For more on how dementia is diagnosed, see How We Diagnose Dementia: The Practical Basics to Know. Hallucinations (especially visual hallucinations) are also common, especially in Lewy-Body dementia. Delusions are extremely common in dementia, especially delusions of theft, spousal infidelity, abandonment, and persecution.Dementia (40%), including Alzheimer’s disease, Lewy-Body dementia, and others.Delusions of guilt or deserved punishment are especially common. About 15% of people with major depression may experience psychotic symptoms.Depression (33%) and other “mood disorders,” including bipolar disease (5%).(A positive urine culture in an older person who has been having psychosis symptoms for a while probably reflects a colonized bladder.) Urinary tract infections can cause psychosis, but in my experience, they are almost never the cause of paranoia or other symptoms that have been going on for weeks, months, or longer.Brain damage from minor strokes can also cause psychosis symptoms. These include electrolyte problems such as abnormal levels of sodium, potassium, calcium, or magnesium in the blood, low levels of vitamin B12 or folate, thyroid problems, severe liver or kidney dysfunction, infections, and neurological diseases. Many physical health problems can interfere with brain function.Abuse of - or withdrawal from - alcohol or other substances can also cause psychosis symptoms. Pay special attention to medications known to affect memory and thinking. Medication side-effects can cause delusions, hallucinations, or other forms of psychosis.See 10 Things to Know About Delirium for more. This is a very common condition of “worse-than-usual” mental function, often brought on by the stress of severe illness, surgery, or hospitalization.I like this review article because the authors organize the causes of late-life psychosis into six “Ds”: That’s because any of these symptoms can emerge when people’s brains aren’t working properly for some reason.Ī 2015 review article on “late-life psychosis” estimates that 23% of people will develop symptoms of psychosis in late life. Psychosis is uncommon in younger people but becomes much more common as people get older.

Disorganized thoughts or speech, meaning saying or thinking things that seem illogical or bizarre to others.

Hallucinations, which means seeing or hearing things that aren’t there.

Delusions, which means believing things that aren’t true or real.

believing that someone is out to get you, or is taking your stuff, or is in the house at night) falls into a category of mental symptoms that is technically called “ psychosis.” Still, it’s worth persisting in this, because many causes of paranoia or other odd behavior in older people can be treated.

That’s because one of the things you must do is help your mother and the doctors figure out why she’s developed these behavior changes and other symptoms.Ī fair number of people don’t get around to the medical evaluation because they assume that these crazy behaviors are either normal aging (definitely false) or dementia such as Alzheimer’s (true about 40% of the time).įurthermore, it’s often hard to get a resistant older parent medically evaluated. I do have some ideas for how you can get started assessing her, which I share below.īut first I want to explain the most common causes of this type of behavior in older adults. You are absolutely right to be concerned about your mom’s safety. Understandably, these problems are frustrating and worrying for adult children. As you may know, it’s fairly common for aging parents to develop problems like the ones you are describing. How can I test her/question her to find out the level of decline she may be in to make sure she is safe? - KĪ: Great question. With her independence comes the fact she won’t share any medical information because she thinks we are out to get her committed.

She also has difficulty with getting the right words to say out and has her sleep pattern out of whack and will call people at odd times of the night. Lately, she has “heard” voices of her grandchildren in her home and called my sister. She is a retired Psych nurse and has shown signs in the past of paranoia.

She is very active (despite breaking her hip 2 years ago), she still attends water therapy 3 times a week at the YMCA, she drives to the base (which is 20 miles away) and pays her bills on time.

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