How is dementia diagnosed and how bad do the symptoms get?

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My 88 year old mother has obvious signs of dementia but has never been diagnosed as such. She had an MRI recently, but it did not indicate anything abnormal (the reason for the MRI was to find the cause of her dizziness). The symptoms do not seem to be as bizarre as some of the Alzheimer symptoms, but her memory and confusion is rapidly getting worse.

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Memory is a tricky thing. We all experience times of forget were we put something or why went down the hall ( what was I going to get or do) what I went to the store for. As we age we have sometimes what my Mom calls as senior moments. She questions what was I going to do? As she is on a # of medications for different problems you can only question is it the mecication or is it her mind going but then is it just that she is getting older. My answer as she has been living with me for 5 years is all of the above. Medication have side affects and so does some of her medical problems. She has thryoid problems which when I looked into was causing short term memory loss. We were repeating things and she was repeating things to the point that we argued. Even when I tried to explain that the doctor said it was do to the medical condition she was upset cause I would tell her she had repeated things a number of time and I already hear what she was telling me. This only upset her as she did not remember telling me so she was intent on repeating things. At one point I felt we would not be able to continue living together. I was exhaused and fustrated with the situation I was trying to care for a alheimer's patient at his home all day and then come home to take care of my Mom. Who I spoke to # of times during the day. I was not able to relax if I came home Mom was always worried about things she couldn't do and that needed done. She was a great house keeper so cleaning was then left to me as she could not do it but she would just keep saying things like I can't do the vacume or the moping I need to get a housekeeper. I would reminder her this was my home and I took care of the cleaning. But do to the short term memory loss she would just keep bringing up the subject till I did it then she would be sorry for making me do her cleaning. Again I would remind her that this was my responsibilites. I did keep a clean home and would usually do most of the cleaning on my days off. But to her things needed done daily and I mean daily dust, vacume, wash floors everything daily. I am also not well and have number of medical issues as to both knees and a shoulder with lots of pain. I have medication that work sometimes but as with that have terrible side affects. I try my best to be a good daughter and caregiver but I am wore out from not my Mom but my own health issues. I look at it this way one day at a time and one hour at a time and sometimes it is just get me thru this next ten minutes. I am trying my best and some days that isn't enought. I just have to remember that yesterday is gone and I can't fix it or change it I can only start today with a smile and say with God's help I will have the strength to do what needs done.and if time or energy runs out there will always be tomorrow. I also have learn to give some things up. Do to my health issues I have limited abilities and energy to complete everything the way I'd like. I have to remember that I am her caregiver and she is doing her best to remember that we are a team. I am not able to work anymore and take care of my Mom and myself. So now I am learning that I have to slow down take care of my health issues and Mom. One day at a time.
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Hi Dianne,

All good input from the others.

When my mother-in-law was diagnosed with Alzheimer in 1993, there weren't so many tests (or meds) being done. There are some basic tests you can do to give you an idea of were she's at so you have a little more info to help the docs, or that the doctor may do initially. They are simple cognitive function things like having the patient draw a clock, the "old fashioned" numbered type, asking them the current day, month, year, who the president is, word recall - tell them a few words, nouns, and after you ask them another question or two, ask them to repeat the words you gave them to remember.

These are only basic screening items these days, but was all they really had to go on back in the day. That and our observations of her. Sadly it was Alzhiemer's in her case. A lot of humor and accepting her for the person she was at any given point in time got us ALL through several years of progression and allowed us to enjoy our time together and build positive memories for us and our children.

God bless you both!
Mary
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Thank you so much, everyone! Yours answers were extremely helpful. I think I will start by talking to our family physican, since my mom likes her (and Mom doesn't like most people!). Mom is upset with having to go to so many doctors lately, I don't think she will be keen on seeing another doctor--at least not for awhile. Then if our doctor wants to refer her to someone, hopefully Mom will be more open to it. At least the information helps me to know where to go from here. I am hoping that some of the medications may help her. Thank you again for your wonderfully informative answers!
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I took my mother to a university who had a research program for dementia. She had very qualified psychologist and psychiatrist, as well as psychology doctoral students, and the fee was very reasonable. They met with me several times and gave me a lot practical help in knowing how to best care for my mother and what to expect as the disease progressed. I had medical doctors and neurologists test her also but found the university to be the most helpful for guiding me. The information was also very helpful when I went to court for guardianship.
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The response by Jess, was an excellent read, gave a lot of very good information.

