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Laurie4b

Verbal combativeness in aged: is this a symptom of anything?

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Bottom line question: In the absence of other  symptoms of cognitive decline, can increasing combativeness, the propensity to take offense quickly, make mountains out of molehills, etc. have clinical significance in a person in their late 70s/early 80s? 

 

There have been no incidents of memory loss. The person plays competitive bridge regularly and can still win, for instance.  

 

This behavior is not entirely new. Phase 1: There was a tendency in early adulthood to this kind of thing but it wasn't as pervasive as it is now 2) there was a turning away from these types of behaviors in the person's 50s in response to a religious conversion--- so about 30 years where the behavior was not frequent, and could be modulated by rational discussion from family members,  and 3) a re-emergence with of this pattern off and on in the past 5 years, but a huge escalation more recently in terms of frequency and intensity. Huge amounts of irritability, escalating conflicts, and willingness to cut off long term relationships (The person recently ended a 50 year old friendship over an exchange over a political email) 

 

Anyone experienced this in someone you know? Does it seem part of a particular diagnosis? If you've BTDT, can you share what you've learned in terms of how to respond/deal with it? 

 

 

 

 

 

 

Edited by Laurie4b

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I hate to mention this, but my grandmother became combative about 5 years (or so?) prior to a diagnosis of Alzheimers. I'm not an expert in it, but from what I understand, a personality change is not at all uncommon in the very early stages of Alzheimers.

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I think it could be a sign of dementia. Or just poor health. In the last few years of my grandma's life she started changing a lot. As a younger woman she was outspoken and opinionated, and she became very offensive and verbally and physically combative as an older woman. It's like the filter came off as she aged. And she did slide into dementia toward the end there.

Edited by KrissiK
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Yes, I think it is an early sign of dementa; people often lose their coping mechanisms, or filter, as someone else said, and act aggressively and/or inappropriately for the situation. My grandmother would become increasingly agitated as the day wore on, with the peak in the evening (it's called sundowning).

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I would suggest a full physical and ask for blood work and urinalysis.  Vit B and D levels, thyroid, etc. can change behaviors in the elderly.  Also, a low grade bladder infection can cause issues----but those are more usually confusion producing.

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I have also read that it is a sign of early dementia. Dementia patients lose their inhibitions and this often leads to tragic results.  Combative Alzheimer patients are sometimes put into mental hospitals because regular care facilities throw them out for violence.

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While combativeness may be an early indication of dementia, it is often something that develops as the condition progresses. 

 

My husband was diagnosed with probable Alzheimer's about 10 years ago, when he was 63yo. I had noticed cognitive decline over the previous several years, but it took a while to get the medical people to see what I was seeing. After all of this time, though, we are blessed that he has not become combative. My mother-in-law, on the other hand, who was diagnosed about the same time, is very much up-and-down when it comes to her demeanor. She can cuss me out like a sailor (very much unlike her pre-dementia self) one minute, and a half hour later be as sweet as can be. 

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It could be a sign of dementia but it could also be a symptom of depression. Depression doesn't always manifest as being down in the dumps or suicidal; often a depressed person just acts cranky and irritable. Has this person experienced a sudden decline in independence or general health recently? Do they talk a lot about being too old to do things they enjoy or complain about having to rely on others for daily needs?

 

 

Sent from my iPhone using Tapatalk

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Yes, it's a thing. And yes, here as well we saw it proceed dementia. In hindsight it was the first symptom and out of place comments about relatives (like randomly talking about their opinion on why a grandchild didn't have friends twenty years ago {when they did}) or mentioning conspiracy theories out of the blue were our first clue something was off. We didn't place it until later in hindsight.

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(like randomly talking about their opinion on why a grandchild didn't have friends twenty years ago {when they did})

 

hmm.  My mom has long done this misremembering-and-then-arguing-about-it and it does seem worse now that she is older.  (Honestly, I don't like to be around her because I often perceive a lot of criticism and judgment involved in the misremembering.  Sometimes I can let it roll off my back but that takes a lot of conscious effort as my feelings go way back to when I was a kid.)

