Critter Corner: Medical Problems That Can Mimic Dementia

Dear Hayek,

My mom is experiencing memory lapses and a lack of focus, and sometimes she seems confused. Of course, I worry about dementia as a possibility. Perhaps there are other treatable conditions with similar symptoms that she may be experiencing. At least I hope there are. Can you ease my mind and tell me about some common medical problems that can be mistaken for dementia? We will definitely get her checked out if her symptoms persist.

Thanks for your help!

Cim Toms

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Dear Cim,

You are correct that there are several other treatable conditions that can cause symptoms similar to dementia. Before jumping to conclusions, it’s wise to rule out all the other things that can be confused with dementia — things that may be easily reversible. As you mentioned, it would be smart for your mother to see a doctor if her symptoms are concerning.

Here are some common medical problems that can be mistaken for dementia.

• A respiratory infection, such as COVID-19: When you have an infection, such as COVID-19, the white blood cells in your body rush to the infection site, causing a chemical change in the brain that makes some older adults feel drowsy, unfocused or confused. Patients have also reported difficulty concentrating, memory slips, and attention deficits after they recover from a COVID-19 infection. In most patients, those symptoms subside after a few months.

• Medication interactions or side effects: If someone complains of memory problems, a common question is if he or she recently started a new medication, as new medications, and medication interactions, can cause something called delirium, which can appear very similar to dementia. Seniors are more likely than younger people to develop delirium as a side effect of a medication. Even a prescription someone has been on for many years can trigger confusion. This is because our kidneys and liver become less effective at clearing drugs from our bodies as we get older, so a medication can build up in our systems over time and cause problems later. It is important to note that delirium tends to come on suddenly, whereas classic dementia usually progresses slowly, with subtle memory changes that gradually worsen over many years.

• A urinary tract infection: Urinary tract infections are another very common cause of delirium and dementia-like symptoms in older adults. The good news is that most UTIs, and the accompanying cognitive issues, can be diagnosed with a simple urine test and then treated with an antibiotic.

• Dehydration: Dehydration can also look like dementia, and it’s common in older adults. As you age, your body’s ability to retain water in blood vessels decreases, and your thirst mechanism isn’t as strong, so it’s easy to get dehydrated without realizing it. To prevent dehydration, older adults should aim to get at least 48 ounces of caffeine-free fluids (six 8-ounce glasses) a day. If necessary, intravenous fluids can often reverse cognitive problems caused by severe dehydration.

• Sleep problems or disturbed sleep: Getting a good night’s rest is essential for protecting the brain as you age. Sleep gives our brain time to learn, store memories and filter out toxic substances. If your sleep-wake cycle is disturbed or you have insomnia, you may experience dementia-like symptoms such as trouble focusing, confusion, mental fatigue, and irritability.

• Other disorders with dementia-like symptoms: Many other conditions, in addition to the ones above, can cause symptoms that mimic dementia or Alzheimer’s disease, including disorders of the heart, lungs, liver or kidneys, thyroid problems, sodium or vitamin B12 deficiency, some cancers, pain, constipation, heavy alcohol use, and depression. Many of those conditions are treatable, and cognitive symptoms can often be reversed so long as they are properly diagnosed.

Dementia is NOT a normal expected part of aging. Currently, about 11% of adults 65 and older have Alzheimer’s disease, the most common form of dementia, according to the Alzheimer’s Association. It is wise to visit your doctor regularly for physicals and/or if you are experiencing symptoms to identify treatable and reversible conditions.

Hope this is helpful,

Hayek