Expert: Alanna Shaikh - 10/22/2008

Question
Hi I am hoping you can help me out.  My mom has recently been diagnosed with Dementia but I am not sure that is an accurate diagnosis. My mom has always had mental illness but has never been treated for it and I am thinking it is more of a mental illness issue than a dementia issue.  How do I tell the difference and is there some type of testing that the doctors can do to give us an accurate diagnosis?  I will give you as brief of a description of what is going on as I can.  My brother is in his final year of med school and my mom has always said when he finished that he was going to take care of her.  In early Aug I received a phone call from my mom (I live 2 states away) saying that she had been terminated from her job because she lost an entire day and was supposed to go into work and instead went to a neighboring town but doesn't know why or how.  Then a couple of days following that she was involved in a car accident in which she says someone hit her as they ran a redlight (in a well traveled area) and then the person ran.  I asked if she contacted the police and she said no she drove home since the person ran.  My brother went and looked at her van which showed front end damage more like she had hit something.  At this point in the conversation she tells me that she has been forgetting things for the past year and a half such as where she put her keys and how she ended up in places she wasn't supposed to be.  I kind of find this hard to believe as I speak with my mom on a regular basis and she is always talking about what is wrong with her but never mentioned any of this until this phone call.  At this point I recommended my mom go in and speak with her Dr. who ran a CT on her and some test on her carotid arteries?  Both test came back normal.  The doctor at that point diagnosed her with Dementia and helped her file for SSDI.  Upon further speaking with my mom she was getting evicted from the place she lived for not paying the mortgage for 3 months but she is trying to tell me that she only owes for 1/2 month.  At this point my brother and I decided it would be best to move her to the state in which I live so I can check on her on a daily basis and take over her finances.  She has now been living here for 2 weeks and I do not see signs of dementia but still continue to see many signs of mental illness.  On occasion she will do things like she did today and call me and say her dogs are missing and she has been looking everywhere for them, then when I get almost to her house she calls and says she found them that they were tied up in the back yard but that she doesn't know how they got there.  She made sure to tell me several times while I was at her house that she had no idea how the dogs got there that she forgot putting them there.  I kind of feel like the entire situation was staged to try and convince me that she has dementia as she knows that I do not think dementia to be an accurate diagnosis.  Other than that when I check on her every day she seems to be ok remembering things and doing her daily task like unpacking her boxes and getting her house together but she does not seem to be doing personal hygiene at all.  Often times when I come out she is in the same clothes as the day before and has not showered or brushed her teeth.  I want to find out what is really wrong with her and if it is dementia to learn more about it so that I get over this feeling that she is playing a game.  Can you please help.

Answer
Dear Tina,

The symptoms of dementia and mental illness are very similar. Your description could easily describe either cause. Dementia can take on a lot of complicated forms; every case is different.

There are several diagnostic tests cognitive capacity, and therefore dementia. If you are concerned about the accuracy of your mother's diagnosis, I would recommend she see a neurologist for neurophysiological testing. A psychiatrist with experience in dementia could also help with diagnosis.

You are in a difficult situation. My thoughts are with you as you handle it.

Best,
Alanna