 

How do you all handle the misremembering?  Do you catch yourself from correcting, nod and attempt to redirect the conversation?

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Bottom line question: In the absence of other symptoms of cognitive decline, can increasing combativeness, the propensity to take offense quickly, make mountains out of molehills, etc. have clinical significance in a person in their late 70s/early 80s?

 

There have been no incidents of memory loss. The person plays competitive bridge regularly and can still win, for instance.

 

This behavior is not entirely new. Phase 1: There was a tendency in early adulthood to this kind of thing but it wasn't as pervasive as it is now 2) there was a turning away from these types of behaviors in the person's 50s in response to a religious conversion--- so about 30 years where the behavior was not frequent, and could be modulated by rational discussion from family members, and 3) a re-emergence with of this pattern off and on in the past 5 years, but a huge escalation more recently in terms of frequency and intensity. Huge amounts of irritability, escalating conflicts, and willingness to cut off long term relationships (The person recently ended a 50 year old friendship over an exchange over a political email)

 

Anyone experienced this in someone you know? Does it seem part of a particular diagnosis? If you've BTDT, can you share what you've learned in terms of how to respond/deal with it?

 

It could be a sign of dementia, as others have already mentioned.

 

OTOH, it could also be that this person has always felt that way and tried to hide it so people would Iike her, and she has reached a point in her life where she simply doesn't care any more and is going to tell people exactly what she thinks of them whether they like it or not. Maybe she's not feeling as well as she used to feel and she is resentful or scared about it, and it puts her in a bad mood. Maybe that long term friend has gotten on her nerves for the past 25 years and she is finally done dealing with their nonsense.

 

I guess what I'm saying is that just because a person is getting older and crankier doesn't necessarily mean they are exhibiting signs of dementia. I know it's important to watch for things like that, but I also think some people are too quick to jump to that conclusion based solely on the person's age.

 

If is a person who has always been cranky or judgmental and who may have felt very repressed during the super-religious years, this may be nothing more than allowing her true personality to shine through.

 

(Sorry I keep referring to the person as a "she" if your post is actually about a man. You didn't specify, so I used "she" so I wouldn't have to keep typing "he or she." I'm so lazy! :))

 

 

 

(Edited for typo!)

Edited by Catwoman
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hmm. My mom has long done this misremembering-and-then-arguing-about-it and it does seem worse now that she is older. (Honestly, I don't like to be around her because I often perceive a lot of criticism and judgment involved in the misremembering. Sometimes I can let it roll off my back but that takes a lot of conscious effort as my feelings go way back to when I was a kid.)

 

How do you all handle the misremembering? Do you catch yourself from correcting, nod and attempt to redirect the conversation?

Said family member has since passed away, but we just said something to the effect of "oh, I think it went better than all that" or "fortunately things improved with time" as a pass-the-bean dip deflection that didn't draw them in for an argument. Said pleasantly enough and changing the topic, it did seem to help.

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I hate to mention this, but my grandmother became combative about 5 years (or so?) prior to a diagnosis of Alzheimers. I'm not an expert in it, but from what I understand, a personality change is not at all uncommon in the very early stages of Alzheimers.

 

My experience with my grandmother was identical to this. 

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It could be a sign of dementia, as others have already mentioned.

 

OTOH, it could also be that this person has always felt that way and tried to hide it so people would Iike her, and she has reached a point in her life where she simply doesn't care any more and is going to tell people exactly what she thinks of them whether they like it or not. Maybe she's not feeling as well as she used to feel and she is resentful or scared about it, and it puts her in a bad mood. Maybe that long term friend has gotten on her nerves for the past 25 years and she is finally done dealing with their nonsense.

 

I guess what I'm saying is that just because a person is getting older and crankier doesn't necessarily mean they are exhibiting signs of dementia. I know it's important to watch for things like that, but I also think some people are too quick to jump to that conclusion based solely on the person's age.

