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Is paranoia a sure sign of dementia?

Answered by David Troxel

June 3, 2015

Hi, I am a social worker and have worked with Dementia patients so not altogether unknowledgeable. My mother is 79 and lives in another city. She is active and lucid and lives on her own. About a year and a half ago she had some heart issues (uncontrolled aortic arrhythmia) and was prescribed Coumadin. Shortly after this, she showed some signs of paranoia that things were going missing. She often loses things and sometimes finds them in strange places. However, to qualify this, she has a lot of stuff and is not the best at organization. This is not new, and I unfortunately have similar issues. That said, it does seem to have intensified since the heart issues, but I cannot say for sure someone is not messing with her stuff. She has had things stolen from her in the past by family members and former foster kids. However the paranoia over this has become more excessive. My guess is that it could be medication related or a combination of things. Although rare, I have read it is possible with Coumadin. My actual question is whether you see dementia with only the paranoia. She doesn't seem to display any short term memory loss at all, although the paranoia symptoms have been present for over 18 months. I have called her several days in a row and she always recalls our previous conversations as well as what see did and ate that day. I know something is up, but not convinced it is dementia. Thanks for the input.

Thanks for writing in.

The Alzheimer’s Association has a great fact sheet on the Ten Warning Signs of Dementia. You can view it here.

Notably, one of the warning signs is personality change. Your mother could have that symptom. Your mother, being a young 79, may also be experiencing what we call fronto-temporal dementia that effects personality before memory and often impacts younger persons.

Recognize that everyone experiencing dementia seems to have their own journey. “When you’ve met one person with Alzheimer’s disease or other dementia, you’ve just met one person with dementia.” One person may have memory and language loss early in the disease process and another person might, for example, maintain language much longer. Thus your mom’s personality change could be a sign of dementia. I encourage you to take her to a good neurologist or geriatrician for a thorough workup. That physician can also look at her blood thinning medication to see if it’s having any negative consequences including stroke.

You mention that people have stolen from her in the past. This is a good time to get her legal and financial affairs in order and to try and simplify the environment of the house. Be sure that important financial documents aren’t accessible to visitors. This can also be a good time to try and introduce some in-home help.

Best wishes and I hope you get a clearer picture soon.

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