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Minding Our Elders: Infections or medications can skew dementia diagnosis

DEAR CAROL: You’ve often cautioned people not to jump to conclusions about dementia, saying that a qualified physician like a neurologist should make the diagnosis. I was grateful to have that information at hand when my father started having memory problems.

Our fear that he had Alzheimer’s disease was laid to rest after his neurologist discovered that the cause was over-the-counter sleep medications plus a vitamin deficiency. It took some time, but now Dad is back to his healthy self. Please keep passing on this information. – Brent

DEAR BRENT: That’s great news for your dad and your family. It’s also a good reminder that people need to seek expert help when they have concerns about memory.

Many people get confused about dementia. It’s actually an umbrella term that describes the symptoms that occur when the brain is affected by certain diseases, conditions or injuries. Alzheimer’s disease and vascular dementia are the most common types of dementia, but there are many others such as dementia with Lewy bodies (LBD), fronto-temporal dementia (FTD) and mixed dementia where Alzheimer’s and another dementia are found together. Most of these have no cure.

However, some types of dementia or conditions with dementia-like symptoms can be halted or even reversed with proper treatment. One example of a reversible dementia is normal pressure hydrocephalus. In this case, excess cerebrospinal fluid in the brain is drained by inserting a shunt in the brain which redirects cerebral fluid elsewhere in the body, generally the abdominal cavity.

Urinary tract infections (UTIs), alcohol abuse, depression and brain tumors can also cause neurological deficits that resemble dementia. Most of these causes also respond to treatment.

Then, there are medications. Your dad’s dementia-like symptoms fortunately were reversed when the cause turned out to be an over-the-counter sleep drug, most likely an antihistamine like diphenhydramine, which is the main component in many OTC sleep aids. Most people can take these drugs occasionally, but if taken routinely, memory issues and dizziness can occur.

Also, vitamin deficiencies, B12 being one of the most common, can cause dementia-like symptoms. It sounds as if your dad had a couple of things working against him, but his neurologist was able to determine the cause and turn the problem around.

There are prescription drugs that even physicians may not readily recognize as a problem, so every drug needs to be checked when someone is examined for possible dementia. An example of this is the case of my friend’s mother. For months this family wrestled with their mother’s Alzheimer’s diagnosis.

Eventually, the neurologist who had made the diagnosis decided to take my friend’s mother off of an incontinence drug as an experiment and the results were amazing. My friend’s mother no longer has dementia symptoms and has returned to normal cognitive health.

Even the best doctor is not able to keep up with every possible side effect of each new drug. Additionally, side effects of drugs often aren’t apparent until the drug has been on the market for an extended period of time. Therefore, checking each drug, whether it’s over-the-counter or prescription, is essential before making a solid case for dementia.

Congratulations on your dad’s recovery, Brent. Thanks for the reminder to once again address this issue.