Forgetfulness & confusion: what causes this behaviour?

Forgetfulness and confusion are often part of every day life if you have dementia, but forgetfulness has many different causes, only one of which is dementia. Here’s the essential information you need to know

As one of the most noticeable symptoms of dementia, forgetfulness and confusion can also trigger a range of emotions in both the person who is living with dementia and their carer. It can be frustrating, upsetting and even, on occasions, funny.

So whether they’re forgetting a conversation that you had the day before, getting lost in a town that they’ve lived in for 40 years, repetitive behaviour or even hallucinations, it’s important to know what you might expect with these symptoms and how to handle them.

Causes of forgetfulness & confusion

- Dementia
- Other medical conditions
- Urinary tract infections (UTIs) and dementia

1. Dementia

It’s tempting to assume that with the first signs of forgetfulness and confusion, you or someone you know simply must have dementia. Awareness of the condition is at an all-time high, so it’s easy to jump to conclusions.

And it’s true, dementia can cause these symptoms. In diseases such as Alzheimer’s or vascular dementia, deterioration and shrinkage of brain tissue (known as atrophy) affects the links between brain cells, which make it harder for people to store memories. These means they’re more likely to forget information and this can lead to confusion.

For more information on how dementia causes memory loss, click here.

2. Other medical conditions

Remember that forgetfulness and confusion isn’t just a symptom of dementia-related illnesses such as Alzheimer’s disease. They can also be caused by other issues and conditions including depression, certain medications, a lack of sleep, poor nutrition and thyroid problems.

That’s why it’s so important to be seen by a doctor before jumping to any conclusions about whether you have dementia or not.

For more information on other causes of memory loss and confusion, click here.

3. Urinary tract infections (UTIs) and dementia

A UTI is caused when bacteria start to grow in the tube that carries waste liquid from the bladder out of the body. People of any age can get them, but when people over 60 develop one they cause distinct symptoms that are different from younger people.

When younger people get a urinary tract infection, most commonly get painful urination, an increased need to urinate, lower abdominal pain, back pain on one side, fever and chills. But because our immune system changes as we get older, and responds differently to infection, seniors with a UTI may show increased signs of confusion, agitation or withdrawal, rather than pain.

Urinary tract infections can make dementia symptoms worse, but a UTI does not necessarily signal dementia or Alzheimer’s. They can cause distressing behaviour changes for a person with Alzheimer’s – often referred to as delirium – and can develop in as little as one to two days. Symptoms of delirium can range from agitation and restlessness to hallucinations or delusions.

For more advice on treating urinary tract infections, and other problems relating to incontinence, click here.

Symptoms of forgetfulness & confusion

- Difficulty remembering information
- Struggling to keep track of conversations
- Getting routines or processes muddled up
- Disorientation – not understanding why you’re in a particular place at a particular time
- Repetitive behaviour
- Hallucinations
- Delirium – more extreme symptoms of confusion, which tend to come on suddenly

How should you respond to forgetfulness & confusion?

Be patient

It can be frustrating if someone is constantly asking you the same question or getting confused, but try to stay calm and remain patient if you can. Getting angry will only end up upsetting you both.

Offer a brief explanation

Don't overwhelm the person with lengthy statements or reasons. Instead, clarify with a simple explanation.

Use props

Photographs, signs and other thought-provoking items can help to remind the person of important relationships, places and information.

Correct through suggestion

If they’re getting the name of an item wrong, or are lost and want to go a particular route, don’t scold or tell them off. Instead, try, ‘I have a feeling it might be this way’, or ‘I think that’s your granddaughter, Helen.’