What is dementia?
Dementia is a neurodegenerative disorder characterized by poor memory, disorientation, impaired judgment, and a decline ability to perform basic ADL’s. Having dementia may affect a wide range of cognitive abilities including language comprehension/expression, attention span, memory, reasoning skills, learning capability, and even personality traits.
Dementia is not a specific disease but rather it is a collection of symptoms that can have several possible causes. The most prevalent type of dementia is Alzheimer’s disease, but there are many other subtypes of dementia including Vascular, Parkinson’s disease, Lewy Body, frontotemporal, head trauma, and HIV/AIDS. As such, the term dementia is considered an umbrella term for a set of symptoms causing a person to have brain changes that interfere with the ability to function and do everyday activities. In addition, there are some types of dementia that are considered reversible, while others cannot be cured at this time.
Dementia is not a normal consequence of aging, although it does become much more common as people get older. While everyone experiences memory lapses or a slowing of cognitive abilities as they age, dementia is a pathological condition within the brain that negatively impacts cognition in a progressive manner.
What are some common signs of dementia?
Dementia causes many problems for the person who has it and for the people that care for that individual. The majority of noticeable problems are caused by memory loss. This can cause frustration and stress for the person but also for their family, friends, and/or caregivers. Some common signs of dementia are listed below. Not everyone who has dementia will have all of these signs.
• Recent memory loss. All of us forget things for a while and then remember them later. People with dementia often forget things, but they never remember them. They might ask you the same question over and over, each time forgetting that you’ve already given them the answer. They won’t even remember that they already asked the question.
• Difficulty performing familiar tasks. People who have dementia might cook a meal, but forget to serve it. They might even forget that they cooked it. They may forget recipes to well-known family meals. They may forget to turn off the stove or oven.
• Problems with language. People who have dementia may forget simple words or use the wrong words. This makes it hard to understand what they want and for them to communicate their thoughts easily. There can be increased instance of “tip-of-tongue” difficulties (e.g., knowing the word you want to say but not being able to say it out loud.).
• Time and place disorientation. People who have dementia may get lost on their own street. They may forget how they got to a certain place and how to get back home. The person with dementia can have difficulty keeping track of the day of the week, the month, or the office/restaurant they are currently at.
• Poor judgment. Even a person who doesn’t have dementia might get distracted. But people who have dementia can forget simple things, like forgetting to put on a coat before going out in cold weather. People with dementia are also more susceptible to scams from people, particularly those asking for money over the telephone.
• Misplacing things. People who have dementia may put things in the wrong places. They might put the keys in the freezer or a wristwatch in the sugar bowl. Then they can’t find these things later.
• Changes in mood. Everyone is moody at times, but people with dementia may have fast mood swings, going from calm to tears to anger in a few minutes. They may become more irritable or frustrated faster than they used to in the past. This may be due to not being able to think clearly or being able to understand other people as easily as they did in the past.
• Personality changes. Some people who have dementia may have drastic changes in personality. They might become disinhibited, suspicious, or fearful.
• Loss of initiative. Some people who have dementia may become passive. They might not want to go places or see other people. There can be increased social isolation or social withdrawal, even for activities that the person previously enjoyed or previously looked forward to.
How is neuropsychological testing beneficial in dementia?
Neuropsychological assessments can provide useful diagnostic and treatment information about an older adult that may not be easily uncovered using other clinical or laboratory investigations. It can provide the treating medical team with objective, functional evidence of an individual’s cognitive abilities that cannot be gleaned from a CT scan, MRI, blood work, or an easy cognitive screening measure (such as MMSE). With recent research suggesting that cognitive changes in someone with dementia are actually beginning 20 years prior to the actual diagnosis it is important for health care professionals not to immediately dismiss cognitive concerns as “normal” or “age-appropriate.” The neuropsychological profile could be beneficial in the individual’s treatment by establishing a baseline of cognitive function to better determine changes over time. This way the neuropsychologist can track their individual score changes over time rather than solely relying on comparisons from the overall population. Neuropsychological assessment at an early stage of dementia can assist the treatment team in differential diagnosis between a particular form of dementia from depression and other psychiatric causes of cognitive impairment. Neurocognitive profiles and assessment data may also help discriminate among various etiologies of dementias and cognitive impairment (AD, Vascular, Lewy Body, FTD, Alcohol-Related, CTE, etc.). However, there may be considerable overlap in these profiles due to the same brain regions being affected and the frequency of comorbidity. Baseline and follow-up neuropsychological testing increase the sensitivity to detect progressive dementias, often at early stages when the cognitive changes are subtle.
If you live in the New Jersey or New York area and would like to schedule a neuropsychological evaluation for yourself or a family member in order to determine if there have been any potential cognitive-related changes that would be atypical for your age and education please contact Dr. Corey Burchette at 201-577-8286 to inquire about scheduling an appointment at the NJ Memory Center which is located in Verona, New Jersey.