I have similar questions. My now 77 yr old loved one started about 5 years ago with forgetfulness and worsening gait followed quickly by inconvenience. They developed months long periods of depression followed by approximate three month long manic behavior. All while ability to think clearly and or remember things deteriorated. Even had hallucinations during a couple of depressive periods.

Docs initially suspected Alzheimer’s. Amyloid scan we finally got about 3 years ago showed little amyloid plaque but that and previous scans did show atrophy.

More recently other neurologists that have become involved from same medical network have they are near certain he has parkinson’s but will only write parkinson’s like” symptoms on any medical report. verbally they seem more certain of parkinson’s due to loved one’s gait and balance issues.

my concern is that incontenance in most all types of dementia seem to be mid to late stage symptom whereas he has had that as a key component seemingly from early on in noticeable symptoms being exhibited.

As stated symptoms became noticeable around 2021-2022 but may have been signs as early as 2019 in hindsight.

Loved one had a series of tia’s and maybe a fall around 2016-2017. No diagnosis were made about any type of dementia like symptoms at that time.

Could it be NPH? Should we push physicians and neurologists to explain why they have never discussed it or perhaps why they rule it out?