Conditions That Mimic Dementia and Why You Need to Watch For Them

Understanding conditions that mimic dementia can help you find answers and treatments you might not otherwise consider.

When someone you love begins showing symptoms like confusion, memory loss, or difficulty with everyday tasks, it’s natural to fear the worst. Dementia is often the first explanation that comes to mind. But what you might not realize is that there are conditions that mimic dementia, conditions that look almost identical at first glance but may actually be treatable. That means the changes you’re seeing may not be permanent, and the future may be far more hopeful than you think.

Before accepting a diagnosis that changes everything, it’s important to understand what else may be going on beneath the surface.

A Diagnosis Isn’t Always as Straightforward as It Seems

Your first instinct is the right one: call the doctor, get testing, and seek clarity. But recent research and clinical warnings show that many older adults are being mistakenly diagnosed with dementia when the underlying issue is something completely different.

These misdiagnoses are happening because the symptoms overlap so closely that even experienced clinicians may not catch the distinction without deeper testing.

Two conditions in particular—Normal Pressure Hydrocephalus (NPH) and autoimmune encephalitis—are among the most commonly mistaken.

Normal Pressure Hydrocephalus: The “Hidden” Dementia Look-Alike

One of the most misunderstood conditions is Normal Pressure Hydrocephalus. NPH happens when cerebrospinal fluid accumulates in the brain and puts pressure on regions that control memory, balance, and thinking.

It causes:

• Difficulty walking
• Cognitive changes
• Memory problems
• Bladder issues

Sound familiar? To many doctors, it looks identical to dementia.

But here’s the critical difference: NPH is often treatable, usually through a shunt procedure that drains excess fluid. Many people regain clarity, mobility, and independence after treatment—sometimes dramatically.

It’s life-changing. And yet, it’s frequently missed.

Autoimmune Encephalitis: When the Immune System Attacks the Brain

Another major imitator is autoimmune encephalitis. This occurs when the immune system mistakenly targets healthy brain cells, causing:

• Behavioral changes
• Confusion
• Personality shifts
• Memory issues
• Hallucinations (sometimes)

Again: all common dementia symptoms.

But unlike dementia, autoimmune encephalitis can improve with medication that calms the immune response. The earlier it’s caught, the better the outcome.

Why Are These Conditions Overlooked?

The reason is simple and unsettling: many providers don’t routinely test for them. The symptoms overlap too neatly, appointments are often short, and routine dementia screens don’t evaluate for conditions like NPH or autoimmune issues.

Families may walk away believing the prognosis is final…when it isn’t.

How You Can Advocate for Better Answers

If something doesn’t feel right, you are absolutely allowed to push for more clarity. Ask the provider:

• Could this be one of the conditions that mimic dementia?
• Should we screen for NPH?
• Could this be autoimmune-related?
• Do we need imaging, bloodwork, or a neurological referral?
• Is a second opinion appropriate?

Your advocacy may be the only reason someone receives the correct diagnosis.

Support Is Here When You Need It Most

Cognitive changes, no matter the cause, turn life upside down. We’re here to help with trained, skilled care professionals who understand the challenges and offer solutions.

To learn more about our customized home care services in Napa, Novato, Petaluma, and throughout the Bay Area, contact us anytime at (866) 940-4343.