AUG 24

Dementia: It's Not Just Memory Loss

When Beth first noticed something was wrong, it wasn’t her memory that was concerning. She began having difficulties with tasks that were once second nature. For example, she struggled to follow new recipes when cooking and made several mistakes when paying her bills. She brushed off her difficulties as stress or just “getting older.” But then Beth’s family began to notice she was speaking much slower, was becoming confused when listening to a story and struggled to come up with the right word when talking. At the urging of her family Beth spoke to her family doctor who recommended she under go neuropsychological testing and other medical testing because she may be exhibiting the beginning signs of dementia. Beth was eventually diagnosed with major neurocognitive disorder (i.e., dementia) due to Alzheimer’s disease.

One of the first things that comes to mind when hearing a loved one has been diagnosed with dementia, or major neurocognitive disorder, is probably memory loss. However, memory loss is just one component of a group of symptoms that are present in individuals diagnosed with a neurocognitive disorder. Neurocognitive disorder is a larger umbrella term that describes decreased mental function due to a medical disease/condition other than a psychiatric illness. Neurocognitive disorders are grouped into two subcategories:

1) mild neurocognitive disorder, and 2) major neurocognitive disorder. Mild neurocognitive disorder is diagnosed in those who show decreased cognitive abilities but are able to complete daily tasks. In contrast, major neurocognitive disorder (also known as “dementia”) is diagnosed in those who have decreased cognitive abilities and a related loss of ability to complete daily tasks.

Neurocognitive disorder can present due to many different medical diseases/conditions, such as Alzheimer’s disease, vascular issues, Parkinson’s disease, traumatic brain injury, and more. When looking for symptoms of an emerging cognitive disorder, it is important to realize that other non-memory cognitive abilities, such as executive functioning, may be impacted first.

Other cognitive domains impacted include:

01

Executive
Functioning

This encompasses several skills like problem-solving, being able to plan ahead, following multiple instructions, and being able to change between activities easily. Difficulties in executive functioning may result in trouble managing finances, difficulties cooking, or learning a new skill.

02

Language

Language impairments can present in a multitude of ways. An individual may struggle to come up with the correct word when speaking or may struggle to express themselves in a coherent manner. Difficulties with writing and reading may also be present.

03

Attention and
Concentration

Difficulties with attention and concentration may make it difficult for a person to follow a conversation or complete tasks around the home due to becoming distracted.

04

Visuospatial
Abilities

Problems in this area may make it difficult to navigate familiar environments and judge distances. This may lead to confusion and accidents when driving.

05

Reasoning and
Judgment

Sometimes individuals may exhibit difficulties with making decisions and may be easily taken advantage of by others. They may not be able to determine the best course of action, which may result in risky behaviors.

In addition to cognitive changes associated with neurocognitive disorder, individuals may also exhibit behavioral changes. These may present as:

01

Mood Changes

This may look like depression, anxiety, and irritability. Individuals may also exhibit significant mood swings and emotional responses that seem out of character.

02

Apathy

For some, a lack of interest or motivation can set in, which can lead to withdrawal from social activities and hobbies that were once enjoyed.

03

Agitation and
Aggression

Frustration, confusion, or physical discomfort may cause some individuals to become more easily agitated or even aggressive. This behavior may also be out of the norm for the individual.

04

Hallucinations
and Delusions

Sensory perceptions without a basis in reality (hallucinations) and firmly held false beliefs (delusions) can occur, often causing fear and distress.

05

Sleep Disturbances

Sleep can be impacted in several ways; for some, they may have difficulties falling or staying asleep, while others may take frequent naps during the day or be excessively tired. Sleep disturbances can impact many other areas of behavior and cognition.

Being able to recognize symptoms that are also associated with neurocognitive disorder is extremely important for early detection and getting the right medical care and resources. Early diagnosis and treatment may be able to slow disease progression and allow for interventions to be put in place to help manage symptoms and educate individuals and their families.

Dementia: It's Not Just Memory Loss

Other cognitive domains impacted include:

01

ExecutiveFunctioning

02

Language

03

Attention and Concentration

04

VisuospatialAbilities

05

Reasoning and Judgment