Dementia May Signal Pneumonia in Elderly

It’s a tragic and well known fact that elderly patients can experience dementia, or an acute mental status change, as a symptom of aging or a disease, such as Alzheimer’s.

But what if confusion, disorientation or a degree of dementia is a symptom of something else that may not occur to a loved one or caregiver?

More frequently, elderly patients in the 70s, 80s and older are seeing their doctors and finding out that fresh episodes of disorientation are actually caused by an underlying infection, and very likely pneumonia.

Link Between Infections and Brain Functions
According to new research reported today, exposure to common infections has been linked to memory and brain function — even if the infections don’t make you ill or are not otherwise symptomatic, according to research presented at the American Stroke Association’s International Stroke Conference 2014.

Earlier studies have already linked certain infections to an increased risk of stroke and Alzheimer’s disease.

But researchers in this new study found links between antibody levels caused by exposure to infections, including those than can lead to lung inflammation and pneumonia, to worsening cognitive performance. Those worsening functions can affect memory, planning and reasoning ability, speed of mental processing and abstract thinking.

Many of these cases are unique because often no other obvious symptoms are present, said Carlos Barrera, M.D., whose specialties include internal medicine and pulmonary medicine.

“Elder patients sometimes don’t have obvious symptoms for pneumonia or upper respiratory infections,” Dr. Barrera said. “They may have a little bit of a fever, but rather minimal symptoms. But if there is an acute mental status change than family members or other caregivers should take them to a doctor.”

The doctor will likely run a blood workup and urinalysis and take chest X-rays. Even lab work may not tell the whole story since white blood cell counts, signifying infections, sometimes do not increase very much, Dr. Barrera said.

What type of dementia could be a result of pneumonia?
Dementia generally refers to a decline in mental ability that is serious enough to interfere with daily life. Short-term memory loss, confusion and disorientation are most common when dementia is a result of injury or infection.

Symptoms of dementia can vary greatly, but at least two of the following functions must be significantly impaired to be considered dementia, according to the Alzheimer’s Association:

  • Memory.
  • Communication and language.
  • Ability to focus and pay attention.
  • Reasoning and judgment.
  • Visual perception.
  • Sometimes, a significant change in behavior is the symptom that should concern caregivers, said Dr. Barrera.

    As the baby boomer generation moves deeper into retirement, the issue of pneumonia-induced dementia is surfacing more often.

    “More people now than ever are over 65 and that will continue to grow for several years before we start to see a decline ,” said Dr. Barrera. “If your loved one  has an acute mental status change, don’t wait for the next symptom. See a doctor.”

    What are other symptoms of pneumonia among older adults?
    A change in cognitive status (delirium, confusion, dementia) is a major sign of pneumonia in the elderly. Other warning signs may not be present, but they  may include:

  • Pain in the chest.
  • Shortness of breath.
  • Sweating.
  • Shaking chills.
  • High fever.
  • Muscle aches and joint pain.
  • “Dusty” or purplish skin (a result of inadequate blood oxygen supply).
  • Clammy skin that is cool to the touch.
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