 

If is a person who has always been cranky or judgmental and who may have felt very repressed during the super-religious years, this may be nothing more than allowing her true personality to shine through.

 

(Sorry I keep referring to the person as a "she" if your post is actually about a man. You didn't specify, so I used "she" so I wouldn't have to keep typing "he or she." I'm so lazy! :))

 

 

 

(Edited for typo!)

:iagree:  This is what I was thinking. I am only 50, but am getting to the point where I refuse to pretend and put up with crap that I just let go in the past. I just don't care anymore what people think for the most part. Losing my filter, I guess. Most of the women in my family have never had a filter. 

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it could be chemical with possiblity of treating by supplementation.  it can also be an early sign of cognitive degeneration, and possibly respond to rx.

 

I would talk to the person's dr.

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It could be a sign of dementia, as others have already mentioned.

 

OTOH, it could also be that this person has always felt that way and tried to hide it so people would Iike her, and she has reached a point in her life where she simply doesn't care any more and is going to tell people exactly what she thinks of them whether they like it or not. Maybe she's not feeling as well as she used to feel and she is resentful or scared about it, and it puts her in a bad mood. Maybe that long term friend has gotten on her nerves for the past 25 years and she is finally done dealing with their nonsense.

 

I guess what I'm saying is that just because a person is getting older and crankier doesn't necessarily mean they are exhibiting signs of dementia. I know it's important to watch for things like that, but I also think some people are too quick to jump to that conclusion based solely on the person's age.

 

If is a person who has always been cranky or judgmental and who may have felt very repressed during the super-religious years, this may be nothing more than allowing her true personality to shine through.

 

(Sorry I keep referring to the person as a "she" if your post is actually about a man. You didn't specify, so I used "she" so I wouldn't have to keep typing "he or she." I'm so lazy! :))

 

 

 

(Edited for typo!)

 

 

to add to the highlighted - maybe said person is realizing their mortality, and is scared of dying.  (I've known religious people who are afraid of death.)

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:iagree: This is what I was thinking. I am only 50, but am getting to the point where I refuse to pretend and put up with crap that I just let go in the past. I just don't care anymore what people think for the most part. Losing my filter, I guess. Most of the women in my family have never had a filter.

:iagree:

 

Now get off my lawn! :lol:

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Thanks everyone. Several new suggestions here that are helpful avenues to pursue. There are some very concerning physical symptoms that may or may not be related. A family member did find that hyperthyroid/Graves disease could cause all the physical symptoms. Unfortunately, getting to the doctor is one of the points of contention. 

 

This is not a simple "tell it like it is " phase. 

 

 It's  making it very costly emotionally for family members to interact and yet the person is on the verge of disability and needs that interaction. One can try to don a fireproof suit and "have a duck's back" but the blows are still felt at some level. And with family members, "old stuff" can be weaponized and hit a mark. 

 

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OTOH, it could also be that this person has always felt that way and tried to hide it so people would Iike her, and she has reached a point in her life where she simply doesn't care any more and is going to tell people exactly what she thinks of them whether they like it or not. Maybe she's not feeling as well as she used to feel and she is resentful or scared about it, and it puts her in a bad mood. Maybe that long term friend has gotten on her nerves for the past 25 years and she is finally done dealing with their nonsense.

 

 

 

 

I think this explains my dad's behavior. My mom kept him in line for many years but since she's passed away he has nobody to keep him in check. In his case, he's always felt this way- he's a pretty judgmental kind of guy- and Mom just kept him from blurting out what he thinks.  He was railing on my nephew this week and my other sister (not nephew's mom) said Dad told him that Mom once told him to never speak poorly of this nephew in front of his mother and he always respected my mother's wishes.  So he pretty much confirmed it. 

