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Is it possible for someone to develop Dementia to where there were just subtle episodes of forgetfulness to literally overnight becoming delusional, confused to the point they don't remember where they have lived for the past two years or that their late husband of 9 years is no longer with us? No doctor has been able to diagnose this.

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When you say "no doctor has been able to diagnose this" what do you mean? What kinds of doctors have seen your loved one? What kinds of tests have they done?

Severe symptoms that come on suddenly MAY be caused by something other than dementia. A thorough evaluation is needed. There may be something treatable going on, such as a vitamin deficiency or a urinary track infection.

It is also possible for dementia to develop very suddenly. My husband had a sudden meltdown one Saturday morning, and that was the beginning of full-fledged dementia symptoms. Looking back I could see very subtle episodes of not-normal behavior but the dementia came on with a bang. This also happened with one other person in my caregiver's support group. So sudden onset is not typical, but it certainly does happen. (My husband had Lewy Body Dementia. I don't know if that is more prone to sudden onset than other kinds of dementia.)

This dear lady does need medical evaluation and a treatment plan. Have she seen a behavioral neurologist or a geriatric psychiatrist yet?
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I don't know if this would be considered sudden, but my mom has dementia and spinal stenosis. She was put on Lyrica and within 2 weeks she was extremely "out of it". She had no memory, hallucinations in the night and wasn't at all with us. When the doctor had us take her off this medication, the symptoms slowly were relieved. She is back to the way she was before starting the medicine. I am wondering if your loved one has been put on a new medicine?
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I've heard that urinart tract infections can cause similar symptoms. Weird but I've heard it several times. Might want to look into that just in case
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In answer to your first question, dementia is diagnosed by others' statements about their behaviors, questions a neurologist asks, and testing which includes psychometric, MRI, and reflexes. An "overnight" event suggests more of a hematoma in the brain, or an undiagnosed mental illness. Both conditions require a neurologist or a psychiatrist and hopefully you can get her to one.
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Urinary tract infection can cause very strange behavior. I would be sure to check that out first
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Certainly check out any medical cause (drugs, stroke, infection...), but also realize that it may not have been that sudden. For many elderly, their coping mechanisms go into high gear as dementia starts. They adapt and compensate for a long time before some cracks start to show, even to those closest to them. With my own father, once I realized he had dementia (because of some pretty clear symptoms), I could look back and identify earlier signs.
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To add to the suggestion to check for a UTI, that is one of the things that is quite often overlooked. When you get older, you don't tend to feel the discomfort. By the time you show any signs of being "not quite right" you probably have it more entrenched that you would have if you could feel the earlier signs as a younger person would. Also, UTIs tend to be somewhat common in older people.

I'm not saying it's not one of the other things, but UTIs are the easiest thing to check for.
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I told my husbands doctor about my husbands problems, forgetting simple things like Area Code or Zip Code, repeating things etc. She did a test in the office.....asked questions about what county is this, where were you born, draw a clock and put such and such time in it, remember these 5 things, and later asking what the 5 things were, etc. Then she ordered a brain scan. Dementia was diagnosis, the Alzheimer's type. We were sent to Neurologist (?), he asked questions and watched my husband walk, talked to my husband (who was already losing ability to speak), looked at the brain scan, and same diagnosis. THAT is how my man was diagnosed with dementia.
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I cant add anything as the others gave great advice, but yes, do check for UTI's, infections, they will do further testing if those are negative. Good luck hang in there.
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What you're describing sounds most like delirium, which is a state of worse-than-usual mental confusion brought on by illness, medications, or some kind of stress on the mind or body. It usually comes on over hours to days.

Anyone can get delirium, but the more vulnerable your brain, the easier it is to tip into it. As others have pointed out, people with early/mild dementia are usually mentally using everything they have, so delirium can make them suddenly seem much worse. People with underlying dementia also often take days to weeks (sometimes even months) to recover to their best mental function. Some never fully recover and instead settle to a new lower "normal".

Other thoughts: some forms of dementia (like Lewy Body) are associated with cognitive fluctuations when people are much worse on some days than others. Lastly, a sudden mental change is sometimes due to stroke or another vascular dementia hit.

Re diagnosing dementia: dementia is supposed to reflect a permanent decrease in mental abilities and the doctors are supposed to rule out reversible causes (including delirium). But often when we evaluate people during or after delirium, we find out that the person was having some signs concerning for dementia beforehand.

Good luck, I hope you get the answers you need soon.
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I agree with everyone that commented but what I want to add is how doctors these days have become so dismissive of the word dementia or ALZ and the diagnosis of it. Its hard enough seeing your love one suffer and being told by doctors that running tests is a waste of time and money and they have to consider these costs are valid for the sake of the taxpayers like yourself. Yah, I had this happen to me recently with a medical emergency situation I had with mom. I looked at the ER doctor and sais "really...my mom pays hundreds of dollars a year for proper medical coverage and you are going to give me that speech right now...WTH...do the tests or I'm calling the facility manger." My point is that there are other doctors out there that are more sympathetic to the individual rather than the taxpayers. Find someone who will care enough to leave you feeling that you have done the right thing. Best of luck to you and sending you a big hug and blessings.
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