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Could these changes come and go?

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Yes they do come and go, stress, exhaustation, poor nutrition, dehydration, can cause befuddlement. Is there a hands on caregiver who is monitoring nutrition? PD causes a loss of fine motor skills, opening a jar or can can become impossible. Also because they can't move quickly to get to bathroom they can stop drinking water, which can cause confusion. PD can also cause vivid technicolor dreams which upsets the sleep cycle, a bad night can cause confusion. I hope this helps.
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My experience has been with Lewy Body Dementia, not with Parkinson's Disease, but there are a lot of similarities, so I'll comment.

I've just read (on MedScape) that persons with PD were found to be 5 times more likely to develop dementia than a control group.

The dementia most closely associated with PD is Lewy Body Dementia. There is nothing to prevent a person with PD from developing Alzheimer's or other kinds of dementia instead of or in addition to LBD, but I think it would be most helpful to look at understanding LBD [which includes Dementia with Lewy Bodies (DLB) and Parkinson's Disease Dementia (PDD)]. There is an excellent website by the LBD Association. That will give you an idea of what to expect, if your loved one is developing PDD. No person with these diseases exhibits every possible symptom, but it is helpful (I think) to see the range of symptoms that may occur. The site is http://www.lbda.org/

One of the defining characteristics of LDB is fluctuations in cognition. Caregivers generally observe that cognition is not the only thing that fluctuates -- behavioral and emotional aspects can fluctuate, too.

Dementia is a progressive disease, and some signs and symptoms can start well before dementia would be diagnosed.
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