 

Dear father in law has become much the same way but I think his is depression from the stress of caring for mother in law who has dementia. They are in denial and won't do anything about it and FIL is isolated and depressed.  But it manifests itself in a similar -but not identical- way to my dad's filter being gone. He  gets combative if his Comcast bill goes up 13 cents.  Stuff like that. 

 

OP, I'm sorry. It's so stressful to try to figure this stuff out...what means something and what's just normal aging or typical grumpy old man behavior. 

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Unfortunately, the only 3 people who I have witnessed this in all had Alzheimers or Dementia.

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I would also think early state dementia.  I've also from personal experience watch my neighbor start getting this way.  We thought it was just old age.  It was found she had lung cancer that had metastasis  to the brain.  She only lived  weeks after the diagnosis.  I'm a nurse and also her daughter and we both didn't really look more closely.  She had weight loss and other signs of cancer but we were not looking. 

 

I've seen this in the hospital a few times.  We would get a older patients combative with other cognitive issues.  the doctors all thought old age dementia but with further analyses  found they had brain cancer.

 

 

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I would suggest a full physical and ask for blood work and urinalysis.  Vit B and D levels, thyroid, etc. can change behaviors in the elderly.  Also, a low grade bladder infection can cause issues----but those are more usually confusion producing.

100% agree.  These things were my first thoughts, too.

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Thanks everyone. Several new suggestions here that are helpful avenues to pursue. There are some very concerning physical symptoms that may or may not be related. A family member did find that hyperthyroid/Graves disease could cause all the physical symptoms. Unfortunately, getting to the doctor is one of the points of contention.

 

This is not a simple "tell it like it is " phase.

 

It's making it very costly emotionally for family members to interact and yet the person is on the verge of disability and needs that interaction. One can try to don a fireproof suit and "have a duck's back" but the blows are still felt at some level. And with family members, "old stuff" can be weaponized and hit a mark.

:grouphug:

 

I'm so sorry, Laurie.

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Behavioral changes in the elderly have a slew of causes. Here are a few:

 

Infection

Depression and anxiety

Dementia of varying causes

Alcohol and drug abuse,

Vitamin deficiencies,

Hypoxia from ischemia (cardiac and strokes)

Medication side effects and drug interactions

Uncontrolled pain

Financial strains

Feelings of inadequacy or fear of becoming a burden

Visual and hearing loss

Autoimmune diseases

Liver disease

Toxins in older homes

 

These are just off the top of my head. There are many more.

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Bottom line question: In the absence of other  symptoms of cognitive decline, can increasing combativeness, the propensity to take offense quickly, make mountains out of molehills, etc. have clinical significance in a person in their late 70s/early 80s? 

 

There have been no incidents of memory loss. The person plays competitive bridge regularly and can still win, for instance.  

 

This behavior is not entirely new. Phase 1: There was a tendency in early adulthood to this kind of thing but it wasn't as pervasive as it is now 2) there was a turning away from these types of behaviors in the person's 50s in response to a religious conversion--- so about 30 years where the behavior was not frequent, and could be modulated by rational discussion from family members,  and 3) a re-emergence with of this pattern off and on in the past 5 years, but a huge escalation more recently in terms of frequency and intensity. Huge amounts of irritability, escalating conflicts, and willingness to cut off long term relationships (The person recently ended a 50 year old friendship over an exchange over a political email) 

 

Anyone experienced this in someone you know? Does it seem part of a particular diagnosis? If you've BTDT, can you share what you've learned in terms of how to respond/deal with it? 

It could be dementia or Alzheimer's.  Or she could have just had enough of annoying people and is speaking out.  Hard to tell without more.

 

My mom had a friend who ended a 50 year friendship and she never knew why (no significant cognitive impairment according to kids).   

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It could be a sign of dementia. But, the fact that 1) there are no other signs/ still able to win at complicated games and 2) this isn't new behavior but rather a return to basic personality prior to religious conversion makes me think that is less likely. I think age tends to distill and concentrate main personality. And it sounds like her inherent personality is somewhat contrary. A physical is always a good starting place, however.

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