Dementia is a general term for a decline in mental ability that is severe enough to affect daily life. It is not a specific disease, but rather a group of symptoms caused by various diseases or conditions that affect the brain, such as Alzheimer’s disease. Some key signs and symptoms of dementia include memory loss, difficulty communicating, disorientation, confusion, poor judgment, and changes in mood and personality.
As dementia progresses, it can also sometimes cause physical symptoms in addition to the mental decline. One common physical symptom that people with dementia may experience is feeling abnormally cold, even when the temperature is normal or warm. There are a few reasons why this chilly sensation can occur with dementia.
Why People with Dementia May Feel Cold
There are several factors that may cause someone with dementia to feel persistently cold:
Poor Circulation
One contributing factor is that dementia appears to affect the autonomic nervous system, which regulates involuntary bodily functions like blood pressure, breathing, and heartbeat. Autonomic dysfunction can disrupt normal blood circulation, making it more difficult for body heat to reach the skin’s surface. Poor circulation results in the sensation of feeling excessively cold.
Loss of Body Fat
Dementia can cause appetite changes, nutritional deficiencies, and unintended weight loss. As body fat is depleted, there is less insulation to retain warmth. The loss of this natural body fat leads to feeling colder than usual.
Dehydration
Staying hydrated is essential for regulating body temperature. Dehydration allows heat to escape the body more easily. Dementia patients are at risk of dehydration if they forget to drink enough fluids daily.
Lack of Exercise
Regular physical activity helps generate body heat. People with dementia tend to become more sedentary and less mobile. The lack of muscle movement can contribute to low energy expenditure and feeling cold.
Thyroid Problems
Thyroid disorders are more common in the elderly and can accelerate symptoms of dementia. Hypothyroidism, in particular, slows metabolism and causes sensitivity to cold temperatures.
Anemia
Anemia, which is a reduction in red blood cells, can arise from dementia-related nutritional deficiencies. Anemia impairs the body’s ability to oxygenate tissues and regulate temperature.
Medications
Some medications used to treat dementia symptoms like depression or agitation may inadvertently lower body temperature as a side effect. Medications for other health conditions like hypertension and Parkinson’s can also alter internal temperature regulation.
Damage to the Brain’s Temp Control Center
The hypothalamus serves as the brain’s thermostat and can directly affect our sensation of feeling hot or cold. For people with dementia, hypothalamic damage may disrupt normal body temperature maintenance.
Poor Communication
Impaired thinking and judgment means that dementia patients may also have difficulty communicating needs like asking for a blanket when feeling cold or removing layers when too hot. This can lead to prolonged uncomfortable sensations of feeling excessively hot or cold.
How Feeling Cold Differentially Affects Dementia Subtypes
While abnormal cold sensitivity is common across most forms of dementia, some subtypes may be more prone to temperature regulation issues.
Alzheimer’s Disease
Fluctuating body temperatures and feeling excessively cold have been frequently reported in Alzheimer’s disease. Autopsies reveal that people with Alzheimer’s tend to have more significant damage to brain regions involved in body temperature regulation compared to cognitively normal elderly people.
Vascular Dementia
Blood flow abnormalities and circulatory impairments due to a series of mini-strokes are characteristic of vascular dementia. Poor blood circulation contributes directly to feeling cold frequently.
Lewy Body Dementia
Lewy body dementia involves abnormal deposits of the protein alpha-synuclein in the brain. Autonomic nervous system dysfunction and temperature regulation problems are pronounced early on in Lewy body dementia due to the brainstem lesions caused by these protein deposits.
Frontotemporal Dementia
The frontotemporal lobes of the brain control personality, behavior, and language. But the hypothalamus that regulates body temperature is relatively spared. As a result, feeling cold is not a primary symptom in frontotemporal dementia.
Tips for Managing Cold Sensitivity
If cold intolerance is making everyday life uncomfortable for someone with dementia, there are some practical ways to help them stay warm:
– Dress in layers to provide better insulation in breathable fabrics like wool.
– Use electric blankets and heating pads to pre-warm the bed at night.
– Set the thermostat slightly higher to maintain a comfortably warm ambient temperature.
– Drink adequate warm fluids like herbal tea to support hydration.
– Fill hot water bottles and microwavable heat packs to have on hand as portable warming aids.
– Ensure the person is getting optimal nutrition to prevent unintentional weight loss.
– Provide fingerless gloves and socks with treads to keep hands and feet warmer without slipping.
– Offer throws and shawls made from wool or fleece to provide extra warmth.
– Install draft blockers around doors and windowsills to reduce cold air leaks.
– Use moisture-wicking fabrics next to skin rather than cotton to retain body heat better.
– Make sure clothing is not too tight as this can restrict blood flow.
– Encourage movement and gentle exercises to boost circulation.
