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

If you notice a sudden onset of dementia symptoms in your loved one, it’s important to see a doctor right away. RPD has many causes, and an accurate diagnosis early on can help secure the best possible outcome for your loved one. RPD can be fatal in certain cases, but research suggests that, depending on the cause, it may be a treatable condition.

Rapidly progressive dementia symptoms develop over the course of weeks or months. Depending on the underlying condition, noticeable symptoms may include ^[01]:

• Poor judgment and difficulties making decisions
• Difficulties solving problems
• Memory loss
• Depression
• Movement disorders
• Headaches
• Apathy
• Seizures
• Flu-like symptoms
• Confusion
• Insomnia and/or excessive sleepiness during the day

Rapid onset dementia has eight known causes ^[02]:

• Vascular — Reduced blood flow to the brain. For example, a senior who has a stroke might later have a sudden onset of dementia symptoms.
• Infectious — Viral, bacterial, and fungal infections that cause brain inflammation ^[03], like HIV, herpes, syphilis, and others.
• Toxic-metabolic — Vitamin and mineral deficiencies like B12, B1, niacin, or folate, and toxicities related to lithium, mercury, and bismuth.
• Autoimmune — Diseases like lupus, Hashimoto’s disease ^[04], and other conditions.
• Metastases/Neoplasm — Cancerous growths in the central nervous system (CNS), primary CNS lymphoma, adrenal disease, and other places.
• Iatrogenic — Disorders accidentally caused by a physician, such as adverse drug reactions, contamination, or negative effects of medical procedures. ^[05]
• Neurodegenerative — Rare conditions like Creutzfeldt-Jakob disease (CJD), corticobasal degeneration, and other neurodegenerative diseases.
• Systemic — Disorders that affect the body as a whole, rather than a single part or organ of the body. ^[06]

What causes dementia to progress quickly?

If your loved one has been diagnosed with Alzheimer’s or another form of dementia, you’ve probably prepared yourself to witness a more gradual cognitive decline. Seeing a sudden increase in dementia symptoms or RPD can be cause for concern.

Though, sometimes, dementia may seem to come on suddenly simply because you recently noticed your parent’s dementia symptoms in a new light. For example, if a dementia patient suddenly can’t walk, consider that it may not be a sudden symptom. They may have had a hard time with their mobility or balance long before losing the ability to walk.

Is memory care the right fit?

Even with an Alzheimer’s diagnosis, it’s much more likely that your loved one’s quick onset of dementia symptoms are caused by another treatable condition. Sometimes, urinary tract infections and pneumonia can cause delirium, making a dementia patient’s symptoms worse. ^[02]

Delirium can be caused by many things and can be easily mistaken for rapid-onset dementia in otherwise healthy seniors. In many cases, this delirium is reversible when the cause is treated. ^[07]

Lewy body dementia (LBD) patients can experience a sudden decline. This kind of dementia is more rapid than Alzheimer’s disease, with more symptoms presenting initially and with patients experiencing a more marked decline.

In conditions with RPD, you may wonder: How fast can dementia progress? More common dementias take years. With fast-progressing dementia, however, the timeline is much shorter. RPD manifests within weeks or months. In some cases, symptoms may even appear over the course of a few days.

Along with the speed of progression, another common concern is the life expectancy of someone with RPD. This is highly variable on the person and the type of dementia they’ve been diagnosed with. For instance, if rapid-onset dementia is due to a prion disease like the rare Creutzfeldt-Jakob disease (CJD), then life expectancy may only be 6-8 months. Other forms of RPD may have a similar life expectancy if the cause of the RPD has not been identified.

A sudden onset of dementia symptoms in an elderly loved one warrants immediate medical attention, usually in a hospital setting. Ruling out other conditions to arrive at an RPD diagnosis can be difficult. In general, to diagnose RPD, you should expect the following from a medical team:

• A thorough physical and neurological exam
• A cognitive assessment such as the Montreal Cognitive Assessment
• Blood work, including a complete panel and specialized tests for rheumatology, thyroid function, and more ^[08]
• Urinanalysis
• An MRI of the brain

Depending on test results, doctors will order more tests until they can gather an accurate diagnosis. The faster your loved one’s care team arrives at a diagnosis, the better their outcome. If RPD is not diagnosed quickly, damage can be permanent. And, if RPD is not caused by something reversible, there’s often no cure.^[09]

Memory care questions? Get expert help

If your loved one has been diagnosed with RPD, much of their treatment may include ways to keep them comfortable for as long as possible. As their dementia progresses, they will need help with a variety of care needs:

• Activities of daily living, such as bathing, grooming, and toileting
• Mobility
• Medication management
• Instrumental activities of daily living, such as household management

To make your loved one’s life easier, you may want to consider home care. Staying in a familiar environment is often comforting but can require an extra set of hands as your loved one’s dementia progresses. Although, moving into a memory care community can offer your loved one the opportunity to work with a group of specialized caregivers in an intentionally designed, soothing environment.

You’ll likely need to consider how you’ll provide care, and what to do when your loved one can’t make the decisions surrounding their care. Consider these helpful resources:

• A Beginner’s Guide to Power of Attorney for Elderly Parents
• 6 Ways an Elder Care Attorney Can Help Family Caregivers
• Memory Care Help for Families: Surprising Ways to Pay for Care
• How to Talk to Your Parent About Moving to Memory Care

If you’re not sure what kind of care your loved one may need after an RPD diagnosis, you can always contact one of A Place for Mom’s Senior Living Advisors. They’ll take into account your loved one’s care needs, preferences, and other circumstances in order to help locate timely care that will keep your loved one comfortable and give you peace of mind.