Dementia Emotional Changes

Overview

Dementia is a group of symptoms that affect memory, thinking, and behavior. Emotional changes are very common in dementia. They can include mood swings, feeling low, anxiety, irritability, or losing interest in things. These changes happen because dementia affects the parts of the brain that control feelings and behavior.

Yes, emotional changes are very common. Most people with dementia will have some changes in mood or behavior at some point.

Anyone with dementia can be affected. It can also deeply affect family members and carers.

Symptoms

Common symptoms

• Mood swings that change quickly
• Feeling sad, hopeless, or crying more than usual
• Worry or anxiety that is hard to control
• Becoming easily annoyed, angry, or aggressive
• Losing interest in hobbies, friends, or daily activities (apathy)
• Feeling restless or pacing
• Being suspicious of others or believing things that are not true (delusions)
• Seeing or hearing things that are not there (hallucinations)
• Not understanding or caring about other people's feelings
• Acting in ways that seem inappropriate, like saying rude things
• Withdrawing from social contact
• Changes in sleep and appetite

Symptoms in children

• Dementia is very rare in children. Emotional changes in a child are usually not caused by dementia.
• If a child has sudden or severe mood or behavior changes, talk to a doctor.

Symptoms in older adults

• Emotional changes are more common as dementia progresses.
• Older adults may also have depression or anxiety that is separate from dementia, but the two can be hard to tell apart.
• Physical problems like pain or infection can cause sudden confusion and mood changes.

Causes

Main causes

• Brain changes from dementia itself
• Unmet physical needs: pain, hunger, thirst, constipation, fatigue, infection
• Side effects of some medicines
• Other illnesses like a urinary tract infection, dehydration, or a chest infection
• Depression or anxiety that is separate from dementia
• Changes in routine, environment, or caregivers
• Overstimulation (too much noise or activity) or understimulation (boredom)
• Delirium: sudden confusion caused by a physical problem

Risk factors

• The type of dementia (some types affect emotions more)
• Later stages of dementia
• A previous history of depression or anxiety
• Poor sleep, pain, or other untreated health problems
• A stressful or confusing environment
• Carer stress and lack of support
• Some medicines

When to see a doctor

See a doctor urgently if:

• Sudden change in behavior or confusion
• Thoughts of self-harm or suicide
• Aggression that feels unsafe
• Refusing food or drink for more than a day
• Signs of infection (fever, burning when passing urine, cough)
• Severe anxiety or panic

Book a routine appointment if:

• Gradual mood changes that are affecting daily life
• New or worsening depression or anxiety
• Sleep problems that last more than a few nights
• Withdrawal from activities or social contact
• Carer feeling overwhelmed or needing support

Diagnosis

A doctor or memory clinic will ask about the person's mood, behavior, and daily life. They will talk to the person with dementia and someone who knows them well. They will look for physical causes and review medicines. They may use tests to check memory and thinking.

Tests that may be done

• Questions about mood, behavior, and daily activities
• Memory and thinking tests
• Blood tests to check for infection, vitamin levels, and thyroid problems
• Urine tests to check for infection
• A review of all medicines
• Sometimes a brain scan

What to expect at your appointment

The assessment is usually relaxed. You can bring a family member or friend. The doctor will explain what they find and talk about next steps.

Treatment

Treatment focuses on understanding the cause and helping the person feel safe and calm. Non-drug approaches are tried first. Medicines are used only for severe symptoms and with care.

Self-care at home

• Keep a regular routine for meals, sleep, and activities
• Use calm, simple language and reassurance
• Avoid arguments; try to redirect to a pleasant activity
• Check for pain, hunger, thirst, and toileting needs
• Keep the home calm and not too noisy
• Encourage gentle exercise and social contact
• Write down what triggers mood changes and share it with the care team

Medical treatments

Doctors will first treat any physical causes, like infection or pain. They will review medicines that might be making symptoms worse. They may suggest counseling or support groups. For severe depression, anxiety, or agitation, a doctor may prescribe medicine. These are used carefully and only after other approaches. Always ask your doctor or pharmacist about side effects and risks.

When is surgery considered?

Surgery is not used to treat emotional changes in dementia. Sometimes surgery may be needed for other medical problems. This is decided by your healthcare team.

Living with this condition

Living with emotional changes can be challenging. Try to keep days predictable. Use a calm voice. Offer simple choices. Give the person time to respond. Look for hidden needs like pain or a full bladder. Take breaks when you can.

Lifestyle tips

• Keep a regular sleep routine
• Plan pleasant activities that the person enjoys
• Use music, photos, or simple crafts to comfort
• Stay connected with friends and family
• Ask for help from carers' groups
• Keep a diary of moods to spot patterns

Diet and exercise

A healthy diet and gentle movement can help mood and sleep. Offer regular meals and drinks. Encourage a short walk or chair exercises if safe. Ask your doctor or physiotherapist for advice.

Mental health and emotional wellbeing

Emotional changes can be very hard for both the person with dementia and their carer. It is normal to feel sad, frustrated, or exhausted. Talk to your doctor about how you feel. If you or someone you care for has thoughts of self-harm or suicide, call your local emergency number or a crisis service right away.

Prevention

We cannot prevent the brain changes of dementia. But we can reduce some triggers for emotional changes. Good physical health, a calm routine, and support can help.

Vaccines

There is no vaccine for dementia or its emotional changes. Keeping up with routine vaccinations can prevent infections that may worsen confusion.

Screening programmes

There is no screening test for emotional changes in dementia. Doctors check for them as part of regular dementia care.

Complications

If left untreated

• Distress for the person with dementia
• Carer burnout and stress
• Unsafe situations at home
• Poor eating and drinking
• More hospital visits
• Faster decline in memory and thinking

Long-term outlook

With the right support, many emotional symptoms can be managed. Each person is different. Working with your healthcare team can make a real difference.

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