Avoiding Misdiagnosis Of Dementia

Signs of dementia
Forgetting appointments or struggling to remember words or details might be a sign of dementia, but these symptoms could also indicate other treatable diseases with similar indications. A physician might make a misdiagnosis of dementia when the patient has something as routine as a urinary track infection, medication side effects, or drinking too much alcohol.

Every year, the world sees 10 million new cases of dementia, a general term for brain disorders marked by cognitive impairment. These disorders include Alzheimer’s disease and vascular dementia, among others. As their symptoms overlap with other conditions, there is a high misdiagnosis rate, as a study found that one in four patients had an Alzheimer’s misdiagnosis.

What Are The Physical And Mental Symptoms Of Dementia?

More common among older people, dementia affects one’s thinking, memory, and communication skills. Such a cognitive impairment can lead to memory loss, disorientation, and loss of ability to handle routine and complex tasks, among others.

Loss of balance

These are the physical and mental symptoms of dementia:

  • Loss of balance
  • Loss of appetite and difficulty swallowing
  • Fatigue
  • Seizures and jerky movements
  • Lack of sleep/sleep disturbances
  • Personality and behavioral changes
  • Paranoia, aggression, and screaming
  • Hallucination and delusion
  • Anxiety and depression
  • Apathy and social withdrawal
Memory loss

Can Dementia Be Wrongly Diagnosed?

The prevalence of dementia misdiagnosis is high. Primarily, it’s because brain disorders categorized under dementia share similar symptoms — such as memory problems — with other diseases, especially age-related ones.

A study of American older adults found that most of them were diagnosed and have received care from non-specialists. Many patients didn’t even meet with a dementia specialist. 

Without a proper diagnosis of dementia, it will be challenging for healthcare experts and caregivers to provide patients with the most effective and appropriate care plans.

What Conditions Can Mimic Dementia?

Challenges in cognitive function aren’t exclusive to dementia patients. Here are conditions where affected individuals can show symptoms similar to dementia-related diseases.

1. Vitamin deficiency

Lack of Vitamin B12 and thiamine, in particular, can impair a person’s nervous system. They can experience a change in mental state and show signs of memory loss and confusion.

2. Urinary Tract Infection (UTI)

As reported by the National Institute on Aging, UTI is more common in seniors, especially women. When someone has bladder control problems, they can exhibit dementia-like symptoms, including sudden confusion and increased agitation. 

3. Sleep disturbances

Geriatric care experts witness how sleep issues are more common among the elderly. A study revealed that 30 to 48% of older people have insomnia. Such problems with sleep can cause someone to be more irritable. They also suffer from mental fatigue and have trouble focusing.

4. Thyroid disease

Both hypo- and hyperthyroidism can cause symptoms that mimic dementia. Because these disease progress gradually, many tend to regard their signs as a normal part of the aging process.

5. Diabetes

Nearly 30% of American seniors have diabetes. In the elderly, this disease can lead to poorer concentration and pronounced memory issues. 

6. Brain tumors

Whether they’re benign or malignant, tumors can be confused with dementia. An abnormal mass of tissue in the brain can negatively impact brain functions. It can also cause someone to exhibit personality changes.

Medication side effects

7. Medication side effects 

Clinicians and caregivers should know that several medicines affect a person’s brain. The side effects caused by certain drugs (e.g., benzodiazepines, opioids, corticosteroids, and some antidepressants) can mimic dementia symptoms.

Once your physician diagnoses the root cause of dementia-like symptoms and properly treats what is causing it, the symptoms should recede.

Can Dementia Be Confused With Other Conditions?

What makes dementia diagnosis difficult is that dementia-related disorders can be confused with other conditions of the brain. This emphasizes the need to consult a specialist.

Non-specialists can mistake dementia for the following:

1. Mild Cognitive Impairment (MCI)

In senior health care, some older people may display memory issues and cognitive decline but not yet at the point that their independent function is compromised. MCI refers to the stage between age-related memory concerns and dementia.

