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For the past 5 years my older brother has been experiencing baffling symptoms, beginning with random falls while he was at work (he was a chef) then weakened knees he found it difficult to step up even shallow steps. We have not yet found out what the problem is. He has had several tests and scans He is now wheel chair bound but refuses to do anything for himself preferring to depend on the family for care.


He has cursed out and fired at least 6 caregivers including accusing one of them of stealing from him. He was aggressive to the point of violence with me but i managed to evade him. In the last 6months his speech has become slurred and sometimes unintelligible, but yet doctors say they dont see whats wrong.


I am beginning to think its early onset Alzheimers he is now 62.


NB. Our mom has dementia

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ALZ is a type of dementia and has some different symptoms and progression but doesn't sound like what your brother has. I just had a cousin pass from ALS (Lou Gerhig's disease) and the symptoms seem similar. And if your brother is depressed, it certainly can add to the mix.

https://www.mayoclinic.org/diseases-conditions/amyotrophic-lateral-sclerosis/symptoms-causes/syc-20354022

Has he seen a neurologist? Have you spoken to the doctors who say the don't see what's wrong? How did you get this information?

Certain dementias can be inherited, but you are not "guaranteed" to get it unless you actually inherit the gene for it.

FYI just because your brother doesn't want non-family caregivers, family isn't obligated to do it, especially if he's violent.
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When I turned 50, I had spells where I fell a lot, passed out, problems thinking, many symptoms that mimic MS. After a lot of trial & error by neurologists, I found one who was a specialist in MS. He ruled out MS, dementia, AZ. He went to work researching data sites, etc and came back with Hashimotos Encephalopathy. After many brain scans, it was determined that’s what I had. He ordered an IVIG for me and we did that. The second day of treatment the nurse wanted my hospital bed and pushed things to fast. I got meningitis. I can’t do another IVIG and their wasn’t much in the medical world they could do. So, I went with naturopathy and found a wonderful doctor who put the HE in remission as well as 7 other autoimmune disorders. I am now 69, still see my naturopath and no more issues. My PCP really dislikes the whole path I have chose but can’t argue that it doesn’t work. Preserverence is the name of the game. Good luck.
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NeedHelpWithMom Aug 2023
I admire your proactive approach to finding your own way through your difficult health issues.

Best wishes to you
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I am not a doctor, but your brother’s condition sounds like it is neurological and it could possibly be ALS. Your brother needs to see a neurologist ASAP to run some brain scans and diagnose his medical condition.
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My husband has FTD. Just on 4 yrs in permanent care. Has never has any awareness of his condition
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Beatty Aug 2023
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How can doctors not see what's wrong? Hasn't anyone told them of his symptoms? You could send his doctor a letter stating exactly what you've told us. There may be medicine that could help him.
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—He needs to see more doctors, better doctors. Maybe he has Parkinson’s, in addition to other problems? Or ALS, as others mentioned?
—Also check what medicines he’s taking. They may be causing problems, side-effects.
—The doctors would have given a diagnosis. They never just say “I don’t know”. When they don’t know, they responsibly refer you to someone else who might know.
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Sorry you are dealing with this, hugs.

Not sure what physicians he is seeing, but a full work up with a board certified geriatric internist, neurologist, and geriatric psychiatrist may be in order. This may entail a variety of tests (brain imaging, an extensive psychological assessment (not the just ask them what day it is and who is the President), and various chems/blood exams, etc.). And it make take some time.

Proper diagnosis is a bit of a ruling out this or that. If brain imaging clearly shows a tumor/cancer, water on the brain/hydrocephalus, or a frontal lob/dementia issue; then perhaps a diagnosis can be made and the course of treatment can defined. If lumbar puncture shows nothing, it may not be MS. Etc.

I have had two friends go through a long road to a clear diagnosis with mental and physical decline. One was mid 50s and after many tests, she was diagnosed as having early onset Alzheimers (AZ). It was awful, she could not walk, talk or remember much of anything. But it turned out NOT to be AZ. It took a very adept neurologist at preeminent teaching hospital she was referred to, to make the correct diagnosis that none others had thought of. My friend grew up in England where the beef is NOT regulated like here in the US. It turned out she had "mad cow" disease. She passed a few years later, there is no treatment or cure for this. Sad. https://www.hopkinsmedicine.org/health/conditions-and-diseases/bse-mad-cow-disease-and-vcjd#:~:text=Mad%20cow%20disease%2C%20or%20bovine,diseases%20caused%20by%20a%20prion.

