Hi. My mother is 93, lucid and of course with a bit of senile dementia. I am not sure the dementia aggravates the narcissistic personality disorder, because I know through research, that her personality does get worse with age, because they have difficulty dealing with the fact and consequences of old age, and of course, she blames others for what she’s going through. Becomes verbally abusive and humiliating, and right down nasty. I’ve hired a number of caregivers which she fires because they’re not good enough to take care of her. She’s manipulative to obtain what she wants. What I’ve learned is it gets worse the older she gets. People who have this disorder, are generally healthy and live a long time; so brace yourself and do the best you can without sacrificing your own health and wellbeing. Big problem is that every limit you set, they do not comply and strive to break it! even if it means that it will put them in danger, also the impulsivity that characterizes this personality disorder is detrimental to their own safety. It’s like having a misbehaved, mean child and not being able to punish their behavior. Also professional psychological help may work for a while until she decides that the professional taking care of her is incompetent and refuses to continue her treatment. Also medication like antidepressants and antipsychotics do not help much. I’m sorry I cannot give you a better outlook on the future, but this is the reality. My advice, make taking care of yourself a priority, like it should be.