Sudden in old person?

[catfunk]

Family member is 78. Lives alone and is independent, previous heart issues and type 2 diabetes (takes metaformin tablets) but health is ok otherwise and walks 3 miles per day religiously. Probably not neurotypical and likes routine, sticks to his walking routine and medication and meal times religiously. No history of anxiety or depression.

Around a week ago he woke feeling confused and upset and couldn't remember which medication he needed to take. Went straight to docs who took bloods - no results yet. My thought was urine infection or blood sugars but they don't seem to have done the quick checks there and then.
His state has not changed and he's requiring assistance from family now to prepare his medication and he's not sleeping and very distressed.

Can dementia come on so quickly ? I would have thought it it was a TIA he may have improved since?

Have booked another docs appointment for Friday as we're increasingly worried about him and haven't seen any improvement. He's really quite scared and upset and aware of his confusion.

Gods sake title was SUDDEN CONFUSION IN OLD PERSON

That sounds really worrying for everyone. It must be horrible for him to actually know he is confused. I haven't heard of dementia coming on that quickly. Hopefully his test results will be on soon and the doctors will know what's going on. Best of luck to him.

my first thought would also be uti or other infection . He needs someone to check for a uti and maybe even if clear to give him a course of antibiotics just in case test doesn’t show an infection as the dipstick and lab tests miss many infections.

He also needs checking for a blocked artery in his neck as that can cause sudden severe confusion and also for a TIA. It sounds very distressing for him and for you too. His blood test results should be back by now but he needs a proper check

Could be delirium. Happened to my mum.

Thanks everyone we will be pushing for a urine test on Friday morning at gp and ask about TIA.

The fact that he knows he is confused is what is odd/ scary. I'd have thought if it was dementia he'd be less aware of confusion and it would creep up suddenly.

@LilacLemur any idea what is the cause of delirium?

@LilacLemur posted too soon, sorry that happened to your mum, do you recall if it came on suddenly and can it be treated ?

My mum had delirium after a fall and a hip operation. It was a little different though because she would tell us things that she said had been happening in the ward e.g. men who were trying to poison her, the virtually unconscious old lady in the next third, who was trying to harm her etc. we are about six months post-accident now and she no longer mentions those things though she is still convinced that they happened. It was very very real to her.

@catfunk

I think it was infection based. Yes came on quickly - like another poster mentioned she saw things and thought things were happening when they weren't. She also forgot how to do basic things like turn the telly on.

Unfortunately due to a completely unrelated illness (and it really wasn't connected in any way so don't worry) she passed away so I can't give you an update.

Delirium is quite common in the elderly.

That doesn't sound like the usual progress of dementia, in that it was so sudden.

However while it appears sudden, it isn't clear how often or in what circumstances you/other family see the person. So it could have been creeping up for a while, and only manifested when the person suddenly couldn't do something in his normal routine.

My mother has had dementia (Alzheimers) for many years, and in the earlier years she could seemingly cope fine, then one day she'd need to do something basic - and suddenly, she couldn't (something basic like make a cup of tea). Her friend once took her to the GP because she seemed suddenly 'worse', and the friend's first thought was a UTI. And it was a good thought, but she didn't have one, she had just suddenly reached a brick wall of inability, and that was the point when she needed daily help with the basics. She was 79.

And my mother was aware of her confusion in those early days, which obviously made it all the more upsetting. It is unusual for someone with dementia to have that insight, but it does happen.

Definitely do check out if there is a physical reason like infection, it may be as simple as that. But it may not.

In my FIL's case it was a stroke. He and my MIL had gone shopping. They were ready to go home, he got in the car, and discovered he'd forgotten how to drive. She walked him home, and when she turned up the path of their house, he asked her why they were going into (neighbour down the road)'s house.

He was completely confused. They went inside and he simply didn't recognise his own house. He had been absolutely normal and fit up to then.

Having worked as a carer I would also say infection. Sounds very much like a uti

Similar happened to a friend a year or so ago. They thought it was fluid on the brain - encaphelitis I think was the word. But a week ago she had a major stroke so now they think the original weird episode was probably a small stroke.

Yes far more likely to be delirium. Dementia - slow onset, person becomes almost accustomed to the confusion…delirium is rapid, scary, person will often be aware and say “I think I’m going mad!”. There’s various causes including infections and medications. It usually settles when the underlying cause is treated but it can take some times (often weeks). It is important you push for a diagnosis though, he could easily be left in limbo.

Thank you all so much much for posting I appreciate it.
The man lives alone but 2 x family members see him a few times a week for a good amount of time (I.e they go out for dinner together one night, a social event another afternoon etc.) and they've never noticed anything untoward. In fact he can be obtuse and a little socially unaware as the norm so it's a worry to see him confused and frightened and aware of himself.

I'm a bit shocked the GP only took bloods and said they'd be back in a few weeks, But he went to the gp alone - somebody will be accompanying him on Friday and advocate for him.

Hi, did you find out the cause. I am just so worried about my father.

So recently, he has been repeating himself a lot.. he repeats the same thing over and over again. He is 61 years old turning 62 this year.

For example today he told me to make an appointment and he kept asking if I made the appointment when I told him that I can’t. He called me again at work and asked if I made the appointment and I told him again that I couldn’t make the appointment. I don’t know if it’s just age related or maybe something else.

He also has been acting very out of character. He has been arguing a lot when he is not like this and has done things which is not even him.

Sometimes we’d ask him if he would like some food he would say no I’m fine I’m not hungry then later he would say why didn’t you make me food? And we are all confused because he already has said he isn’t hungry.

could this be something?

Mumoftwo your DF definitely checking out. Has he had any falls recently that you know of, has he had covid or another virus or other infection. is he on any different medication? It could be so many things from concussion, small stroke, an infection. If it’s come on pretty suddenly - ie within days, a few weeks - I would be thinking of something other than dementia which usually starts pretty subtly. If you suggested a GP appointment would he agree? If not, I would phone his surgery or 111 and explain what’s going on and get advice. I’m not a HCP but if it was my friend or relative, I’d want them checking out quickly. Hope he’s ok.

@Mumoftwo367743 my relative is still being investigated. It's a long slow process which needs a lot of pushing from us. Scans and bloods were clear apparently but they're definitely missing something. Some days he's worse than others. In the mean time his gp has prescribed a mild sedative so at least he's sleeping a little better but he's still v confused and anxious at times.