Can delusions be a symptom of early Alzheimer’s?

KathyF1

My DH has Alzheimer’s, stage 5 or 6. His memory issues became apparent about 4 years ago. Here is my question- ( something that has been bothering me for a long time)- can delusions show up even before the memory loss? We’ve only been married 11 years. His first wife died, a very traumatic time for him. After we married there were times he would tell me these crazy stories about dreams he had that he thought were more than dreams, that he had had an actual reunion with his wife - in heaven. Other stories involved an encounter with an angel when he was a young man. I started to think I had married a crazy man. He was otherwise “normal”, very successful in business and from a great family. But obviously this was disturbing. He also had no “filters”. He’d tell just about anyone his stories, they of course would look perplexed, but I guess he couldn’t tell he was causing people to feel uncomfortable. I’d try to tell him to please stop “sharing” his experiences with others (especially my friends) but it was like he not only really believed his (delusions?) but he couldn’t tell he was freaking people out. (Especially me). Now- he has more delusions. He thinks he and I started the January 6 riots. He thinks we saw Hunter Biden in town not too long ago and talked to him. He’ll tell everyone these stories too. SO- can anyone tell me if they know if it’s possible that the delusions can precede the memory loss? And the missing “filters” when he had no perception of how people were reacting to his ramblings? It troubled me for years, he has been a wonderful husband in so many ways but I truly thought I had married someone with mental problems! Maybe you all can share your opinion?

Vitruvius

Are you sure he has Alzheimer's?  In other dementias memory loss tends to come later.  According to UCSF "In Alzheimer's, one of the first symptoms is memory loss. With FTD, unusual or antisocial behavior as well as loss of speech or language are usually the first symptoms."

They also list as an early symptom "Lack of inhibition or lack of social tact."

I'm not a neurologist, I'm just suggesting an avenue for investigation if it's important to you. 

Rick4407

Hello Kathy,  My DW had serious delusions in stages 4-5 or so.  A small dose of seroquel put her more back into reality and eliminated the militancy of her behavior about the delusions.  Over the last 3 years the dose has slowly increased from 25 mg to now 75 mg.  Still a fairly light dose.   I would recommend you contact his neurologist.  As the disease progresses having good communications with the neurologist or NP in the office really facilitates getting meds adjusted quickly to avoid difficulties.  

As you may note in many other threads here, there are a number of important recommendations you need to do as early as you can.   As new problems develop knowledge obtained here will help you to adjust and accept each new limitation.  Rick

Ed1937

Hi Kathy. There are some other conditions beside dementia that can cause delusions. We have a son who has been having delusions for more than 10 years, but he does not have one of the dementias. As Rick and others have suggested on this forum, seroquel might help.

harshedbuzz

Kathy-

My dad did something similar. This might not be a universal experience, but I saw it. 

My sister died of HIV/AIDS in 1994. She'd been dad's favorite and his mini-me in terms of looks, personality and mental health issues. It had been ugly; there wasn't much in the way of help and there were people of a certain mindset being quite vocal about letting nature run its course. He grieved long and hard and pretty much burned through is outer circle of friends-- golf buddies, neighbors, etc. This is also when he began abusing alcohol. By 2000, my parents retired and moved away. My mom only agreed to get a fresh start for dad as he'd become persona non grata and they had no real social life. 

They bought a house in a golf community and were pretty engaged there for several years. But over time, dad became less filtered and inappropriate socially and over time their social world shrank again. They bought a house in FL to spend the winters; mom said she hoped it would be a fresh start for dad. Around 2005 I noticed a mood shift that was different than mourning and an uptick in strange false beliefs, a hard-right turn in his politics and a kind of re-writing of family history in which he and my sister were a whole lot better behaved than they'd ever been. He did sometimes "Forest Gump" himself into history at times; this behavior became more prevalent in later stages when he claimed to have had mom's total knee replacement while pointing to his elbow or claiming his house was destroyed in a flood (my house/my flood). By 2008 he was having serious memory issues and was conflating stories more and more to the point that he'd offended most of his close friends, his brother, my nieces and my family to the point I was the only family member checking in with them by 2012. 

Vitruvius-

I always thought my dad's dementia had a dash of FTD behavioral in the mix. His behaviors seemed to change well before his memory issues were obvious to me. His speech was not impacted aside from word-finding in which he subbed a more high-falutin' one- I recall him battling with the director of the SNF at which he was doing rehab demanding to know "by who's authority am I incarcerated in this place?". He was verbal right up until he passed from aspiration pneumonia. 

HB

Pam BH

Kathy, my DH has mixed dementia (Alzheimer's and Vascular Dementia). My perspective is the Vascular Dementia is more prominent.  He had delusions long before the memory loss.  The delusions change over time but are very real to him, so I play along with them as much as possible.  He's on Seroquel which doesn't stop the delusions but tamp down his anxiety about them. Some of the delusions involve altered reality about real time events, which it sounds like your DH is also experiencing. I'm glad you found this forum because it's truly lifesaving when you're in a situation you have no idea how to handle. The people here have been where you are and so very willing to share their experiences and tips.

Iris L.

There is a book, "What if it's not Alzheimer's? ".  It may be informative.

Iris L.

KathyF1

Thank you all so much for your input! Pam, it sounds like my husband may have a similar condition as your husband. Right now the delusions aren’t the “main” thing. But before the memory loss, they were. It disturbed me so much to think he was “crazy”. To have an explanation, even though this is terrible, gives me some comfort. His mysterious behavior made me feel actually afraid. Now I at least understand - he may have a combination of Alzheimer’s and another form of dementia.  This forum is valuable. Thank you!

jfkoc

You might review exactly how he was diagnosed.