Expert: Mary Gordon - 8/25/2006

Question
Hello again Mary!You were so very helpful when I lost my mother
to Alzheimer's this past May.Here we go with round 2.My 84
year old father has been living with us for the past year.Lately he
has been confused as to whether his dreams are real.After being
in bed for a few hours,he's been getting up, trying to
resolve"problems"from his dreams.He is fully awake,and though
the dreams seem ridiculous to us, it's hard convincing him that
they aren't real.For example,he was up at 1:30 am calling my
brothers and my cell phones,because he dreamed he was at the
VAhospital,and we forgot to pick him up.He often thinks he is
still in his house in NY,or that he is talking to my deceased
mother and brother.He asked me this morning if I really believed
my brother was dead,because he heard him talking to my
mother last night.He remembers the dreams and what he did the
following day,and then finally comes to the realization that
maybe it was a dream.It's getting scary,we just don't know what
he'll do while we are sleeping,and can't hear him.Is this the start
of dementia?All he does during the day is doze in his recliner in
front of the tv.He's been a semi-invalid for 50 years(MS)and isn't
interested in outside activities.We've tried.Any thoughts?

Answer
Hi Jamie, I'm thinking Lewy Body Dementia. You need to get him to a neurologist or psychiatrist with a dementia specialty and find out what is up.

Lewy Body Dementia is actually fairly common, and one thing it causes in many people is unusually vivid dreams because of disturbances to REM sleep patterns  - they may act out their dreams and can't tell if they are dreaming or not. It also seems to cause delusions and hallucinations that may seem very real to them.

You can do a google and see if any of it sounds familiar but here are a couple of sites with some info.

http://www.alz.org/AboutAD/RelatedDiseases/Lewy.asp
http://www.lewybodydementia.org/symptoms.php

If he has a neurologist for his MS, make sure that neurologist knows something about dementias, or else ask him to send your dad to another neurologist who is more of a brain function/dementia specialist. Your dad needs a full examination to rule out a variety of other problems, and a good review of medications to make sure he isn't taking anything that might exacerbate the situation (some drugs like wellbutrin can cause very vivid dreams).

You need some answers, since if it is Lewy Body (or even other progressive dementia), you will have to be prepared for what lies ahead.

You poor thing - you've had the one-two whammy this last few years coping with all this.

Mary