– Check for thyroid issues or anemia that may be exacerbating cold symptoms.
– Discuss any cold medications or supplements that could be inappropriate with the doctor.
Making adjustments to help someone with dementia feel warmer and more comfortable can greatly improve their quality of life. It preserves dignity when they no longer have to feel chronically cold.
When Feeling Cold May Indicate a Serious Health Problem
In someone with dementia, a sudden drop in core body temperature or reporting new sensations of feeling extremely cold may signify an underlying medical condition requiring emergency treatment.
Some potentially serious causes of acute cold symptoms to watch out for include:
– Hypothermia – This dangerous drop in body temperature below 95°F can lead to organ failure.
– Sepsis – A severe bacterial infection in the blood steam causes fever, chills, and shivering.
– Low blood sugar – Feeling cold and clammy can signal hypoglycemia, especially in diabetes.
– Heart attack – Cold sweats are a common heart attack symptom.
– Stroke – A sudden numb or cold sensation on one side of the body may indicate stroke.
– Hypothyroidism – Newly onset hypothyroidism provokes unexplained cold intolerance.
– Anemia – Rapid development of anemia can manifest with feeling very chilled.
– Adverse drug reaction – Allergic reactions and medication side effects like cold chills need evaluation.
When acute cold symptoms do not have an obvious explanation like exposure or illness in someone with dementia, prompt medical attention is warranted. Sudden temperature changes can represent a dangerous underlying condition requiring rapid treatment. Call a doctor right away or go to the emergency room for any severe, unexplained body temperature abnormalities.
The Bottom Line
In summary, feeling chronically cold is a fairly common complaint of elderly individuals with dementia. The cognitive decline and physiologic changes that develop can disrupt the body’s normal temperature regulation. This leads to a pervasive sensation of being cold even in warm conditions. While uncomfortable, persistent cold sensitivity by itself is not necessarily dangerous in someone with dementia. The cold sensation can often be eased through simple adjustments like warm clothing, elevated home temperatures, and maintaining good circulation. However, sudden acute episodes of severe cold sensations warrant urgent medical evaluation to rule out a serious underlying health issue that requires treatment. So while not every instance of feeling cold must trigger major concern, new onset of severe cold symptoms should prompt a proactive clinical assessment.
Frequently Asked Questions
Is feeling cold a key symptom used to diagnose dementia?
No, feeling chronically cold is not a primary symptom used to make a diagnosis of dementia. The core criteria focus on progressive neurological symptoms like memory loss, impaired communication, and declining mental capabilities that interfere with daily function. However, temperature dysregulation and abnormal cold sensitivity commonly develop as secondary symptoms later on.
At what stage of dementia does feeling cold occur?
There is no set stage when cold intolerance definitively arises. But abnormal sensations of cold tend to correlate with more advanced dementia that involves autonomic dysfunction. Mild dementia is less likely to impair temperature regulation. The cold sensation can develop at different points along the progression depending on the individual.
Is persistent feeling cold a sign of early onset Alzheimer’s?
Not necessarily. While cold sensitivity can accompany Alzheimer’s disease, it is not specifically indicative of early onset versus late onset Alzheimer’s. The cold sensation is generally linked to disease progression rather than the age of onset. However, since autonomic dysfunction manifests earlier in some forms of Alzheimer’s, feeling cold may potentially appear sooner.
Should someone with dementia who feels cold be given extra blankets at night?
Yes, providing extra blankets and warm bedding at night is advisable if someone with dementia feels chronically cold. The elderly are already at higher risk of becoming hypothermic. Dementia compounds this due to poor communication about feeling cold. Extra blankets help prevent overnight hypothermia. However, excess blankets could cause overheating in some cases. Check that the room temperature is appropriately cool.
When should a doctor be consulted about cold sensations in dementia?
Discuss any major changes in cold tolerance with a doctor to identify possible causes like thyroid dysfunction or anemia. Also contact a physician promptly if severe cold symptoms emerge suddenly and seem inconsistent with the environment. Acute, severe cold sensations may indicate a dangerous drop in core temperature or other medical emergency in someone with dementia.
Conclusion
Feeling cold frequently affects many people with dementia as a secondary symptom of the neurological disease. Declining cognition makes it challenging to communicate needs for warmer clothing or adjustments to the environment. Age-related changes and dementia-related circulatory deficits prevent the body from maintaining its optimal temperature. While feeling chronically cold can be uncomfortable, simple adaptations to increase warmth are often effective. However, suddenly feeling extremely cold warrants medical evaluation to determine if it signifies a serious underlying condition requiring prompt treatment in someone with dementia. With proper awareness and responsiveness, steps can be taken to help improve cold sensitivity and overall quality of life for individuals exhibiting this common symptom of dementia.
