Thanks for reading
Today, we’ll be looking at the clinical features of Dementia.
The mental functions that are commonly affected in persons with Dementia include:
Memory, Speech, Intellect, Judgement, Ability to find their way, Ability to plan, initiate, multi task and change plan.
Please note that ANYBODY can forget, fail to plan, have a poor sense of judgment, or mix words. This is especially so with increasing age. This does not mean that the person already has Dementia. For it to be Dementia, the problem is enough to impair everyday functions and activities as we shall see below.
Memory is usually the most important and most obvious function lost. There are many classifications of memory. One of the simplest classifications is the Classification
according to duration: long and short term memory. Long term memory ( information gathered over years) is less likely to be affected.
Recent or Short term memory is more readily affected.
Actually, the memory is like a filing system. It has three steps: Registration, Storage and Retrieval.
Registration is lost very early in Dementia. This is the reason persons with Dementia ask the same questions over and over again. It is because the information was never registered: hence it can’t be retrieved. The information especially when recent like the meal just eaten, the message received hours, days or weeks earlier is totally lost. One of my patients will ask for breakfast every 20-30 minutes. Eating that meal never registered, telling him that he has eaten never registered either.
Note that we all forget naturally, but remember once we are reminded. This is because the information registered and as such can be retrieved.
The forgetfulness starts from everyday information, misplacing personal items like tooth brush, comb, wristwatch, keys, money ETC.
On some occasions, the person may put the items in illogical positions, e.g. Palm oil in the bathroom, bathing towel in the kitchen or parlour ETC.
Often times the person may discuss an incident that occurred 20 years earlier as though it happened yesterday. An 80 year old woman may ask for her late husband or her new born baby because what she can remember is 45 years ago when she was nursing a baby with her young husband by her side. This is because the long term memory remains intact for long.
In view of the forgetfulness, the person becomes unable to function. The deterioration leads to difficulty in remembering familiar persons. They may call their children the wrong names. They are unable to cope with every day duties or keep appointments. One of my patients came out of the bathroom without rinsing off the soap: he had forgotten that step in bathing. Another woman couldn’t remember the ingredients of a dish she had cooked for more than 60 years.
Dementia gradually changes the person in many different ways.
We’ll continue tomorrow. Thanks for reading