Think You Know What Dementia Is?

Dementia. Alzheimers. Those are two scary words. Many people think they know what dementia is. What Alzheimers is. They use the terms synonymously. Alzheimers is the most common one, but it is not the only dementia.

image of a man where the top of his head is puzzle piece that are floating away

Over the last month we’ve been talking about memory. In my post “What Do You Remember and How” you learned about the study of memory, the stages of memory, and the types of memory. “Do You Have a Terrible Memory?” discussed why you forget, the types of forgetting, and what normal forgetting is. You also learned that there were two umbrella terms that describe abnormal types of forgetting: Amnesia and Dementia. My post, Amnesia: Beyond the Tropes described what the scientific or medical reality of the forgetting called amnesia.

What Dementia Is

Many people think it is only about forgetting past events and people. It is more than that. Some believe that changes to memory, thinking skills, behavior, movement, and emotions are signs of senility or senile dementia. That represents a misbelief that serious mental decline is part of aging.

Dementia is a term for a variety of symptoms caused by damage to brain cells. This damage is not normal aging. Usually, it occurs after age 60. But in rare cases it may develop at earlier ages.

It can affect memory, thinking skills, behavior, movement, and emotions.

There is no cure for dementia. It is permanent and progressive.

While brain damage is permanent, there are conditions that cause the same symptoms but are treatable problems. Things like depression, medication side effects, excess use of alcohol, thyroid problems, vitamin deficiencies can cause thinking and memory problems. They can treat these conditions.  If you or a loved one have any of these symptoms, don’t guess or assume. See a medical professional. Get a diagnosis and appropriate treatment.

What Causes Dementia?

We don’t understand what causes these diseases well enough. More research is needed. Better devices to study the brain are needed. In many cases today, only an autopsy can definitively diagnose the specific disease. 

There are conditions scientists have identified as causing dementia.

  • A genetic mutation passed down from one generation to the next.
  • Alzheimer’s disease patients have plaques and nerve tangles in their brains.
  • Damage to the vessels that supply blood to your brain result in damaged brain cells in Vascular Dementia.
  • Other diseases are due damage from other kinds of proteins or damage from degeneration (breakdown) of nerve cells.

The Diseases of Dementia

Alzheimer’s Disease is the most common cause one. Ronald Reagan and Glen Campbell had Alzheimer’s. 

Vascular Dementia is the second most common cause of dementia. Actor Andrew Sachs had this disease.

Atypical Parkinsonian Dementias are dementias with Parkinsonian movement disorders. This group of dementias include: Progressive Supranuclear Palsy (PSP), Multiple system atrophy (MSA), and Corticobasal Syndrome.

Lewy Body Dementia is a dementia caused by a protein in the brain. Robin Williams had LBD (discovered on autopsy).

Frontotemporal Dementia (a group of diseases) where nerve cells in the frontal lobe (behind the forehead) are damaged. 

Mixed Dementia is when multiple diseases of dementia are present. People with dementia who are over 80 often have more than one.

Huntington’s Disease, Traumatic Brain Injuries,  Creutzfeldt-Jakob Disease, Parkinson’s Disease, and other conditions and diseases may also cause dementia. Huntington’s disease causes certain nerve cells in the brain and spinal cord to whither away. Traumatic Brain Injury (TBJ) refers to injuries of the brain such as concussions and severe injuries to the head and brain. Creutzfeldt-Jakob Disease is a rare, fatal brain disorder. And Parkinson’s Disease is a movement disorder.

Symptoms

There are many distinct areas in the brain. Each area controls certain functions. The area and extent of damage causes compromise or loss of those functions. For example, damage to the hippocampus affects long-term memory and emotional responses.

Each disease has specific symptoms. And each type’s symptoms can overlap other diseases of dementia. For symptoms specific to each disease, see the links above.

According to Mayo Clinic, symptoms can include:

Cognitive changes

  • Memory loss, which is usually noticed by a spouse or someone else
  • Difficulty communicating or finding words
  • Difficulty with visual and spatial abilities, such as getting lost while driving
  • Difficulty reasoning or problem-solving
  • Difficulty handling complex tasks
  • Difficulty with planning and organizing
  • Difficulty with coordination and motor functions
  • Confusion and disorientation

Psychological changes

  • Personality changes
  • Depression
  • Anxiety
  • Inappropriate behavior
  • Paranoia
  • Agitation
  • Hallucinations

Dementia can cause loss of short-term memory, long-term memory, and/or the inability to encode memories. But remember, memory loss isn’t the only symptom.

Usually symptoms develop gradually. Sometimes, especially early in the disease’s course, symptoms can be mild or seem to appear and disappear. Family members who live outside of the home or friends may notice the symptoms first.

Diagnosis

Diagnosis of dementia, particularly the specific disease, is challenging. There is no one test that will clearly diagnose these diseases.

The doctor must review the patient’s medical history and symptoms and do a physical examination. He may order several tests to rule out other medical conditions. He may also refer the patient to a neuropsychologist for cognitive testing. A neurologist’s exam assesses movement, senses, balance, reflexes, etc.

