Medical Conditions That Mimic Dementia

Several medical disorders interfere with the mental ability and cognition; it might even capacitate to mimic dementia. A progressive change in human behavior comes mostly due to several changes which occur in the body and not just one condition. The changes are not always neurological but instead are of different types which ultimately impact the neurological condition. For example, any sort of operation might make a person irritable, angry, and dependent over others which might temporarily seem to be the progression of an existing neurological condition.

Older adults are more prone to dementia and several other illnesses. It becomes very important to be able to differentiate and diagnose proper medical ailment via symptoms. However, sometimes similar symptoms can appear in certain disorders like dementia and Alzheimer’s disease. A doctor needs to be careful in diagnosing similar-symptoms appearing diseases.

Dementia as a Major Neurocognitive Disorder

Dementia is a neurological disorder which is very easily misdiagnosed as several other disorders by many doctors during the diagnosis. An acute organic brain syndrome or delirium is responsible for altering mental state causing confusion, memory impairment, disorientation, and behavioral changes, etc. These symptoms appear in dementia as well and hence can easily mimic the condition or cause misdiagnosis. Delirium is very different from dementia since it involves rapid onset after any surgical treatment or some medical ailment or even due to the toxic effects of some medications. In delirium, there is an alertness drift, changes in sleep patterns causing agitation, visual hallucinations, and psychotic delusions etc. which makes it entirely different from dementia.

Dementia slowly onsets and can be really a challenging problem. A proper diagnosis should be made through detailed understanding of the signs and symptoms, the past medical and family history and a thorough understanding of the patient’s condition. There are a number of medical conditions which mimic dementia and hence a thorough evaluation is necessary.

Medical Conditions That Mimic Dementia

Medical Conditions That Mimic Dementia

Several symptoms which can mimic dementia include communication troubles, forgetfulness, impaired judgment capabilities etc. Several medical conditions affect a certain part of the brain causing impaired thinking ability and several dementia-like symptoms. Neurological conditions like stroke, Parkinson’s disease, etc. can come up with dementia-like symptoms. Medical conditions which either resemble or mimic dementia are as follows:

Depression: Dementia is mostly linked up with depression because memory loss also accompanies certain levels of emotional despair and coping up with the disease1. Further chronic depression can even mimic dementia-like symptoms since the person usually tends to forget the assigned tasks or even new information. Memory troubles easily appear whenever the brain naturally tries to cope up with painful experiences like depression etc. Also, a certain part of the brain, under the influence of the disease, might also mimic dementia symptoms like trouble in focusing2, and taking decisions leading to voluntary social separation from events, people or friends, and sleep cycle is completely wrecked up. Hence, appropriate diagnosis and treatment can only help to cope up with the situation.

Thyroid Disease Can Mimic Dementia: Thyroid gland disorder, either under-active or overactive, can cause issues which may appear like memory loss. Hormonal fluctuations are responsible for proper organ functioning and controlling mental health and any impairment in the hormones easily affects the mental health causing several dementia-like symptoms. Hypothyroidism causes the body to slow down and affects the thought process and mental ability negatively3. So recalling things or even learning capabilities gets easily affected when a person suffers from hypothyroidism. Further, overactive thyroid or hyperthyroidism builds an opposite reaction causing anxiousness and jitteriness. The state of hyperthyroidism at times makes a person even lose control over oneself and a sonnet between reality4. Fortunately, either of the thyroid conditions can be treated with medical therapy if diagnosed appropriately and its symptoms mimicking dementia can be controlled and minimized over time eventually leading to complete eradication of the disease.

Lyme Disease Mimicking Dementia: This particular disease is mainly caused by bacteria which might enter the body via tick bite. However, it is little difficult to diagnose since its symptoms take time to appear and can show up in months or might take years to appear. Further, the longer the incubation period becomes for symptoms to appear more are the chances of getting central nervous system damaged or affected since the bacteria remains inside for long without diagnosis and treatment. It might lead to short term memory loss or other dementia-like symptoms including clouded thinking and creating issues in communication ability5-7. Its initial symptoms might start with taking more time to complete daily chores and needing more effort to accomplish them. Antibiotic treatment can be of great help to control and minimize its symptoms if diagnosed at the right time.

Hypoglycemia: This is a condition usually faced by people who are diabetic wherein a drastically low sugar levels causes episodes of a shock to the brain as less fuel hinders the ability to work properly and effectively. The hypoglycemic state also makes a person clumsy and might also lead to fainting in extreme cases8. One can overcome this state by making a person eat or drink something so that the blood sugar levels rise and later a doctor can be consulted. However, if such hypoglycemia stays for longer durations or reoccurs periodically then it might alter the state of mind of a person as well mimicking dementia like symptoms especially in case of older adults9-11.

Urinary Tract Infection Mimicking Dementia: These infections are very common to occur due to the penetration of bacteria in the urethra or anywhere in the urinary tract. If not treated with early diagnosis, this infection might spread to the bladder and even the kidneys. In older adults, UTI’s even causes some symptoms like confusion, difficulty focusing, sleepiness, feeling sad and low, all of which can resemble dementia12. Hallucinations also appear in extreme cases of UTI’s but this infection can be easily treated with antibiotics.