Another friend (73) was in physical and mental decline; kept falling, could not read, hard to speak, severe cognitive decline. Given Parkinson's is common in her family, she assumed it was that. IT WAS NOT. It was "water on the brain/hydrocephalus. She had surgery to install a drain system from her brain into her abdomen to reduce the excess brain fluids her body was creating (why, who knows) and it is like a miracle. She is back to her old self, fully cognitive, drives a car again. But she initially did not want to go see any physician, resigned that she too got the "family Parkinson's affliction." Thank God her family insisted she go see specialists to get a proper diagnosis. Left unaddressed the "water on the brain" would have killed her, but now she has a new leaf on life.

Two different stories, two different outcomes. It can all be so terrifying and depressing. I hope you can help your LO go get with the right specialists to work on a diagnosis and perhaps a treatment plan that will improve or perhaps turn things around. But if there is no treatment, then at least all will know what to expect, what you/your LO is dealing with and if others in the family should be aware if there is a genetic/family issue here.

Best of luck, hope you can find answers and hope you can also take care of yourself as you go through this.
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This doesn't sound like dementia. It sounds more like MS or ALS; have those two been ruled out. Sounds like something where the myelin sheath on nerve cells is deteriorating. He truly needs an EXCELLENT neuro exam. What testing has been done for dementia? Is the short term memory gone?

Your brother is exceptionally young, and this sounds physical to me unless the mental changes came at the exact same time. If this doctor cannot figure out what is happening, cannot find an answer, cannot make referrals to good neuro consult then you need another doctor for your brother.

I am so sorry to hear this for you but you need answers. It is terrible to have this amount of deterioration this suddenly without any answer at all.
To address your question re heredity, some mental illness and some dementias are more "tending to run in families" than they are "inherited". You should discuss, if you ever have a diagnosis, with your MD.
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SusieJay: He needs to be seen by a physician who will properly dx him. Perhaps he's suffered a transient ischemic attack, aka mini stroke. He may not have dementia, but MS or any other neurological disease.
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I had a long response and lost it.
Google: (below and this one:
https://www.alz.org/help-support/caregiving/stages-behaviors/agression-anger_

These is a huge amount of information available. You need a local MD to assist in making the changes needed. Even try Hospice for help. A person doesn't need to be terminal to get services although they do need to be diagnosed.
Google:
dementia and depression)
Anger, dementia, depression
Is it depression or is it anger?

If I were you, I'd get your brother another MD ASAP.
If a situation requires YOU (or anyone) to '... I managed to evade him' due to aggressive violence, it is time that he be placed in a facility.

- He likely won't change his feelings/reactions to caregivers (although medication may help). Ask his MD about this ASAP.

* Cognitively, with brain changes, he may be unable to manage his emotions / anger / behavior.

* You do not want to wait until he assaults one of them. In addition to injuring a person (and this could be YOU), this is a lawsuit you do not want.

Yes, He will RELY on the family / you until the family / you decide to stop.
Why would he think otherwise? And, he may NOT be able to cognitively understand what is happening with his care / responsibilities on the family.

He is 'just there' accepting the support and 'help' because he needs it ... and is used to the family being there doing the hard, essential work to care for him.
* In other words, what else is he going to do?
* His cognitive functioning appears to be compromised?
* He cannot handle his anger / outbursts / violent behavior.

VIDEO TAPE HIM WHEN HE IS ACTIVATED / exhibiting angry outbursts and violent intentions / behavior towards others. This could be very helpful in medication assessment and/or facility placement.

The question is, why are you waiting to make obvious needed changes - for his well being and yours/the family?

Do you want to wait until something 'more serious' happens due to his anger / aggressive behavior?

You need professional support to make needed care (medical assessment, MD provider, housing) changes.

* At this point, it doesn't matter what he wants. You do what is in his best interest, and that of the family).

Perhaps APS (Adult Protective Services) might be able to guide you or give you some input. He needs to be in a situation where others will be protected, and he needs to be protected from injuring himself. This isn't the role of APS although they may be able to lead you to a resource that is more appropriately / helpful.

Gena / Touch Matters
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