Activity coordinator in a 42 bed dementia unit. A young male (60) seems more psychotic than demented. Nursing insists he is early onset Alzheimer's, but the behavior resembles psychosis to me. How can I differentiate?
Individuals with dementia may experience a range of symptoms, including delusions and hallucinations; these symptoms can also be present in psychotic individuals. However, Alzheimer’s disease is distinguished by degenerative memory loss, which is not present in psychosis. In other words, a person with Alzheimer's disease will gradually lose their memory – first short term, then long term-over time. Psychotic individuals will experience behavioral and mood changes but memory is not affected. In order to be sure of this person’s diagnosis, a doctor must conduct a series of tests that could confirm likely causes of his symptoms. These tests can include a blood/urine test, comprehensive medical history, cognitive screen, and brain imaging such as MRI.
As you probably know psychotic describes an abnormal condition of the mind where someone is unable to identify what is real and what is not.
Having a progressive illness such as Alzheimer's, that has an organic basis where the key features include problems with memory, does not preclude also having psychotic episodes. So you can have someone with Alzheimer's exhibiting similar behaviors and expressing delusions or experiencing hallucinations.
His diagnosis will, presumably, have been reached after a lot of tests and interviews with a doctor.
Best Wishes, Christine
I would think a psychiatrist would know. Someone may have both mental problem and AD. My FIL has AD but he is also antisocial. He had some kind of mentality that was different. Since he has AD, it does not seem to be significant. He is like that kind of genius that is self-absorbed. So it is hard to tell if his outburst is about AD or about his own mentality. I would not speculate about this unless it is diagnosed properly.
Hi "shiriesz", I'm a caregiver without any medical background, but do have some experience dealing with my mother's dementia related delusions. I also have a friend who is residing in a state mental hospital due to a violent episode resulting from his psychosis. Both conditions appear similar. Either can present a paranoid element, as well. Interestingly, both can be treated with atypical antipsychotic medications, although drug warning labels usually warn against use on the elderly to treat dementia.
My mothers delusions also occasionally include hallucinations. She is making some improvement with the drug Risperidone. She has the confusion associated with dementia, but fewer delusions now. The delusions can be quite wild and dangerous. I can easily compare them to my friend's psychotic episodes. I'm not sure that being able to differentiate between the behaviors is important, once Alzheimer's has been diagnosed. Without a diagnosis, it would be a tough call. I hope this helps! -- Joe