What are the symptoms of dementia in a 90 year old person?

According to the National Institute on Aging, about one-third of all people age 85 or older may have some form of dementia. Understanding what are the symptoms of dementia in a 90 year old person is critical for families, enabling early detection and helping to differentiate between typical aging and serious cognitive decline.

Quick Summary

The symptoms of dementia in a 90-year-old can include progressive memory loss, difficulty communicating and performing familiar tasks, impaired judgment, and significant personality changes. These cognitive declines can severely interfere with daily life and functional independence, requiring careful observation and medical evaluation.

Key Points

• Progressive Memory Loss: A key sign is forgetting recently learned information and repeated questions, distinct from normal age-related memory lapses.

• Behavioral Changes: Watch for sudden mood swings, increased anxiety, withdrawal from social activities, or new signs of paranoia and suspicion.

• Communication Difficulties: Pay attention to struggles with finding the right words, following conversations, or completing sentences.

• Impaired Judgment: Note any poor decision-making regarding finances, personal safety, or daily routines.

• Physical Decline: Loss of balance, coordination issues, and difficulty with daily tasks like dressing are late-stage indicators of dementia progression.

• Seek Medical Advice: Early and accurate diagnosis, even for a 90-year-old, is crucial for effective care planning and support.

Recognizing Cognitive and Memory Symptoms

In a 90-year-old, distinguishing typical memory lapses from dementia symptoms can be challenging. A key difference lies in the frequency and impact on daily function.

Progressive Memory Loss

This is often one of the most noticeable signs. While a healthy 90-year-old might occasionally forget where they placed their keys, a person with dementia might:

• Forget newly learned information and struggle to retain new memories.
• Repeatedly ask the same questions within a short time.
• Fail to recall the names of close family members or friends.
• Forget recent conversations or events entirely.

Communication Difficulties

Language skills can decline significantly, affecting both speaking and understanding. This can present as:

• Trouble finding the right word, often substituting unusual words for familiar objects.
• Trailing off in the middle of a sentence with no idea how to continue.
• Difficulty following or joining a conversation.
• Withdrawing from social interactions because communication is too frustrating.

Problems with Abstract Thinking and Judgment

Everyday tasks that require problem-solving become increasingly difficult. An individual may experience:

• Challenges managing finances, paying bills, or handling complex transactions.
• Impaired judgment that can lead to poor decisions, such as falling for scams.
• Difficulty with planning and organizing, from making a shopping list to preparing a meal.
• Poor hygiene and neglect of personal care due to an inability to follow multi-step routines.

Behavioral and Psychological Changes

Dementia is not just about memory; it profoundly affects a person's behavior, mood, and personality. These changes can be particularly distressing for family members.

Personality and Mood Shifts

Noticeable shifts in personality can include:

• Increased irritability, anxiety, or depression without a clear cause.
• Becoming uncharacteristically withdrawn from social activities and hobbies they once enjoyed.
• Loss of empathy or not caring about other people's feelings.
• Sudden, dramatic mood swings.

Wandering and Disorientation

Disorientation can manifest in various ways, often escalating as the disease progresses:

• Getting lost in familiar neighborhoods or one's own home.
• Confusion about the time of day, day of the week, or current year.
• Wandering away from home, which poses significant safety risks.
• Losing track of how they arrived at a particular location.

Hallucinations or Paranoia

In certain types of dementia, such as Lewy body dementia, hallucinations and paranoia are common:

• Seeing things that aren't there (visual hallucinations).
• Believing that people are stealing from them or that others are plotting against them.
• Experiencing delusions or unfounded suspicions.

Physical Symptoms and Functional Decline

As dementia progresses, physical abilities and the capacity for self-care diminish.

Difficulty with Everyday Tasks

What were once simple routines become monumental challenges:

• Inability to perform routine activities like dressing, bathing, or grooming.
• Trouble operating household appliances or following a recipe.
• Needing assistance with using the toilet.

Loss of Balance and Coordination

Physical symptoms can include:

• Uncoordinated or slow movement.
• Changes in gait, leading to shuffling or a higher risk of falls.
• Stiff limbs or tremors, particularly in the later stages.
• Issues with depth perception and recognizing objects, leading to increased clumsiness.

