Is this the beginning of dementia and what do I do?

[Anonymous]

My 73 year old parents live far away in another country.
My mother is physically disabled, and relies on my father.
My father has, since the pandemic, exhibited signs of anxiety, hypochondria and an increasing avoidance of social contact, or even going outside, except when he runs out to see his doctor for various very minor skin ailments that really seem to be all in his head.
My mother has to insist that he takes her out for fresh air, and has to insist that they have a friend over for a chat.
He spends most of his day examining his skin for eczema, or browsing on the internet, or jotting in a notebook his daily weight and everything he had for every meal.
When I Facetime, he chats with me briefly then excuses himself to go do various chores. He seems perfectly normal during our short conversations.

The problem has come to a head because he promised to travel to visit us this summer, but he is now stalling over buying plane tickets, saying he's too busy to sit down and book them. He used to travel internationally A LOT before he retired, and he used to enjoy coming to visit us and play with his grandkids. He has the money. I have offered to book him whatever he wants, but he has firmly refused that offer, and keeps saying he'll get to it. My mother is distraught, because she cannot do any of this herself, having a severe arm/hand handicap.

So now we're stuck. Does early dementia present in this way? Are there any other medical conditions that we need to rule out? What medical specialty best treats patients like this? Is there a dementia test that could reveal anything at this point? And do you think anti-anxiety medication would help him travel and see people, and possible stave off dementia in the long term?

Thank you.

[Anonymous]

OP here. The reason I ask is that my mother needs encouragement to speak to their doctor about all of this. She is afraid her concerns will be laughed at, so I need to help her out with information about all of this.

[Anonymous]

It sounds like anxiety to me. And that would be a good thing, becuase there is medication for anxiety, but nothing really for dementia (which in itself is not a medical condition, but a catch-all term.)

[Anonymous]

Anonymous wrote:My 73 year old parents live far away in another country.
My mother is physically disabled, and relies on my father.
My father has, since the pandemic, exhibited signs of anxiety, hypochondria and an increasing avoidance of social contact, or even going outside, except when he runs out to see his doctor for various very minor skin ailments that really seem to be all in his head.
My mother has to insist that he takes her out for fresh air, and has to insist that they have a friend over for a chat.
He spends most of his day examining his skin for eczema, or browsing on the internet, or jotting in a notebook his daily weight and everything he had for every meal.
When I Facetime, he chats with me briefly then excuses himself to go do various chores. He seems perfectly normal during our short conversations.

The problem has come to a head because he promised to travel to visit us this summer, but he is now stalling over buying plane tickets, saying he's too busy to sit down and book them. He used to travel internationally A LOT before he retired, and he used to enjoy coming to visit us and play with his grandkids. He has the money. I have offered to book him whatever he wants, but he has firmly refused that offer, and keeps saying he'll get to it. My mother is distraught, because she cannot do any of this herself, having a severe arm/hand handicap.

So now we're stuck. Does early dementia present in this way? Are there any other medical conditions that we need to rule out? What medical specialty best treats patients like this? Is there a dementia test that could reveal anything at this point? And do you think anti-anxiety medication would help him travel and see people, and possible stave off dementia in the long term?

Thank you.

I don’t know, but it could be. There are other signs though, that you would only notice if you spend time living with them for a week or more. Do you travel there occasionally? Does he seem confused? I witnessed confusion a lot at the early stages.

[Anonymous]

Yes, early stage dementia can ABSOLUTELY present with obsessive anxiety and yes there are things that need to be ruled out like anywhere from a UTI (which can cause all sorts of crazy in the elderly) to B-12 to maybe even thyroid. A Dr. who works with the elderly will know all that needs to be ruled out.

Both my parents-already anxious people became ridiculously anxious-way worse-as demetia/Alzheimers started creeping in. The anxiety meds did help when they stayed on them, but it needs to be monitored and in one case the anxiety became so obsessive and resulted in anger outbursts and tantrums needing seroquil (sp?)

Will it slow dementia-no, not exactly. It helps to manage mental health, but there are meds specifically for slowing dementia-not great meds and he will need regular MRIs, but the earlier you start the better if he is a candidate.

Have no idea of the research, but those of us who have very bright parents found that our parents displayed the other issues too, but compensated well and tried to mask and hide it, but they could not mask the out of control anxiety.

[Anonymous]

One more thing...re:being afraid concerns will be laughed at...many of us have experienced having to prove just how BAD things are with videos, etc. So yes, the Drs may minimize things and not be alarmed, especially if they don't enough experience with the elderly. Document things too. One of my parents was getting fired by Drs., nurses, for extreme hostility or bad behavior in the waiting room etc but could turn it on and seem normal. My friend's mom almost burned down her house cooking dinner and she had to keep reminding people of this.

