Wild swings

[Simon Penn]

I am puzzled. Can anyone shed light, please? My wife, who is a Stage 1 Alzheimer's patient, and has been complaining of MCI since 2015 when she was first referred for an MRI scan, fluctuates wildly in her mental capacity. It swings between a state of near normality (though with seriously impaired memory) where we can go out for dinner, hold a pleasant conversation about the diners and the view, though not about anything that requires her to call on her memory - nothing doing there - and a state of relative incomprehension and anxiety that bears no relation whatsoever to the woman who was with me 12 hours earlier. I thought it seemed as though the quality and amount of sleep were a factor. Yet today, after what she said was 'a good night', my darling wife was on edge, could with extreme difficulty process information, became distressed and angry and then later started showing physical symptoms - persistent coughing, vacant expression etc. Recently she's been pretty stable after a very testing year of bad symptoms so today's lurch into the depths has been a shock. I'm guessing the amyloid plaques just affect the brain randomly, but if anyone has a clinical explanation, or a practical course of management for the bad days, I'd be hugely grateful. Thanks.

 

[SeaSwallow]

@Simon Penn if today’s symptoms came on suddenly, for example the coughing, distraction etc, it could be that your wife has an infection which can play havoc in a person with dementia so it might be worth having a word with her GP.
However, as dementia progresses there will be fluctuations in cognition and memory. Again it might be useful to discuss this with her GP.

 

[Simon Penn]

Thanks SeaSwallow. I don't actually think she's unwell (other than the obvious), though I have several times suggested she talks to the GP about her coughing (it seems to be nervous and transitory) which has featured for about a month. She has often been in the 'lost' state previously, but has been much more stable and able to process information recently, has been sleeping well and without nightmares (which were an early feature of Donepezil) and generally getting up feeling and sounding positive. Previously she had had many bad days, with outbursts of fury at - eg - the voices on the radio, needly complaints about me and moments when I frankly didn't know how to deal with her. I'm just curious about how these sudden changes come about.