Dementia: More than just memory

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When people hear Alzheimer’s, they think about memory. Does the person remember her family? Does he remember where he lives? But because Alzheimer’s is a disease of the brain, there are many aspects of a person’s life that are affected.

A person with dementia often loses the ability to recognize objects, faces, sounds, colors, and/or smells. This is known as agnosia. The damage in certain parts of the brain because of dementia is the cause of this. A person with dementia doesn’t necessarily forget what a cup is. But instead, the eyes see the cup but the brain cannot process that it’ a cup. A mom could tell you her daughter’s name and describe what she looks like. But when she sees her, the brain is unable to process recognition. A dad could hear the phone ring but interprets it as a siren.

Communication is also an aspect of life that is impaired because of dementia. This loss of ability to understand or express speech is called aphasia. Not being able to call a fork a fork is not necessarily because the person forgot what it is. The person may see it as a fork and know what it is used for but the brain is unable to formulate the right word. Other signs of aphasia include substituting one word with another word, using made up words, and having difficulty putting words together. Aphasia can also affect the person’s ability to understand written and/or verbal communication from others. It is not uncommon for a person to lose the ability to read. Even when they are able to grammatically read the word, there may not be comprehension of what was read. Also, understanding what others are saying could be difficult. This is especially true when there is too much information provided or when there are outside distractions. Sarcasm and figurative speech may be misinterpreted. When we say, “It’s raining cats and dogs”, the person may take it literally.

There are also changes and deficits in physical ability due to dementia. Inablility to complete physical tasks due to a disconnect in the brain is known as apraxia. This can be seen in tasks such as dressing, eating, and even walking. The person could feel the button of his shirt and have the dexterity in his fingers to button the shirt. But the message the brain is sending is disconnected from the rest of the body. When you ask the person to stand up, he may understand you and have the physical capabilities but his brain is unable to send the messages needed to stand up. Caregivers sometimes interpret this as the person being stubborn or resistant.

Agnosia, apraxia, and aphasia can all be impacting the person at the same time at varying levels. It is important to understand that impairment in one does not necessarily mean the same level of impairments in others. These areas are all separate from the person’s memory issues related to dementia.