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Rapidly Progressive Dementia: Reasons for a Sudden Worsening of Dementia Symptoms

Watching an older loved one’s mind fade is often a slow, challenging experience for everyone involved. However, sometimes the memory loss can happen fast, leaving little time for answers. Your loved one suddenly seems confused in casual conversations, can’t remember familiar faces or isn’t steady on their feet any more, when none of this seemed to be an issue just a few weeks ago.

Changes like these are alarming and can be the signs of rapidly progressive dementia, a rare type of dementia that causes sudden decline. Read on to learn more about the causes, symptoms and treatment of the condition.

What Is Rapidly Progressive Dementia?

Rapidly progressive dementia is a syndrome characterized by a decline in cognitive function that progresses faster than typical types of dementia.

Typical types of dementia progress over years, or even decades. The stages of Alzheimer’s disease, the most common form of dementia, progress gradually, starting with basic forgetfulness and advancing to severe symptoms like difficulty swallowing.

Rapidly progressive dementia, on the other hand, usually progresses within a matter of weeks or a couple of years, says Dr. Alvaro Pascual-Leone, a professor of neurology at Harvard Medical School in Boston, a senior scientist at the Hinda and Arthur Marcus Institute for Aging Research and medical director of the Deanna and Sidney Wolk Center for Memory Health.

“Deterioration in rapidly progressing dementia tends to be clearly evident, even from day to day or week to week” adds Pascual-Leone, who is also the chief medical officer and co-founder of Linus Health, a digital health company enabling early detection of Alzheimer’s and other dementias.

Compared with typical dementia, in rapidly progressive dementia:

— The start of symptoms leads to a faster official dementia diagnosis.

— There is a quicker timeline between symptom onset to death.

— There are more rapidly decreasing scores in cognitive testing, such as the mini-mental state examination, a common dementia evaluation tool.

[READ: 8 Health Problems That Can Mimic Dementia]

Causes

Knowing the underlying cause of the rapidly progressive dementia is essential, because this will ultimately determine the treatment course.

Pascual-Leone says rapidly progressive dementia can be caused by a variety of conditions, such as:

— Inflammatory conditions, such as brain swelling

— Limited blood flow to the brain

— Viral or bacterial infections

— Prion infections, contracted through invasive medical procedures or animal contact, such as Creutzfeldt-Jakob disease

— Unusual forms of Alzheimer’s disease or other types of neurodegenerative disorders

— Autoimmune conditions, such as lupus or Lyme disease

— Some types of cancer can produce a substance that goes to the brain and damages it, causing rapidly progressing dementia.

— Toxic metabolic disease, such as toxic concentrations of lithium, mercury or copper in the bloodstream

Vitamin deficiencies, such as B1, B12 or folate deficiency

[READ: Therapeutic Lying to Comfort a Loved One With Dementia]

How common is rapidly progressive dementia?

Dementia overall affects approximately 10% of adults age 65 and older. Rapidly progressive dementia, however, may affect far fewer people, research suggests.

But the average person shouldn’t be too concerned.

“Though it can have numerous causes, rapidly progressive dementia is quite rare,” Pascual-Leon adds.

[READ: Dementia Care Activities]

Symptoms

Although rapidly progressing dementia is uncommon, Pascual-Leone says if you or a loved one show symptoms, see a medical provider as soon as possible.

Symptoms of rapidly progressive dementia may include:

— Sudden and noticeable decline in memory, language or problem-solving

— Reduced mobility

— New neurological symptoms, such as seizures or confusion

— Systemic changes, such as unexplained weight loss, fever, injuries from falls or other physical symptoms in relation to an underlying cause of rapidly progressive dementia

Diagnosis

Rapidly progressive dementia falls under an umbrella of major neurocognitive disorders but is not an official diagnosis on its own. This means that there is no standardized diagnostic criteria for the condition, and defining the condition can vary slightly between clinicians.

“Evaluating rapidly progressive dementia requires a comprehensive, stepwise approach to identify the underlying medical cause,” says Dr. Rehan Aziz, a geriatric psychiatrist at Hackensack Meridian Jersey Shore University Medical Center in Neptune, New Jersey.

Aziz says a diagnostic evaluation may include:

— A detailed history, focusing on the timeline of symptom onset, symptom progression and symptom details

Family history of relevant information, such as cancers, infections or neurodegenerative disorders, such as Alzheimer’s disease or Parkinson’s disease

— A detailed physical examination, including evaluation of movement abnormalities and a neurological exam

— Blood work and urine testing to measure metabolic imbalances, potential infections or autoimmune markers

— Cerebrospinal fluid analysis to detect inflammation, infection, neurodegenerative disorders or prion diseases, which are rare disorders caused by misfolded proteins, causing irreversible brain damage

— Imaging, such as a brain MRI to identify potential tumors, brain swelling or strokes

— EEGs, which measure electrical activity in the brain, to scan for seizures or electrical abnormalities

Early and accurate diagnosis is very important because many rapidly progressive dementias are often treatable and reversible if diagnosed quickly, says Dr. Muhammad Ali Abbas, vice chair for the department of psychiatry at Hackensack Meridian Raritan Bay Medical Center in Perth Amboy, New Jersey.

For some other rapidly progressive dementias, there are no cures, and the progression of symptoms is inevitable. Abbas adds that in rare cases, a brain biopsy may help confirm the underlying cause.

Treatment

Treatment for rapidly progressive dementia “focuses on reversing the cause and preventing more deterioration,” Pascual-Leone says.

Addressing the root cause

To treat rapidly progressive dementia, a medical provider must address the root cause, such as:

— Antivirals for viral diseases, antifungals for fungal disease or antibiotics for bacterial disease

— Correcting a vitamin deficiency

— Immunosuppressant medications for autoimmune diseases

Treating the underlying cancer

“In some cases, the rapidly progressing dementia manifests itself before other signs of the root disease, so in those cases, the cause must be identified as quickly as possible,” Pascual-Leone says.

Living a brain-healthy lifestyle

Living a brain-healthy lifestyle, both as a preventive and a treatment measure, can be helpful.

A brain-healthy lifestyle involves:

— Remaining physically active

— Being socially active

— Challenging your brain, such as reading or learning a new skill

— Eating a healthy diet

Managing stress

“While these actions won’t stop or reverse the progression of dementia, research has shown that they can help you live well for a longer period of time, slowing the progression of dementia into the middle and late stages,” Abbas says.

Managing symptoms and side effects comfortably

Older adults with rapidly progressive dementia can experience discomfort. Pain can stem from the symptoms of the dementia itself, such as anxiety and agitation. Discomfort may also come from side effects of a treatment medication, such as nausea from an immunosuppressant.

In both cases, it’s important to manage symptoms and side effects comfortably. A medical provider can discuss the risks and benefits of adding medications to reduce pain and discomfort.

Abbas also recommends considering alternative therapies under the direction of a medical provider, such as:

— Aromatherapy

— Massage therapy

Music therapy

— Pet therapy

These treatments can be another tool to reduce stress and manage symptoms, without running the additional risk of another medication’s side effects, Abbas says.

The Bottom Line

Rapidly progressive dementia is a rare form of dementia that manifests through rapid mental decline and sudden neuromuscular symptoms. Treating the root cause of the rapidly progressive dementia is the most effective treatment and can stop the condition from further progression.

If you or a loved one notice symptoms of rapidly progressive dementia, seek medical evaluation right away.

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Rapidly Progressive Dementia: Reasons for a Sudden Worsening of Dementia Symptoms originally appeared on usnews.com

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