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My 92 year old father is getting more confused. It tends to be worse in the evening. I know about sundowners but I thought that was more with moderate and advanced dementia. He recently passed the MMSE test when I had the doctor check him for dementia symptoms, so I am wondering if his confusion could be depression related. I’ve never really seen anything that compares specific confusion-related depression symptoms with dementia symptoms. Dad's biggest issues are short term memory loss and that he doesn’t think he is home. For example, he asks when we are going home. I think this is a pretty typical dementia symptom but is it also a symptom of depression? I also talked to his doctor and we took him off his pravastatin, which I’ve heard might cause confusion too. I think I heard that it may take up to three weeks for cognition to improve if it is statin related. Anyone that can share experience or knowledge about this is much appreciated.

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If there is no improvement in a few months he should have a much more thorough exam with a neuro psych doctor. I doubt this is depression.
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Sorry to hear what you are going thru, I feel for you.

Both my parents have memory issues and both are in their 80's. My Dad is very well aware that he does not remember things, especially appointnents or even coming to my house for dinner, he needs to write it down in his pocket calendar.

My Mom however, has different memory issues. Can't get her to the doctor, although the one time we did the neorologist thought dementia. She does not believe she has any problems, and always, in her mind, has a reason for why something happened. I'm often the one she blames when she can't find something, I've stolen it.

Does your Dad have a favorite blanket? Or a clock? Something that really means home to him? Thinking if its like an afgan then maybe put it on his favorite chair that he sits in or something.

We really need to keep advocating for our parents, or elderly family. We know them at their best and at their worst keep it up.

Just thinking to, is he drinking enough fluids? Dehydration can be a corncern.

Hope this helps and keep up the good work.
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Yes, my sister did in-home care for an elderly Russian woman who was highly functional and spoke English fluently. Her doctor put her on a statin drug and she began to speak only Russian and believed she was living in St. Petersburg, Russia.
The doctor told the family that their mother had developed severe dementia.
My sister convinced the family to try taking her off of the statin, and within about 2 -3 weeks she was her normal self again.
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My mother's been depressed her whole entire life and it's never manifested itself in Memory loss, not realizing she's home when she is, or Sundowning. All those symptoms started when she was diagnosed with dementia in 2016 and have gotten progressively worse. I don't think there's a blueprint as to when Sundowning should or should not start in an elder suffering from dementia, just as all the symptoms wax and wane quite a bit. My mother is now 94 and has days where she's quite lucid and others where she's getting ready to ride the bus to NYC from Colo to see her papa who's been dead since 1949.

My father was 91 when he was hospitalized with a broken hip. After surgery and general anesthesia, then I saw Sundowning and mass confusion, out of nowhere. It lasted about a week and then cleared up.

If you think your dad is reacting to being taken off of a statin, wait 3 weeks and see if he improves. If not, you'll know it's not the meds.

You say dad "passed" the MMSE.....what score did he get out of 30? Mom got a 19 on her first go around and was dxed at that time, with that score, with progressive dementia. The drawing of the clock was key; she was unable to do it which indicates an executive brain function impairment.

Like Alva said, if you see no improvement in dad here soon, get him to the doctor for better testing.

Good luck!
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FargoDan Apr 2021
Thanks to you both for your responses! He scored 25 on the MMSE test. I think that is on the low end of normal cognition.
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The short term memory issues, and not tracking/remembering where he is are the only two symptoms my dad has of moderate dementia. My dad’s doctor said he was fine too, but my mom pushed to have him seen by a Geri neurologist who diagnosed the dementia with scans. He’d had noticeable issues for 3 years before he finally got diagnosed. Now he fell in November and had a brain injury that led to Major Depressive Disorder, and that manifested in a lot of “I don’t know”, “whatever” and “I can’t think about that right now“ answers to questions because he didn’t want to engage with me at all; now that he’s on good meds he is back to baseline (which is short term memory issues and needing to be reminded where he is).
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Like others have suggested, more thorough testing can be helpful if he’ll agree to it. My father was very resistant to testing. He was afraid the doctors would think he was “crazy” and put him in a mental institution. For lots of great info on dementia types, symptoms and care, watch Teepa Snow videos. She also talks about the types of tests that are done, and the fact that the GP test is rather unreliable.
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Seems your father may have some cognitive impairment but not dementia per se. Confusion has lots of causes: infections (those pesky UTIs), blood chemistry imbalances, poor oxygenation, neurological insults, side effects of medications, inadequate sleep.... The best way of treating the confusion is determining the cause which is the job of the doctor. Since your father has stopped a medication is may take a few weeks to see change. Remember that older body systems do not clear medications as fast from the body as younger systems.

Meanwhile, you can do something about Sundowner's Syndrome. Keep your father on a consistent schedule. Turn on more lights in the afternoon/evenings (shadows tend to be confusing). Have your father's vision checked in case he needs an eyeglass prescription. Make sure he gets enough sleep at night (7-9 hours is about right). Try to make sure your father is getting enough tine interacting with other people since loneliness/social isolation can sometimes be confused with depression.

Hope this helps.
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As several have said, there is good information on this topic online. However, I would say that it's unusual that someone with depression alone will completely forget they are home, or get confused about something that basic. The kind of memory issues that come with depression are more about the thoughts being a bit jumbled, slowed down, and the person forgetting to do things, or not recalling what they've been told because they weren't fully paying attention or registering the information. There can also be notable mood changes with depression, including irritability. With Mild Cognitive Impairment, there is memory loss, with early-stage dementia, there can be more than memory loss: reduced executive functioning - i.e., not being able to follow directions or do more complex tasks - confusion about time and place, and mood/personality changes. So there can be some overlap, but the real confusion issues usually are part of a dementia syndrome. Also, one person can have early-stage dementia and depression or anxiety concurrently. In fact, when people realize they are starting to forget and become confuse, it is often cause for them to become discouraged and anxious, at least temporarily.
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I've learned that confusion can also set in from dehydration or UTI/infection.
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A uti ???

also be very watchful about meds as he may not be able to tell you if he feels he is having a problem.
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