Differential Diagnosis for Dementia Causing Functional Incontinence
- Single most likely diagnosis
- Frontotemporal dementia: This is the most likely diagnosis because frontotemporal dementia often presents with significant changes in behavior, personality, and motor function, which can lead to functional incontinence due to the patient's inability to recognize the need to use the bathroom or to perform the necessary actions to do so.
- Other Likely diagnoses
- Alzheimer's disease: As the disease progresses, Alzheimer's can cause significant cognitive decline, leading to forgetfulness about the need to use the bathroom, resulting in functional incontinence.
- Vascular dementia: This condition, resulting from reduced blood flow to the brain, can lead to cognitive and physical impairments that may cause functional incontinence.
- Lewy body dementia: Characterized by fluctuations in cognitive function, visual hallucinations, and motor features of parkinsonism, Lewy body dementia can lead to functional incontinence due to the patient's decreased ability to respond appropriately to the need to urinate.
- Do Not Miss diagnoses
- Normal pressure hydrocephalus (NPH): Although less common, NPH is crucial to identify because it is treatable with the placement of a shunt, and one of its classic symptoms is urinary incontinence, along with gait disturbance and dementia.
- Neurosyphilis: A potentially treatable condition if caught early, neurosyphilis can cause a range of neurological symptoms, including dementia and incontinence.
- Rare diagnoses
- Creutzfeldt-Jakob disease: A rare, degenerative, fatal brain disorder, Creutzfeldt-Jakob disease can lead to rapid cognitive decline and physical deterioration, potentially resulting in functional incontinence.
- Huntington's disease: Characterized by chorea, psychiatric symptoms, and cognitive decline, Huntington's disease is less commonly associated with dementia leading to functional incontinence but should be considered in the differential diagnosis due to its progressive nature and potential for significant motor and cognitive impairment.