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My 97 year old father has recently begun to have lost touch with reality. For example, confusing what he dreams or sees on TV with his personal life. Until now, he has been cognitively normal, with little dementia. What does this mean?

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I don't know what you mean by a “little dementia”. Has he been screened for dementia and determined that he is in the early stages? If he's never been screened for dementia, it would be wise to do so. Confusing what one sees on TV with reality can be an early symptom of dementia. His PCP can administer the screening along with checking him for a UTI.
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Being cognitively normal until 97 is quite a feat!

Looks like he is slowing down a little and losing some of the function that lets up keep dreams, thoughts, memories and reality in their proper places in our brain. This can lead to confabulation - they tell us "crazy" stories that are mixed up hodge podge of things real and/or imagined. They don't realize that they're lying - they think what they are saying is true and makes perfect sense.

If he is living alone, might be time to start thinking about if he is safe and able to make decisions necessary to continue to stay safe.
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I agree with funkygrandma59 that a UTI should be discounted so that it if did have one, and it went untreated, it could turn into sepsis which would be a bad turn for him. UTIs are very common in the elderly and often have no other physical symptoms, but instead show up as confusion and behavior/personality changes, usually described by family as "sudden".

Also, if your LO is on any medications, and he is in charge of administering them to himself, please check to make sure he is taking only what is prescribed and that it is appropriate to his weight (if he dropped weight his prescription could now be out of proportion to his body size and he could be "overdosing").
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It just means that he's 97 years old, and his age is catching up with him, and his "little dementia" is probably getting worse. Or it could mean that he has developed a UTI, as that can cause confusion among other things as well. Probably want to get him checked out by his Dr. Good luck.
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