Can depression cause dementia like symptoms?

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Have just posted re power of attorney but thought I would post separately on mum's health.

My mum is 90 and has been living 'independently' (ie on her own but with my sister close by and visiting her several times a day). She had a fall a month or so ago and ended up in hospital since which time her mental state has deteriorated dramatically.

With hindsight she was ok until a few months ago when my sister and I started to observe worrying behaviour (she'd heard/seen things she couldn't have done), was getting confused etc etc. She was given morphine in hospital and when she came round she was totally confused. She was diagnosed with a UTI but that has long since cleared up, and she's had loads of blood tests.

She is now been diagnosed with significant cognitive impairment and is doing something which has been described to us as 'confabulation' ie where there are gaps in her thinking her brain is filling them in as best it can. She doesn't know she's doing it so the fabricated bits are very very real to her. I would say that 80% of what she says now is wrong in some way. She often thinks she is at home whereas she is an intermediate care facility to try and get her mobile again (mobility was an issue before this happened). She thinks almost all the members of her family work in the hospital in some capacity, thinks her great grandsons are running around the corridors late at night, thinks she can walk when she can't, wants to redo her will to leave something to one of the nice male nurses(!), can't remember what she's eaten etc etc.

The intermediate care facility have been focusing on her mobility and it has been a bit of a struggle to get someone from Mental Health to visit her. Someone has now been (mum is certain it was an old friend she hasn't seen for about 40 years) and they want to explore whether or not she is suffering from depression before they go down any other route. I accept that depression can cause confusion, but does anyone know if it can cause it to this extent or had any similar experiences? The MH person felt that if mum could get out of the artificial environment of the hospital and take anti-depressants she would improve dramatically ....

I hope I am not stating the obvious, but has she been checked for a urinary tract infection? It is a huge cause of confusion in elderly people, especially as they often do not drink enough.

if very recent only, maybe another uti, which causes dementia type symptoms?

Depression can cause dementia type symptoms. Or dementia can be unmasked by unfamiliar surroundings. With the history you give, this sounds more probable

Depression can cause what is called pseudo-dementia, so it could've that but it sounds like a bit more than that.
UTIs can cause sudden confusion and symptoms can last beyond the infection. Did they send a sample off or just dip it and give a broad spectrum antibiotic? If not she may need an antibiotic which is specific to the actual bacteria.
Have they checked for other infections? Did they do a scan after the fall? She could have had a bleed in her brain.
Did she have any symptoms of memory problems before the fall? Dementia doesn't come on suddenly so there may be another physical cause.

I think mum has been quite emotionally detached for a year or so and we have commented on it regularly. But she is someone who thinks depression is a weakness and you should be able to just get on with things and 'not feel sorry for yourself' (though god knows she has always done that in spades).

We can think of examples of odd behaviour since before christmas but, because she had been living independently we maybe didn't see the full picture. She was diagnosed with a uti when first admitted to hospital (over 6 weeks ago). After 2 weeks we were told the uti had cleared (though her confusion had not) and she was admitted to an intermediate care unit where they checked her urine again and confirmed she no longer had a uti. She has remained on the unit where the focus has been on getting her mobile again. Her confusion has steadily worsened and again this week she has been diagnosed with a uti. She has been on antibiotics for 3 days and no improvement.

Her mental state gets worse every day. She has regained some mobility but can't remember to summon help when she wants to move so has had 3 falls and been admitted to A&E after one of them.

I was told that there are only 2 antibiotics to treat a uti and one of them could make her very nauseous. So it sounds like they are just using something general.

Her mental state is absolutely appalling and she believes the most horrendous things are happening. We have a meeting at the unit on Monday to review her case as she can't stay there any longer. No idea what the next steps will be.

I think you should treat this as if it is dementia. The reason i say this is that there are drugs available that can significantly slow down the progress of the condition, but they only tend to work in the earlier stages. I suffer from depression and anxiety - it does make me confused and there are other MH conditions that would produce the symptoms that your mum is displaying however due to her age etc, i would really be pushing for those drugs. Sorry i can't remember what they are called,my father had dementia and it was left too late for him to have them because they all had their (me included) head in the sand. I would recommend getting on to the alzhiemers society as they will be able to offer lots of advice.

Haing been through similar with MIL, I think you're in a catch-22. Being in hospital, away from familiar surroundings, with all the strange faces and noise makes everything worse. MH person's advice rings true to our experience. MIL would improve dramatically after a week back home and some proper (not hospital!) rest but you worry about taking her out of the hospital until the appropriate care is in place.

It sounds like quite advanced dementia to me, and remarkably similar to that of my mum. She has levy body dementia, which is a type that has an element of psychosis as well as Parkinson.

My mum functioned reasonably well in her home, but when she started accesssing daycare one day a week (more as respite for my dad) she did not recognize her house when she came back - she had been away so long. From there the step to carehome was relatively short. I think the move to unfamiliar surroundings for an extended period of time enhanced her confusion.

She insisted my children had been at her house, making trouble in the night. In fact she rang me in the morning begging me to pick them up - needless to say they were asleep in their beds.

In the beginning at the carehome, she thought she was working there, and everybody else in her family were in the same building, somewhere. She remembered the people, but her world had shrunk to that of her immediate surroundings, nothing existed really outside what she could see - much like a 6 month old child would think the toy has ceased to exist, if you hide it.

I would talk to my mum about London, my dads house, and she was responding, they are masters at hiding their lack of knowledge and up to a point will agree with you and follow your conversation making the right noises. It is interesting though if they take the lead, you get a real window to their mind.

I used to think of the mind as a big filing cabinet. But with alzheimer and dementia illnesses, somebody has made a mess of the files, added files that were tv programs, books read or stories other people have told into the filing cabinet, removed some files (memories), and just jigged the others around. As time goes by, more and more files are removed...

My mum was put on antipsychotics, muscle stimulating, mood enhancing, Vit B injections in her bum (helps memory) and some alzheimer drug I dont know the name of.

At 90, sadly, you must be prepared that the hospital has policies regards to life extending medicine where quality of life, or chance of improvement is very little.

To be honest Quinteszilla, it sounds horrible, but my sister and I don't want to prolong my mum's life. My dad died 2 years ago - they had been married for 66 years. She doesn't like where she has been living (we moved mum and dad to be close to my sister). She has macular degeneration and cataracts so had stopped reading, knitting, sewing etc. She is constant pain with arthritis and, before this happened, was only just mobile with a zimmer frame. She has heart problems. She has clearly been deeply unhappy for a long time. Life has no joy for her.

Not callous, but caring. I am in a similar position with my mum. She is on "the pathway". They have stopped all medication that are not essential for life, and her illness will take its course. If she gets an infection, they will make her comfortable, but thats it. They do not prolong life that has little quality, and we agree with that. I wish you the best.

Your poor Mum's, I would not want to have to make the decision to put someone on the pathway, what a decision to have to make.

What is the pathway? I've heard it mentioned (though not in the current context with my mum) but don't know what it is.

I thought it was Liverpool Pathway. From what I can gather, the Dr's medicate the patient so they are not in pain, and remove everything else including water.

Long shot, but is she taking codeine? My grandmother saw people hiding in the garden etc. due to taking codeine after a fall... Apparently it affects some people with dementia- like symptoms. Or could be the morphine?

I'd get her medication reviewed just in case.

She's been taking codeine for donkey's years so I doubt it's that.

Hospital are now thinking it's a combination of things - some dementia; uti; strange surroundings; depression etc. But she is getting worse every day. A psychiatrist is coming to see her so we'll see if they have any suggestions.