Expert: Cindy Keith, RN, BS, Certified Dementia Practitioner - 12/4/2011

Question
My 85 yr old mother is currently in a rehab facility after an extreme bout with Pancreatitis that left her very weak. (non alcohol related but probably due to hpyothryroid). I was there when they did a memory test on her and was surprised when she could not remember where she had lived, birthdates of family members, towns her children lived in, what state or town she was lived in now and in the past.  The most startling thing was that she was confusing her husband's occupation and birthdate with her fathers.  She also stated that the year was 1934 but then that her children were born in the 40's and 50's.  The next day I repeated some of these questions to her and she still got these type questions all wrong but can repeat up to six unrelated words, identify use of specific items, knows political persons, etc.  The family background, dates and places seems to be all that are affected.  When I tell her the correct answers she realizes how bad her memory is in these areas.  She started forgetting what day of the week it was about 8 months ago but I did not consider this abnormal since her only appointment was to go to church.

She has taken two falls (12-28-10 and 12-1-11)where she struck her head very hard (one requiring sutures).  A CT was done after the first fall but no damage was seen at that time and she did not lose consciousness on either fall. No CT was done after the second fall.  

My question:  Is this dementia, AD, or a result of the falls or pancreatitis and is there anything that can be done to reverse this?  My father died from AD but Mother's memory problems don't seem to be similar to those of his.

Thanks for your help.

Answer
Hello Ann:  I'm sure you and your family are quite concerned about your mother's memory problems.  Without having a complete dementia work-up, it would be impossible to say why she's experiencing these memory problems.  They need to do blood tests to rule out a number of other conditions that mimic AD--things such as untreated thyroid disorder, B12 deficiency, a major depressive disorder, and a host of other things.  Also, they should do some brain scans to see if there is excess fluid or evidence of strokes in the brain.  Neurologic testing would also be done to test for symmetry on both sides, or deficits in certain areas.  If she has access to a geriatrician, I would schedule for the dementia work-up there first.  If not, I would take her to a neurologist with the understanding that they will be performing a dementia work-up.  Medication interaction, strokes, a lingering delirium from the pancreatitis, and a host of other things could explain the confusion.  The answers can only be teased out after ruling out a lot of other conditions, and relying on past exams and family input.
I wish you luck Ann as you and your family move to find answers to your dear mother's worrisome confusion.  Cindy