What may be causing this
- Urinary or respiratory infection
- Pain, constipation, or urinary retention
- New or changed medication
- Dehydration
- Stroke or head injury
What to try first
- Check for fever, pain, and last bowel movement
- Review all medication changes in the past two weeks
- Ensure adequate fluids
- Contact the clinician the same day
What usually makes it worse
- Assuming decline is 'just the dementia'
- Waiting several days to report an abrupt change
- Adding sedating medications without evaluation
Simple things you can do today
- Keep an up-to-date medication list on the refrigerator
- Write down when the change began and what it looks like
When to call the doctor
- Change happened over hours to days
- Fluctuating alertness or new drowsiness
- New falls, fever, or refusal to eat and drink
When it may be an emergency
- Unresponsiveness or new severe weakness
- Chest pain or trouble breathing
- Violence toward self or others
Medically reviewed. Last reviewed August 2026. This page is educational information, not individualized medical advice.