A recent discovery led to biomarkers that makes a more accurate Alzheimer’s Disease diagnosis.

Some of these diseases can only be discovered or confirmed by autopsy.

Treatment

There are a few medications that may temporarily improve the symptoms. Medications may manage symptoms such as sleep disturbances, agitation, hallucinations, Parkinson’s, or depression.

There are non-drug treatments, too. Occupational therapy, changing the patient’s environment, simplifying tasks, and simple directions are helpful. 

You may read about dietary or herbal treatments. Mayo Clinic reports there is no scientific evidence that these treatments are beneficial.

Coping with Dementia

image looking at the back of a woman in a wheelchair facing some buildings that are not sharp in appearance but fuzzy

A diagnosis of dementia is devastating. Many things will and must change. Decisions, dealing with day-to-day care and concerns can be overwhelming.

Use trusted websites such as the Alzheimer’s Association or Mayo Clinic or the National Institute on Aging. Learn as much as you can about the disease.

Do advanced planning as soon as you can. Consult an elder care attorney. Establish a trust. Get a medical power of attorney and a financial power of attorney.

Learn about options for in home care and for long-term care in a facility.

If you are the caregiver, take care of you. Get counseling. Join a support group. Get help. Stay connected to your friends and family.

Caregivers frequently feel caught between guilt and anger and frustration. The dementia patient will act normal then, out of the blue, do or say something that triggers an emotional outburst. Forgive yourself. Be patient and kind with the dementia patient—and yourself.

Did You Learn What Dementia is?

You learned what dementia isn’t. It isn’t normal aging. Forgetting isn’t the only symptom.

It is a broad term for a multifaceted group of symptoms. This post only brushes across the surface of information about dementias. And the condition affects more than the sufferer. Forgetting isn’t the only symptom, but it is often the most painful one to caregiver(s) and family.

Now you know what dementia is. Did you learn anything new? Next week we’ll talk about a phenomena called Recovered Memories.

What Do You Remember and How?

What do you remember and how do you remember one thing and your sibling remembers something else? Human memory is complex. We try to replicate it with computers and A.I. Technology. But we barely understand how human memory works. Or where we store our memories. Or how and what corrupts our memory. Scientific examination and study of memory only began in recent history. 

Image of a brain with lightning coming out of it illustrates memory retrieval but do you understand what you do remember and how

The Study of Memory

The scientific study of memory didn’t begin until fairly late in human history. Hermann Ebbinghaus (1850–1909), a German psychologist, pioneered the study of memory. The “father of experimental psychology of memory” began his first experiment in late 1878. He published his study, Memory: A Contribution to Experimental Psychology (Über das Gedächtnis in the original German), in 1885. They published the English version in 1913.

His study had many limitations. The major one being that his only subject was himself. But he made many discoveries: the forgetting curve, spacing effect, and the learning curve. You can read more about his discoveries on Wikipedia or on Flash Card Learner.

What is Memory?

Even our everyday definition of memory is complex. Memory is—

1a: the power or process of reproducing or recalling what has been learned and retained especially through associative mechanisms–began to lose his memory as he grew older

b: the store of things learned and retained from an organism’s activity or experience as evidenced by modification of structure or behavior or by recall and recognition–has a good memory for faces

2a: commemorative remembrance–erected a statue in memory of the hero

b: the fact or condition of being remembered–days of recent memory

3a: a particular act of recall or recollection–has no memory of the event

b: an image or impression of one that is remembered–fond memories of her youth

c: the time within which past events can be or are remembered–within the memory of living men

4a: a device (such as a chip) or a component of an electronic device (such as a computer or smartphone) in which information can be inserted and stored and from which it may be extracted when wanted–especially: RAM

b: capacity for storing information–512 megabytes of memory

5: a capacity for showing effects as the result of past treatment or for returning to a former condition—used especially of a material (such as metal or plastic)

Merriam-Webster Dictionary

According to Boundless Psychology there is a simpler definition. Memory is “the ability of an organism to record information about things or events with the facility of recalling them later at will.”

Stages of Memory

The three stages of memory are encoding, storage, and retrieval.

Encoding is the process of receiving, processing, and combining information. 

Storage is the process by which we keep memory for a time. 

The third stage of memory, retrieval, is also called recall or recognition. Something triggers us to recall a memory and use it in a process or activity.

Types of Memory

Scientists have identified three major types of memory: Sensory, Short Term, and Long Term. 

Sensory memory is a detailed representation of an entire sensory experience. It is not a conscious process. There are many types of sensory memories. The most frequently studied include iconic (visual) memories, echoic (auditory) memories, and haptic (tactile) memories.

Short Term Memory, also known as working memory, lasts for about twenty seconds. We can only store about five to nine “items” in short term memory. However, we can move these items to long-term memory via what scientists call rehearsal. Rehearsal or repetition is the act of repeating the memory over and over. 

Long Term memory includes anything we hold in memory for longer than twenty seconds. Scientists have identified many types of long-term memory, too many to discuss in a brief, introductory blog post. 