Hand tremors

2. Parkinson’s Disease And Other Neurocognitive Disorders

Parkinson’s is a brain disorder that causes an affected individual to lose control over their movements. They may suddenly experience shaking or stiffness and face difficulty walking and talking. Over time, a patient can develop the so-called Parkinson’s disease dementia.

This form of dementia — characterized by a decline in thinking and reasoning skills — surfaces at least a year after their Parkinson’s diagnosis. 

3. Normal Pressure Hydrocephalus (NPH)

When brain fluid pools in certain parts of the brain, it can cause excessive pressure that wreaks havoc on brain tissues. Patients with NPH will show symptoms that can be mistaken for Alzheimer’s (e.g., disorientation, forgetfulness).

4. Delirium

Research published in The American Journal of Psychiatry states that delirium is a “direct consequence of an underlying medical condition or toxic exposure.” It causes a severe change in one’s mental status, leading to confusion and a lack of awareness of their surroundings. Upon diagnosis, a patient can reverse this condition with proper treatment. 

Depressed woman

5. Mood Disorders 

Mood disorders such as bipolar disorder and depression can affect one’s ability to make decisions, pay attention, and think clearly. As their mental and emotional states worsen, they may also experience memory lapses.

6. Alcohol Abuse 

Excessive alcohol consumption can damage brain cells, leading to memory loss. High levels of alcohol can also cause liver disease, which, in turn, further impairs one’s cognitive function.

What Disorder Is Often Misdiagnosed As Dementia?

Attention-Deficit Hyperactivity Disorder (ADHD) is characterized by hyperactivity, inattention, and impulsiveness. Though commonly detected during childhood or adolescence, symptoms continue well into adulthood. Today, about 3% of adults across the globe have ADHD.

Among older adults, ADHD symptoms like short-term memory loss overlap with dementia. People with ADHD tend to misplace things, forget names or words, find it hard to follow conversations, and get easily distracted. Hence, misdiagnosis is not uncommon. 

Frontotemporal dementia, a rare form of dementia, also has non-memory-related symptoms that intersect with ADHD. As it affects one’s frontal lobes (in charge of brain functions like problem-solving and impulse control), patients with this dementia may show impulsive behaviors and difficulty making decisions. 

The good news is that, unlike dementia, where there’s still no known cure, ADHD is treatable. Patients can manage their symptoms with medication, a healthy diet, and exercise. Treatment plans also typically involve skills training and psychological counseling.

Diagnsoing dementia

Can Dementia Be Diagnosed With An MRI?

The accurate diagnosis of dementia-related diseases involves the use of brain imaging and neurology tests. 

Though neuroimaging alone isn’t adequate to diagnose dementia, it helps identify the baseline of the degree of brain cell degeneration and rule out other possible causes of dementia symptoms (e.g., stroke, brain tumor).

Magnetic resonance imaging (MRI) uses magnets and radio waves to produce an image of a person’s brain. To support a dementia diagnosis, a neurologist can order MRI to determine which parts of the brain have decreased in size. 

To accurately diagnose dementia, specialists also perform neuropsychological exams, mental status assessments, and laboratory tests. 

What Should You Do If You Fear A Misdiagnosis Of Dementia?

Alzheimer’s disease and other forms of dementia are tricky to diagnose. Once you notice a loved one exhibiting symptoms of dementia in its early stages (e.g., memory lapses, increasing confusion, and inability to perform daily tasks), you should take them to a specialist.

As mentioned, cognitive decline is marked by symptoms that overlap with other medical conditions. Don’t hesitate to opt for a second opinion if you fear a misdiagnosis. Also, ensure that a suspected patient undergoes brain imaging tests. 

A second opinion can confirm or rectify a previous diagnosis. It plays a crucial role in designing and implementing a proper dementia care plan and ultimately improving a patient’s quality of life.

Randell S.

Randell Suba is a former Physiotherapist who returned to his first love, writing. He has over a decade of online writing and research experience. Randall has experience managing the care of elderly parents who lived with his family and other relatives with dementia, so he writes in the area of senior living and care with considerable experience.

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