Is it common for people with Alzheimer's to believe they have symptoms of other diseases?

A fellow caregiver asked...

Do people with Alzheimer's frequently think they have symptoms of other diseases or health problems?

Expert Answer

Jytte Lokvig, PhD, coaches families and professional caregivers and designs life-enrichment programs and activities for patients with Alzheimer's disease and related dementia. Her workshops and seminars help caregivers and families create a healthy environment based on dignity and humor. She is the author of Alzheimer's A to Z: A Quick-Reference Guide.

It's not uncommon for people with dementia to become obsessive. One obsession could be thinking they have symptoms of imaginary diseases "“ in other words: hypochondria. Hypochondria is a psychological condition that requires a certain amount of awareness and cognition to pull off. By the time a person is in the advanced stages of the disease, it's more likely that his complaints are real. He may be feeling ill or he may be anxious or lonely.

We want to be compassionate, but it's tough when we feel bombarded with repetitive complaints and it's difficult to tell the imaginary from the real. It's tempting to dismiss these persistent grumblings as nuisances, however there are times to take them seriously, especially coming from a person in the more advanced stages of Alzheimer's. As the individual's short-term memory declines, he loses the ability to hold on to his thoughts for very long. The simplest way to discern if his pain is real, is to offer a diversion, such as a favorite activity or ice cream or a cookie. If he returns to his complaint in spite of a normally successful diversion, we need to pay attention.

A person in the later stages of the disease may not be able to tell us exactly where it hurts or describe how he feels, but he still remembers terms for ailments from the past and will use those to try to convey his needs. So when he says he has a migraine, it may be his only way of telling us that his feet are killing him because of a blister or ingrown toenail.

If his complaint has been accompanied by a change in demeanor and a loss of appetite it's likely sign of a physical problem. It could be a low-grade urinary tract infection (also know as UTI,) which is very common in elders, especially in those with incontinence. Other subtle problems are sore gums and toothaches "“ or dehydration. It could also be a negative reaction to medications.

On the other hand if there are no real causes for his imaginary symptoms, he needs stimulating activities to give him purpose and keep him engaged.