| Dementia
and Memory Problems Dementia is the loss of memory and other
cognitive abilities. Alzheimer’s Disease is the most common cause, and the most
feared. However, dementia can be due to a number of causes, including various diseases and
alcohol abuse.
Some of these other causes can be treated, or at least the progression
can be minimized, so it is important to get a complete evaluation of the problem. If you
are concerned about dementia, we encourage you to get a thorough medical evaluation and to
consider psychological or neuropsychological testing of your memory and cognitive
abilities.
You also should be aware that older people can show sudden declines in
memory, attention, and other cognitive abilities as a result of even minor infections,
like a cold. Again, it is worth having a medical checkup whenever you see a decline in
mental abilities. This is true even when someone is known to have dementia, because their
condition can get much worse during the illness, and improve when the illness is cured.
Two other conditions are worth mentioning, as well. One is delirium,
which is a state of acute mental confusion and disorientation. It can occur as a result of
strokes, as a side effect of some medicines, and from other medical conditions. It is
essential that you obtain prompt medical care if delirium occurs.
The other condition is depression. Severe depression can lead to
changes in concentration and memory that look very similar to dementia. A skilled
diagnostician can often differentiate these two conditions so that appropriate treatment
can be offered.
Note that some weakening of memory and learning is expected as you get
older, but this should not be significant enough to interfere with your ability to work,
take care of yourself, meet your responsibilities, or be socially involved.
In the sections below,
we talk about the symptoms of dementia and the role of psychologists in diagnosis and
treatment.
Symptoms of Dementia
Dementia is
characterized by symptoms like the following:
- Significant problems with learning new information or remembering information from the
past (sometimes long-ago memories are intact, but you can’t remember what you had for
breakfast).
- Repeating the same information over and over, or asking the same questions, because you
don’t remember you just did it.
- Forgetfulness, like leaving the stove on and forgetting there is something cooking on
it.
- Getting lost in familiar settings.
- Describing events that did not happen or giving explanations that are not true, not
because of any intent to deceive, but because you are automatically filling in memory gaps
you don’t even know you have. This is called confabulation.
- Processing information much more slowly than in the past, or being unable to manage
tasks that you could do before (like evaluating a hand of cards).
- Loss of ability to plan ahead or organize activities.
- Loss of ability to understand general concepts; a tendency to become concrete and see
things only in terms of specific examples rather than broader categories.
- Difficulties with expressive language, finding words, misusing words, misnaming things,
etc.
- Difficulties with understanding language.
- Difficulties in performing motor tasks, like dressing yourself (not due to physical
limitations).
- Wandering.
- Difficulties with recognizing familiar objects or people.
Top of Page
The Role of the Psychologist
Diagnosis:
Psychological testing
can be essential in making the diagnosis of dementia. It is worth noting that 10-15% of
people diagnosed with Alzheimer's Disease do not have it. They may have another form of
dementia (perhaps one that can be treated), or they might be suffering from depression,
which can mimic dementia.
The psychologist uses standardized tests of intellectual functioning
and memory abilities, along with the clinical history and other measures, to assess for
cognitive losses and to rule out disorders like depression. Sometimes, periodic
reassessment can be useful to track the progress of the dementia.
When there is a strong family history of dementia, it can be useful to
obtain baseline testing before any problems develop. This can be used later for
comparison, if necessary, in order to see the extent of deterioration.
A neuropsychologist can offer an even broader assessment of cognitive
functioning and can pinpoint specific deficits more precisely. The neuropsychologist can
do the entire assessment, or can build on the evaluation done by the clinical
psychologist.
Treatment:
The psychologist can
provide therapeutic
services for the person with dementia, including support and ideas for managing the memory problems (e.g., using
notes, keeping familiar objects in sight). Also, the psychologist can help the person
adjust to the losses they face and assist with any depression that develops secondary to
the dementia.
In addition, the psychologist can provide support for the caregivers in the family. No matter how much you love your
elderly parent, the role of caregiver is very stressful, emotionally painful, and often
thankless. It can be helpful to have a place where you can express your feelings, your
frustrations, and your questions.
Top of Page |