More to Come

This blog post is a brief introduction into what you remember and how. Over the next few months we’ll look deeper into the mystery and complexities of memories retained and lost.

I find human memory fascinating. The lack of and haunting presence of memory plays a part in my series, My Soul to Keep. In the next few posts, we’ll touch on diseases of memory. Diseases you may be interested in like Alzheimer’s and dementia and White Matter disease. And if you’re interested, we’ll discuss trauma-induced memory loss. Do you have other questions or topics regarding memory that you’d like me to discuss?

All Systems Nominal

Flash fiction comes in all lengths. The very best flash fiction has character, conflict, and plot. For me, flash fiction is all about mood. I hope you enjoy “All Systems Nominal.”


All Systems Nominal

by

Lynette M. Burrows

The soft whirring sound of M.A.R.C., the best medical assistive robotic caregiver money could buy, moved closer to the bed  The bed’s occupant, a human male, age 100, didn’t respond. 

All Systems Nominal. Flash fiction by Lynette M. Burrows Image shows an Android-style robot with a puppet-style face.

M.A.R.C. extended its sensor arm precisely two inches above the human’s still form and swept the man from head to toe. Readouts of respiration, pulse, core temperature, blood pressure, and other biological measures flickered across M.A.R.C’s chest. All systems nominal. Sleep mode. A mechanical arm reached out and tucked the blanket under the old man’s chin. 

M.A.R.C slid back away from the bed and into its charging station. The parameters of its programming satisfied, it wouldn’t stir again for another sixty minutes. If the patient’s implanted A.I. detected an anomaly, it would alert M.A.R.C. M.A.R.C.’s programming included responses for all medical emergencies and would summon human help if necessary. But for all systems nominal, it would wait until the next programmed time to check on his patient. 

His Early Life

When the man had been a fetus suspended in the nutrient soup of the artificial womb, the analysis of his DNA indicated that he had a forty percent risk of diabetic and vascular dementia and an eighty percent chance of developing cancer. The chances that he would develop one of the few incurable cancers that remained were less than one percent. Confident their offspring would lead a long and healthy life, his 100-year-old parents did not push the abort button. 

His parents cherished the child he became. And he cherished them. 

He grew into a productive citizen and amassed a great fortune. When his parents reached their second century mark, they held an extravagant end-of-life ceremony and pushed each other’s euthanasia buttons.

During his grief, he rebooted their A.I. backups frequently. They comforted him.

As time passed, he rebooted the backups less and less frequently. His work became his solace. He spent time in meetings with the world’s greatest scientists and engineers and robotics manufacturers.

His Work

He tweaked and improved many time-saving devices and created a master control center for all of them. The world’s oldest citizens called this, his primary invention, the Jetson Control Center. His own home had one. It was the one he tinkered with to test new ideas.

Even with the amazing buttons of the master control center, he found that some things required a more hands-on-approach. But androids that looked too human, whether from his or someone else’s company, frightened real humans too much. Even androids and robots painted clownish colors did not ease human fears. He created androids and robots that looked machines and still the humans were frightened. But when his androids and robots looked like toys or dolls or puppets the humans were unafraid. In fact, the real humans loved them.

The First Alert

In his sixties, his implanted A.I. alerted. He went to the doctor for confirmation. Chance had not favored him. Diabetic. He poured all his energy into refining the artificial pancreas. His body rejected his. They tried every known metal and even tried an organic transplant. His body rejected each of them. Not even rejection suppression medication helped. 

He refined and improved the first robotic caregivers and created the M.A.R.Cs. And as the diabetic vascular dementia took over his brain and his body, he relied more and more on his A.I. 

His A.I. restored his sense of balance and kept his paranoia from flaring. It allowed him to continue to function as the COO of his corporation, but it did not support creative thinking. Still, he felt and was productive. It was unusual for him to stay in bed past 6 a.m. But his A.I. Did not send M.A.R.C. an alert. So M.A.R.C. Stayed in his charging station, leaving only to check on his patient every hour. 

M.A.R.C. went to the bed. His sensor arm swept across the old man. All systems nominal. Sleep mode.

The Last Alert

The medical bed’s A.I. recognized that the old man lay without moving for too long and rolled him on to his right side. His deep regular breaths didn’t change. His open, unblinking eyes remained unblinking. The AI that supplied his dementia addled brain with sufficient connections to overcome his condition ran a continuous alert to the old man. The hologram message floated above his unperceiving eyes. Backup Failed.


“All Systems Nominal” is about dementia and human hubris and Murphy’s Law. Dementia is a horrible disease process that comes in multiple forms. All of its forms cause deep heartache for victims and families and caregivers. If you or a family member or a friend are dealing with dementia, please reach out to the Alzheimer’s Association (it’s for all types of dementia, not just Alzheimers). They have information and resources and support. And they could use your support if you’re inclined to offer a donation.

If you enjoyed “All Systems Nominal,” you might also enjoy For Better or Worse or The Yellow Rose of Valentine’s Day.