Dementia presentation - then OK - then dementia again (and repeat)

[Maplewood6]

Hi. My DM (in her 90s) had in the past week or so started displaying dementia symptoms (doesn't know who her family are, where she is, paranoia, distress, agitation). This might go on for 12 hours, then she emerges out of it and is completely normal for 12 hours, then she goes back into the dementia presentation again. She's on medication for a UTI (the GP is guessing that this might be what it is) but it's not making any difference even though they say the UTI is being treated effectively. Does anyone know whether this presentation HAS to be UTi related. Could it be another form of dementia? I'm just reallly confused by this on/off presentation as she's literally like two totally different people in the space of a day.

It absolutely sounds like a UTI.

This.

Sadly it could be either - there are definitely UTI medications (and symptoms, like dehydration) that cause that kind of behaviour, but it's also sometimes how the dementia progresses.

I'm sorry you're going through this, I have a situation in my family that is exactly the same and it is an unpleasant roller coaster. Unfortunately even with asking all of the right questions and being very aware, I still haven't had a helpful answer on this.

With dementia, ime, you can be two different people/personalities in the blink of an eye. I would try to get a memory clinic referral. Good luck whatever the diagnosis

In 2 weeks you will know. Treat the UTI and you will be able to sort her out.

I hope your mum is better soon. Look up delirium OP, it is very common in older people when they become unwell with e.g. an infection.

https://www.nhs.uk/conditions/confusion/

It comes on suddenly unlike the slower, insidious onset of dementia.

There is a link between delirium and dementia though, in that people who suffer from the former are more likely to develop the latter. People with existing dementia are also more likely to become delirious when ill.

It sounds like delirium if she has never shown any memory loss before- which could be down to a myriad of things in someone who is 90, one of which would absolutely be UTI (or any infection).
That being said, at 90 most of us will probably have some brain changes that would be unmasked by a persistent delirium, and sadly it can persist for some people.
It’s totally reasonable to continue treating the UTI, and looking out for other problems like constipation, pain etc, and ask for a referral to the Memory Clinic / local Medicine of The Elderly clinic. I hope she feels better soon.

Has she been given any new medications? I only ask because my GP persuaded me to try statins again. The side effects were awful, confusion, forgetfulness, woolly head, symptoms diminished within 48 hours of the last tablet and I was back to normal after another couple of days. I dread to think how a person with a UTI or early dementia could be affected by this med.
Cannot remember the name, sorry.

Thanks everyone for your responses. She's had some memory loss for the past few months e.g. repeating herself, not being able to remember people's names from the past etc but she was still living independently. This sudden personality shift was preceded by a few episodes of her having blankness where she just can't remember what she's doing and in the few days before the above presentation her getting up and saying she didn't know where she was or who I was. No agitation or anything though. Just a bit troubled by it. I'll get a memory clinic appointment ASAP. She's still taking the antibiotics for a possible UTI so will also see how that goes.

Much of what you describe does sound like the dementia symptoms suffered by my DM and my MIL, which can certainly come and go as you describe. However, with them we had a lots of clues over several years leading up to the dementia becoming a real problem. The fact that this has come on so suddenly in your DM seems to suggest (to my utterly inexpert opinion) that it could be the UTI.

Keep her warm and well hydrated and fingers crossed,