My mother has been diagnosed with Alzheimer's disease, but she seems to be declining rapidly. Doesn't Alzheimer's usually get worse slowly?
Answers from Jonathan Graff-Radford, M.D.
Yes, Alzheimer's disease usually worsens slowly. But its speed of progression varies, depending on a person's genetic makeup, environmental factors, age at diagnosis and other medical conditions.
Still, anyone diagnosed with Alzheimer's whose symptoms seem to be progressing quickly — or who experiences a sudden decline — should see his or her doctor. The doctor will look for complicating conditions or factors that can cause a rapid — but possibly reversible — progression of symptoms in someone with Alzheimer's disease. The doctor will also make sure that other causes of rapidly progressive dementia are excluded.
Such conditions and factors could include:
- Infections, such as pneumonia, a urinary tract infection or a sinus infection
- Reaction to some prescription medications, such as anticholinergics, narcotic pain relievers, sedatives, corticosteroids and some antidepressants
- Fatigue or lack of sleep
- Social or environmental changes, such as moving or the presence of new medical care staff or family members
- Vitamin deficiencies, including B-12, thiamin, niacin and folate
- Thyroid problems, such as hypothyroidism
- Additional neurological conditions
- Autoimmune neurological disorders and paraneoplastic disorders, which are conditions that can cause rapidly progressive dementia
Seek a prompt and thorough medical evaluation to determine the exact cause of rapidly progressing symptoms. Additional treatment may be required, and it may be possible to reduce or reverse symptoms.
Jonathan Graff-Radford, M.D.
Oct. 07, 2017
- Haaksma ML, et al. Comorbidity and progression of late onset Alzheimer's disease: A systematic review. PLOS One. 2017;12:e0177044.
- Larson EB. Evaluation of cognitive impairment and dementia. https://www.uptodate.com/ contents/ search. 2011;68:1124.
- Basics of Alzheimer's disease. Alzheimer's Association. http://www.alz.org/alzheimers_disease_publications_alz_basics.asp. Accessed Sept. 19, 2017.
- AskMayoExpert. Alzheimer disease dementia. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2017.
- Yang B, et al. The relationship between cognition and depressive symptoms, and factors modifying this association, in Alzheimer's disease: A multivariate multilevel model. Archives of Gerontology and Geriatrics. 2017;72:25.
- Graff-Radford J (expert opinion). Mayo Clinic. Rochester, Minn. Sept. 25, 2017.