Leroy
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My Mom is unable to take any of the drugs (namenda, aricept, etc.) Her paranoia and delusions are driving us crazy and no medication agrees with her. Last week the neurologist put her on risperdal...very small dose in morning and evening. One day into it, and she started with atrial fibrillation. (she has heart problems) She is 86 with stents, triple bypass, pacemaker, etc. She is extremely difficult but is still high functioning in her personal habits. Not everyone can take all these so called wonder drugs.
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Dianne you've gotten really good information so far.

I think of dementia as an umbrella that all seniors are under and each of the spokes represent the different aspects or diseases of dementia.

There are several diseases - NOT just Alzheimer's - within dementia: Lewy Body(LBD), FrontoTemporal(FTD) or Picks's Disease, Vascular Dementia. And each of these have similar and yet different aspects. And then there's the overall aging of the brain causing "senior moments" that happen to all of us as we age.

There are simple tests to see where the person is on the dementia scale: in addition to those mentioned above there is the clock drawing test, the MMSE, Folstein test. These plus a MRI or scan can give the physician a baseline of where a patient is at. The MRI/brain scan can look at brain shrinkage and where which is useful. All of these should get repeated pretty regularly to be able to evaluate whether a particular set of med's are working.

My mom has LBD and is mid-90's. LBD tends to be more episodic. For her, the antianxiety / depression med's seemed to work well without the dementia drugs until just the last 6 months. As the episodes got closer and closer and she had more false beliefs and paranoia to the point it was controlling her. Her doctor put her on the Excelon patch and continued the Remeron. Now she is much more even and relaxed. The dementia is still there but it doesn't control her constantly.

She is mid-stage dementia but it comes and goes for LBD. Her roommate is also mid-stage but is Alzheimers and is on the Aricept and Namenda combo.

Most MD's are not trained for dealing with dementia. You should try to get her to see a gerontologist who will become her primary doc and they can refer her to the neurologist, psych. or others needed for her care. Good luck.
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You should have your mother evaluated by a qualifed neurologist or geriatric psychiatrist specializing in Alzheimer's care ( full medical history, blood tests to rule out thyroid and other treatable conditions that mimic Alzheimer's, MRI, and cognitive tests.) If there is a diagnosis of probable dementia, get your mother started on the combination of Aricept and Namenda. These drugs have helped to reduce my mother's symptoms for over two years now and have made caring for her alot easier. Lots of luck.
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Hello Dianne --

The National Institutes of Health's Senior Health resource guide has a good article on Alzheimer's Disease, its diagnosis, and treatment. Here's the section on symptoms and diagnosis: http://nihseniorhealth.gov/alzheimersdisease/symptomsanddiagnosis/01.html The last page of this section has a video on diagnostic techniques. For more indepth information, including research, see the NIH Medlineplus articles at http://www.nlm.nih.gov/medlineplus/dementia.html

I hope this information is helpful to you and your family!

---Jess
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dianne.....if you are looking for a definitive diagnosis such as x-ray or MRI to show this disease....there is no such thing. As kt says, there are tests that they give and then determine whether or not there is some dementia going on. These are simple tests, such as saying three different words and then having the patient repeat them back. Or showing a picture and having them redraw it, or have them make change......my mil failed all tests.....but I already knew she had dementia going on. It is a normal part of aging....happens sooner, later, not as severe, terribly severe, it just depends on the person. I have seen some people well into their 90's and their mind is as sharp as a tack! Others are showing signs of dementia in the early 60's. Just remember that all of the "brain diseases" fall under the category of dementia...Alzheimer's, OBS, etc...it will be up to her doctor to put her into which disease she has. I hope this helps a little bit......

Jam
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