Normal Aging vs. Dementia in a 90-Year-Old

It is important for family and caregivers to understand the key differences to seek a proper medical evaluation.

Characteristic	Normal Aging	Symptoms of Dementia
Memory Loss	Occasionally forgets a name or appointment but remembers it later.	Forgets newly learned information, recently-told facts, or significant events.
Problem-Solving	Makes an occasional error when balancing a checkbook.	Inability to follow a familiar recipe or keep track of monthly bills.
Completing Tasks	Needs help using new technology or programming a TV.	Finds it difficult to complete daily, routine tasks like getting dressed.
Communication	Searches for the right word occasionally.	Frequently struggles with conversations, repeating phrases or stopping mid-sentence.
Misplacing Items	Puts an item down and can retrace steps to find it.	Loses items and is unable to retrace steps; may accuse others of stealing.
Mood & Personality	Develops specific ways of doing things and can be irritable if routine is disrupted.	Shows dramatic, sudden personality changes; becomes fearful, anxious, or suspicious.
Social Withdrawal	Sometimes feels tired of social obligations.	Avoids social engagements because of communication difficulties or confusion.

When to Seek Medical Attention

Early diagnosis, even in a 90-year-old, can offer benefits like better management of symptoms and planning for the future. If you observe any of these symptoms, it's advisable to consult a doctor. Here's a guide to what you should do:

1. Start a journal. Keep a log of the changes you've observed, noting when they occurred, their frequency, and their impact.
2. Schedule a visit. Make an appointment with the person's primary care physician for a comprehensive evaluation. Consider bringing your notes to share with the doctor.
3. Encourage evaluation. The doctor may conduct cognitive screening tests and order further diagnostic imaging or blood work to rule out other potential causes.
4. Explore resources. Visit reputable organizations like the National Institute on Aging for information and guidance on dementia types and care.

Conclusion

While some cognitive changes are a normal part of aging, the progressive and life-altering symptoms of dementia are not. Recognizing these signs in a 90-year-old can be a difficult and emotional process for family members. However, understanding what to look for and seeking a medical diagnosis early is a critical step toward providing the right support and care. A diagnosis helps create a roadmap for managing symptoms, ensuring safety, and preserving the best possible quality of life for your loved one for as long as possible.

Frequently Asked Questions

Is forgetfulness a normal part of aging for a 90-year-old?

While some memory changes are normal with age, dementia involves more significant, progressive memory loss that interferes with daily life. Normal aging might mean occasionally misplacing keys, while dementia could mean forgetting how to use them or what they are for.

What is the difference between dementia and Alzheimer’s disease?

Dementia is a general term for a decline in mental ability severe enough to interfere with daily life. Alzheimer’s disease is the most common cause of dementia, but not the only one. Other types include vascular dementia and Lewy body dementia.

How can I tell if my 90-year-old parent's confusion is dementia or something else?

Sudden confusion can be caused by many factors, including urinary tract infections (UTIs), medication side effects, or dehydration. Dementia, however, develops gradually. It is important to consult a doctor to rule out reversible conditions.

Are there any treatments for dementia symptoms in a 90-year-old?

While there is no cure for most forms of dementia, medications and therapeutic interventions can help manage symptoms and slow cognitive decline. Non-drug strategies, like creating a structured routine, can also be highly effective.

Should a 90-year-old with dementia stop driving?

Driving can become extremely dangerous for someone with dementia due to disorientation, poor judgment, and slowed reaction times. It is critical to have an honest discussion and assess their abilities with a medical professional to ensure safety for them and others.

What should I do if my 90-year-old parent with dementia starts to wander?

Wandering is a serious safety risk. Consider using safety locks, door alarms, or a GPS tracking device. Creating a predictable daily routine and ensuring the living space is safe can also help mitigate wandering behaviors.

Is it normal for a 90-year-old with dementia to have hallucinations?

Visual hallucinations are common in certain types of dementia, like Lewy body dementia. It is important to inform a doctor so they can adjust medication or recommend coping strategies. Do not argue with or dismiss the person's experiences, as they are very real to them.