[Anonymous]

Anonymous wrote:Yes, early stage dementia can ABSOLUTELY present with obsessive anxiety and yes there are things that need to be ruled out like anywhere from a UTI (which can cause all sorts of crazy in the elderly) to B-12 to maybe even thyroid. A Dr. who works with the elderly will know all that needs to be ruled out.

Both my parents-already anxious people became ridiculously anxious-way worse-as demetia/Alzheimers started creeping in. The anxiety meds did help when they stayed on them, but it needs to be monitored and in one case the anxiety became so obsessive and resulted in anger outbursts and tantrums needing seroquil (sp?)

Will it slow dementia-no, not exactly. It helps to manage mental health, but there are meds specifically for slowing dementia-not great meds and he will need regular MRIs, but the earlier you start the better if he is a candidate.

Have no idea of the research, but those of us who have very bright parents found that our parents displayed the other issues too, but compensated well and tried to mask and hide it, but they could not mask the out of control anxiety.

All of this.

Experiencing dementia, even a little, causes terrible anxiety. It's understandable, I'm sure I would feel very anxious if I couldn't remember things and felt I was declining.

[Anonymous]

My parents got to the point where they just didn't like traveling. Let's face it - airports aren't fun, nor is staying in someone else's house, even your daughter's place.

I'm the one that has to arrange the mail, the dog, the garden, the garbage, the newspaper, the packing etc etc when we travel, and it sounds like you're father is the same, as well as managing your mother through all this. You can be exhausted before you've even started a vacation.

Now it's a relief to have a vacation that is a few hour's car ride from our house taking whatever we like versus being squashed into a sardine can for hours, queuing in customs for hours and adjusting to the time difference, which does get harder as you get older.

If he has the money, can you suggest that he pays for your family to go and visit him.

[Anonymous]

You need to go to see what's going on.

[Anonymous]

Anonymous wrote:You need to go to see what's going on.

+1
Go there for 4/5 days to listen to him.

[Anonymous]

Maybe you can visit his doctor with him?

This sounds more like the aftermath from the isolation of Covid lockdown policies to me, but I’m not a doctor.

[Anonymous]

Agree that you should go and have some prolonged exposure with him to see what behavior he exhibits.

My mom was doing the same thing while living in another state—putting off travel, etc. and then Covid hit. Her phone calls became very short, she said she “had things to do” and we are all thinking “what things?”

I suspected something other than just her regular anxiety and my siblings told me I was being alarmist. I don’t know exactly what I was picking up on but something seemed off.

Once I was able to travel I went there and it was clear once I spent even just 24 hours with her. Her memory was definitely impaired and she had been using strategies to try to hide it. It is easier to do with very short calls.

Go. See for yourself. You will know.

[Anonymous]

Maybe take some time off and visit them and see what you observe for yourself. Also, speak with their friends, neighbors and doctors. If you find that they need more help with things around the house, help them find the right people and services. Also consider if you need to request medical power of attorney once you've made the needed discoveries.
You can also contact the hotline below and talk to a counselor for free.
https://www.alz.org/

[Anonymous]

Sounds like OCD. It seems to get worse with age and isolation. It's anxiety based.

[Anonymous]

OP here.


Thank you so much for your insight.

My parents were able to come after all!

My father was able to buy the tickets, book the hotel, etc, but then had massive cold feet 2 days before their flight, and declared he couldn't come. I had a long Facetime with him and laid it all out - that I believed he had debilitating anxiety, that perhaps it was the first signs of dementia (both his parents had some forms of dementia), and that the best remedy to ensure his continued good health was that he push himself to travel and socialize, as much as he could. I could see the wheels turning, and he made a big effort to pack and organize himself, with my mother's help.

Once in my house, I saw no signs of obvious cognitive impairment, but a LOT of rigidity surrounding his daily routine, a disinterest in seeing new things and talking to people. It seems he has lost all curiosity about the world, is very anxious and has OCD symptoms surrounding his health (some sort of hypochondria/germophobia, with skin-picking).

So... I think Covid isolation might have made his symptoms worse, and that there is a window right now when they could get better, with anxiety meds and more stimulation thanks to little trips and dinners with relatives nearby (not me, I'm a continent away).

But ultimately, I feel he does need to be screened for dementia - can this be done as a baseline, so that if he deteriorates later, subsequent tests can be compared to this one?

Thank you again!