5 split second “blackouts” and sleeping 18 hours a day during the last two months. Does this mean his AD is progressing?

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abcdiane3 Asked January 2020

5 split second “blackouts” and sleeping 18 hours a day during the last two months. Does this mean his AD is progressing?

My dad is 80 and has AD. He’s on 13.3 mg Exelon patch and 5mg twice a day Memantine. He also takes 3mg Vraylar to manage his hypomania. The split second blackouts and long sleeping times are the two big changes in the past two months. He also needs help choosing clothes, dressing, buttoning up clothes, doesn’t shave and will go days without changing clothes or taking a shower if I don’t make him. He no longer can use escalators safely and always an elevator over stairs. Dexterity I’m eating and opening any package is very difficult. Too many other things to mention here, but I think all are classic AD. I’m really concerned about the blackouts. The neurologist didn’t seem too concerned and wanted him to stay on all the meds. The internist said he’s dubious of the meds. His heart is fine. Blood pressure good too. Are the blackouts why he’s now sleeping more? Are all the other changes progressing more quickly because of the blackouts? He wanted to know if he was going to experience more? Each time he loses a little more that never comes back. I think if he’s had 5 in 2 months- the probability for more is high. Could they be TIAs? I’m worried about a stroke because another change is he hiccups all the time now too.

Alzheimer's & Dementia Dementia Behaviors Medications Severe Dementia

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score 0 · Answer 1

Maybe take a video of one of his episodes; it could give his doctors an idea of what’s going on.

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score 0 · Answer 2

Thank you so much. I think you’re right in the neurologist not feeling there is any benefit to investigate further because each time I call to report what’s going on, I get nothing. I think if there is something that could show up on an MRI or some kind of scan, at least I would be able to understand more of what’s going on. I feel like just knowing more helps even if there is nothing we can do. Again, I’m worried these split second blackouts could be a precursor to a stroke.

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score 2 · Answer 3

I wouldn't take a chance with blackouts. If you have a neurologist, take your father to see her or him, and do raise the issue of blackouts. They could become longer, he could be severely injured. Passing out needs to be addressed, quickly.

It may be that they're related to something else, but do find out.

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Thank you so much! I have an appointment for him with his neurologist this week. Each time he had a split second black out, I was there and he didn’t fall. I saw him lose focus and his whole body was shaking. Then he snaps out of it. I called his internist each time to report what was going on. He had him come in to check him ( heart, blood pressure, etc) but only said he’s ok and the meds for Alzheimer’s aren’t helping him. The neurologist ( through Emil) only said stay on the meds and never comments on the black outs. I think now that there have been 5 and he has significantly deteriorated in daily life tasks, maybe the neurologist will address the issue this time at our appointment.

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score 0 · Answer 4

They sound more like absence seizures to me, but what do I know.
The combination of blackouts, increased sleep and rapid loss of function are not likely a coincidence but the neuro may not feel there is any benefit to investigating further (I'm not saying s/he is right though). Sometimes you need to weight the pros and cons of investigations and treatment - in your best case scenario what would you like to see done about it? How can you accomplish that?

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5 split second “blackouts” and sleeping 18 hours a day during the last two months. Does this mean his AD is progressing?

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