Vitamin B12 Deficiency: This is a weird condition which can mimic dementia-like symptoms13. Vitamin B12 is a mandatory requirement of the body for making up red blood cells, nerves, and even the DNA. However, if someone lacks this vital vitamin then a state of delusion or feeling out of place might appear. This is a very common condition among vegetarian or vegan diet consumers or in a person with Crohn’s or celiac disease which disrupts the absorption potential of the gastrointestinal tract. Excessive consumption of heartburn medications to neutralize the acid of the stomach might also cause absorption issues from the food leading to vitamin B12 deficiency and a delusion state of mind mimicking dementia14.

Toxic Metal Poisoning: The accumulation of toxic metals in the body can impair the central nervous system after affecting the liver and kidneys causing dementia-like symptoms15. Hence, an immediate thorough treatment is required to reverse the situation.

Head Injury: In many cases, head trauma might lead to symptoms which might appear like that of dementia16. However, it needs a detailed analysis for the diagnosis as the symptoms can be due to some fall and head injury and accumulation of blood inside the skull causing a subdural hematoma.

Hearing and Vision Issues Mimicking Dementia: Limitations with the sensory organs like eyes and ears might cause cognitive impairment and even can isolate the person from society. Several types of research on this issue depict that there is a link between vision and hearing loss causing dementia and depression-like symptoms, especially in socially isolated persons.

Disorders of the Vital Organs: Heart, lungs17, liver, and kidneys are such vital organs which if gets impaired effects can be seen over the entire body that too in massive forms. Aging comes with several organ disorders. Lack of oxygen supply to the brain17 causes conditions like stroke, vascular dementia, or Alzheimer related dementia in some cases. It also affects memory, alertness, and functioning, etc.

Cancer: Several types of cancers especially brain cancer can cause brain tissue damage along with increased pressure inside the head. This even leads to some secretions at times which travel via blood in the body affecting other areas of the body. Any alteration of brain functioning can easily cause memory issues mimicking dementia-like symptoms18.

Infections that Mimic Symptoms of Dementia: Several types of infections like HIV19,20, syphilis21, etc. alters the mental functioning and causes dementia-like symptoms and state of confusion. If an infection is diagnosed and treated early the damage can be reversed and all symptoms will eventually go away.

Conclusion

Most of the medical conditions either neurological or other causing neurological symptoms are treatable or curable. However, a complete in-depth analysis is required to identify and correctly diagnose the issue before any treatment can be started. The mental state can be examined via several tests like blood and urine test followed by CT scans. Several specific tests like kidney function test, liver enzyme, complete blood count analysis, thyroid test, heavy metal screening, MRI, PET scan can be recommended for detailed analysis while finding the root cause of dementia-like symptoms. A doctor can assess the situation and recommend the required tests for the screening purpose and sometimes invasive tests like biopsy might also be needed in case brain cancer is the root cause of some disease.

All sorts of cognitive disturbances can be treated these days due to the advancement in the medical field. However, a patient needs to be vigilant and open towards seeking treatment for any neurological disorder in case the symptoms surface.

References:  

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3039168/
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4078009/
  3. https://www.ncbi.nlm.nih.gov/pubmed/17353866
  4. de Jong FJ, Masaki K, Chen H, Remaley AT, Breteler MM, Petrovitch H, White LR, Launer LJ. Thyroid function, the risk of dementia and neruopathologic changes: The Honolulu-Asia Study. Neurobiol Aging. 2007
  5. Blanc F, Philippi N, Cretin B, et al. Lyme neuroborreliosis and dementia. J Alzheimers Dis. 2014; 41(4):1087–1093.
  6. Itzhaki RF, Lathe R, Balin BJ, et al. Microbes and alzheimer’s disease. J Alzheimers Dis. 2016; 51(4):979–984.
  7. Steere AC, Taylor E, McHugh GL, et. al. The overdiagnosis of Lyme disease. JAMA. 1993; 269(14):1812–6.
  8. Action to Control Cardiovascular Risk in Diabetes Study Group. Gerstein HC, Miller ME, Byington RP, Goff DC, Jr, Bigger JT, et al. Effects of intensive glucose lowering in type 2 diabetes. N Engl J Med. 2008;358:2545–2559.
  9. ADVANCE Collaborative Group. Patel A, MacMahon S, Chalmers J, Neal B, Billot L, et al. Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes. N Engl J Med. 2008;358:2560–2572.
  10. Ott A, Stolk RP, van Harskamp F, Pols HA, Hofman A, Breteler MM. Diabetes mellitus and the risk of dementia: the Rotterdam study. Neurology. 1999;53:1937–1942.
  11. Sims-Robinson C, Kim B, Rosko A, Feldman EL. How does diabetes accelerate Alzheimer disease pathology? Nat Rev Neurol. 2010;6:551–559.
  12. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4531168/
  13. https://www.ncbi.nlm.nih.gov/pubmed/15681626
  14. https://www.ncbi.nlm.nih.gov/pubmed/15029091
  15. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4798150/
  16. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5790223/
  17. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4369069/
  18. https://www.ncbi.nlm.nih.gov/pubmed/16120848
  19. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2779773/
  20. https://www.ncbi.nlm.nih.gov/books/NBK507700/
  21. https://www.ncbi.nlm.nih.gov/pubmed/10920426

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