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    Ronald Petersen, M.D.

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Question

Rapidly progressing Alzheimer's: Something else?

My mother has been diagnosed with Alzheimer's disease, but she seems to be declining rapidly. Doesn't Alzheimer's usually get worse slowly?

Answer

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from Ronald Petersen, 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 who seems 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.

Such conditions and factors could include:

  • Infections, such as pneumonia, a urinary tract infection or even a common cold
  • 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
  • Depression
  • Thyroid problems, such as hypothyroidism
  • Additional neurological conditions

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.

Next question
Alzheimer's test: Detection at the earliest stages
References
  1. Knopman DS, et al. Essentials of the proper diagnoses of mild cognitive impairment, dementia, and major subtypes of dementia. Mayo Clinic Proceedings. 2003;78:1290.
  2. Rosenbloom MH, et al. The evaluation of rapidly progressive dementia. The Neurologist. 2011;17:67.
  3. Josephs KA, et al. Rapidly progressive neurodegenerative dementias. Archives of Neurology. 2009;66:201.
  4. Schott JM, et al. Brain biopsy in dementia: Clinical indications and diagnostic approach. Acta Neuropathologica. 2010;120:327.
  5. Ropper AH, et al. Delirium and other acute confusional states. In: Ropper AH, et al. Adams & Victor's Principles of Neurology. 9th ed. New York, N.Y.: The McGraw-Hill Companies; 2009. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=54. Accessed June 20, 2011.
  6. What is Alzheimer's? Alzheimer's Association. http://www.alz.org/alzheimers_disease_what_is_alzheimers.asp. Accessed July 26, 2011.
  7. Petersen R (expert opinion). Mayo Clinic, Rochester, Minn. July 25, 2011.
AN01206 Oct. 15, 2011

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