Dementia Question

[HurricaneDolphinTulip]

My father has been referred to the memory clinic. He is mid 70s, and has definitely declined cognitively over the past 7 years or so. He retired over a decade ago and lives with my DM.

Some examples of his declined functioning are not being able to manage forms or letters from the bank, and not being able to follow what his GP says at appointments when he goes for check ups.

He has a lot of trouble making decisions about things when asked simple questions like “what do you want to drink?” - he just dithers and looks to you to make the decision for him.

There are some other changes too - he has wet himself on long car journeys, and has completely cut off one of my siblings for a non-issue that happened a year ago (think along the lines of forgetting to pick something up at the shop for him).

He seems to lack judgement for things such as giving workmen inappropriately large tips before they’ve even begun the job.

He gets very obsessive over little projects in the house or garden and demands that my mum/me/my siblings drop everything to assist him, even though these things are of no real objective importance and we all work full time. He has been happy to spend thousands on home improvements despite previously having been very frugal.

HOWEVER, his memory doesn’t seem to be terrible. As in, he knows who everyone is, he remembers things from recent times that he is interested in, remembers conversations e.g. was able to recount a conversation recently where he fell out with another family member.

Is it possible to have dementia and not have your memory affected much (at least at first)? I would be interested to hear what other people’s experiences are. I sometimes wonder if dementia can be masked by high IQ, but maybe that’s nonsense.

Thanks for reading.

Dear Hurricane, Sorry to hear your Dad is struggling. Yes it does sound like dementia. Difficulty with money and numbers is a common problem. Being unable to make new memories/retain new information is another. Huffing/imagined slights also common.

I hope the appointment brings support. High IQ does not protect us unfortunately.

Thank you for replying @Shouldbedoing I have to say writing it all down and reading it back is pretty stark. I am a healthcare professional myself and see people with dementia all the time, but it’s so different when it’s someone you know and you’re seeing them in their day to day life.

I’m a mental health nurse who used to work in a memory clinic. This sounds to me like frontal lobe dementia-although you would need scans/tests to confirm as symptoms could be caused by other things. Have a look here and see if this feels familiar. https://www.alzheimers.org.uk/about-dementia/types-dementia/frontotemporal-dementia How is his speech? Frontal lobe dementia can present with word finding difficulties before anything else. Also, yes, not all dementia results in typical “memory” issues; the brain is a complex thing. I’m so sorry this is happening and I really hope this is helpful.

Thanks @JennieTheZebra I keep looking at dementia profiles but for some reason have always skipped over that one, as I thought it affected younger people more. English is his second language but he is having more difficulty finding words and gets agitated. I don’t speak his first language which makes it trickier to judge.

FTD does sound possible. Lack of judgement, but being able to find words, obsessing about things, but not having real memory problems to start with.

How old is he? Although it frequently starts in rather younger people, it can start at any age.

Mid 70s is still quite young for dementia-in the clinic I worked in it would have been considered very young as most of our referrals were for people in their 80s. It’s good that he has a referral in place as it does sound like he’s struggling.
EDIT: in fact, looking back at the OP, you say that he has been declining cognitively for at least 7 years which would make the onset late 60s. That’s squarely in the age range for FTD.

The other thing that sticks out on the frontal lobe dementia description is the sudden liking of sweet food, which never used to be the case. Now he thinks nothing of eating half an entire cake and in fact anything left out for him to see.

Interesting what you say about age @JennieTheZebra

I was just going to ask you about sweet food.

I have a relative with Lewy Body Dementia, and his symptoms have definitely not been predominantly memory-related. It's far more to do with confusion and lack of executive function - for example trouble with forms and numbers (he used to work in finance), trouble with planning (eg being able to work out the appropriate time to leave for a journey), difficulty finding his way around. It also causes issues with taste and smell, and often with urinary continence. Other key things are fluctuating alertness (a tendency to zone in and out), and sleep disorder. With FIL, the taste/smell and sleep problems started nearly two decades before the confusion set on - dementia can start years and years before it causes cognitive symptoms. With him, the cognitive problems started early to mid 70s.

I’ve read that, while high IQ doesn’t protect you, it can mask symptoms at an earlier stage, so the dementia can be quite advanced before it’s picked up.

My dad was diagnosed with Mild Cognitive Impairment about 5 years ago. For years he had been getting more obsessive and more paranoid. Unable to handle his savings because he would read terms and conditions in full, then get them muddled, between building society, bank, and British Gas. Would insist on solving problems in bizarre ways, eg wanted the wardrobe fixed firmly to the wall so he could use the doorknob to pull himself up without pulling the wardrobe over, and would consider no other solution.

As things progressed, he has taken to living in the Cold War period. His time sense is off. “I was without food for 8hours” “I ‘ve been in this hospice for 30 years”. He can’t get to the end of a sentence without drifting off topic, and has bizarre word substitutions (eg Weetabix instead of Cruse missile) Yet he still knows the Queen has died, who Rishi Sunak is, and still remembers what has happened today, eg that I’ve just popped out to check my car is locked and will be back.

So whether that’s dementia or not I don’t know, but it’s a demonstration that brain function can be completely shot without short term memory being affected.

@MereDintofPandiculation Thanks for sharing what your Dad has been like. The IQ thing has made me wonder as he definitely aware that he struggles with some things. I feel a diagnosis will help in a lot of ways unless there is huge denial at that point.

My mum had FTD - first apparent in her early 60's and her early symptoms were word finding, behavioural, and temper. The word finding was really bad with nouns - so she could tell you the prime minister but not what a cup was. She lost the ability to read due to visual processing, and her food tastes changed from super healthy to very unhealthy (and sugar packed).
Its really important someone goes with him to the memory clinic to tell them what specifically his challenges are. On my mums diagnosis she was only just into dementia on the MMSE, but when given the more specific test which looked at language and visualisation (MOKKA I think it was) she absolutely tanked it.