severe).  This was even in younger adults.  This seemed to have happened with my Dad.  He had a UTI and became very disoriented.  He was hospitalized for some time and started a sharp decline afterward.

Our mom had surgery on her elbow and also went in fine but left not knowing her own house. We thought it was the anesthetic. I read that if the brain is already vulnerable then it can be affected. She has never recovered to her regular self.

It's always good to rule out condition called 'Normal Pressure Hydrocephalus' (NPH) with an MRI or CT Scan to look for enlarged ventricles in the brain. Also a spinal tap can be diagnostic for this condition (by draining CSF if pressure is high; decrease in cerebral spinal fluid (CSF) pressure can helps reduce symptoms of dementia). There have been many cases where patients who have NPH are wrongly diagnosed with Dementia, or Alzheimer's.
... *Treatment for NPH is simple; surgical placement of a shunt to drain build up of CSF preventing symptoms of dementia and permanent damage to areas of the brain affected by increased CSF pressure.

That's exactly what happened with my 96 year old mom in mid-stage dementia. She fell, broke her hip and hit her head hard. That fall seemed to fuel the dementia -- like you said, from 0 to 60 almost overnight. Her decline was very very fast after that. At the beginning of February, she fell again in the NH, trying to get up to pee (even though she had been catheterized for almost 2 years). The result was a devastating head injury that she never recovered from. She was gone 10 days later.

all it takes is one fall to become the "game changer"

It's also possible he has a "subdural hematoma" - (basically a bruise of the brain that expands within a few weeks following the fall as it absorbs fluid while the body/brain's cerebral spinal fluid/surrounding vasculature absorbs the accumulation of blood (the bruise). The swelling of the bruised area; i.e., bleeding from small vessels due to fall/injury can cause symptoms of confusion (especially if on a blood thinner/aspirin/alcohol use that decreases clotting resulting in larger bruise). If accumulation of blood significant enough to increase pressure on that area of the brain, it can be removed via surgery. As we get older, it sometimes can just take a change in scenery to increase symptoms of dementia, so there may be several factors with potential to resolve

Definitely could be brain injury. Has he been seen by a neuro doctor? Whatever kind of doctor is treating him should be asked your concerns about the immediate decline

There could be a bladder infection involved in all this now; and in any case your Dad now needs diagnostic workup by MD neuro. Your father, I assume, got a brain scan after this last fall and change? There could be concussion.

The fall did not cause or exacerbate Alzheimers or Dementia.

A fall, injuring the Temple area, however, could permanently damage the brain resulting in behavior that seems like Alzheimers or Dementia either started or was progressing.

As for him making up stories, now,.....the temple area is where the temporal lobe is located. Damage to the temporal lobe can cause hallucinations and talking too much.

Here is some info with a link:

https://www.neuroskills.com/brain-injury/temporal-lobes/

Right temporal damage can cause a loss of inhibition of talking. The temporal lobes are highly associated with memory skills. Left temporal lesions result in impaired memory for verbal material. ... Seizures of the temporal lobe can have dramatic effects on an individual's personality.

IMHO, I would be very concerned with the patient hitting their head. Take the patient to the neurologist.

My mother experience a head injury yrs ago as a senior citizen. Parkinson-like physical behaviors exhibited within months. Now several yrs later, dementia (brain) symptoms have showed. NeuroPsych testing revealed LBD, Lewy Body Dementia. Since her symptoms began after aged 75-80, Dr Neurology said not a genetic happenstance. Said more likely due to fall she took resulting in head injury and old age, combined. Head injuries in old age do more damage than head injuries in early/middle age, in general. My mom's LBD brain dementia started 2.5-3 yrs after fall. That said, UTIs can cause brain dementia even after UTI treated and dismissed from body. Brain still affected, takes time to heal the UTI brain. I would have your father analyzed by NeuroPsychologist. Good luck.

The home health nurse told me whenever a person hits their head they should be checked out. So whenever my mom hit her head in a fall I took her to the hospital. She never experienced any memory issues after hitting her head. I suppose it matters where they hit and how hard of the impact.

Gosh, my mom has wonderful memory. She remembers things that younger people in the family don’t. The same with my 98 year old cousin. If I have questions I ask her and she is the one to know the scoop!

After they refresh my memory, then I recall it. Some of the elderly are amazing in what they remember.

I suppose my earliest memory is my first day of kindergarten. I remember not wanting my mom to leave. In my day, preschool wasn’t common so I was dealing with separation anxiety.

I find memories fascinating. My husband is very intelligent but he doesn’t recall a lot of things in his early childhood. He says he filters out unimportant stuff! Hahaha

Yet, being an engineer he is extremely detail oriented but with the day to day stuff, not so much.