Dementia

Type of psychology: Cognition; memory; psychopathology
Fields of study: Aging; cognitive processes; depression; interpersonal
relations; social perception and cognition; thought
Dementia is a chronic progressive brain disorder that may occur as a result of various
events. Dementia is the loss of cognitive and social abilities to the degree that they interfere
with activities of daily living (ADLs). Dementia may or may not be reversible.

Key concepts

• activities of daily living (ADLs)
• cognition
• delirium
• depression
• memory loss
• pseudodementia

Dementia is usually characterized as a gradual, progressive decline in cognitive
function that affects speech, memory, judgment, and mood. However, it
may also be an unchanging condition that results from an injury to the
brain. Initially individuals may be aware of a cognitive decline, but over time
they cease to notice. The insidious and progressive nature of dementia may
make early diagnosis difficult because cognitive changes may appear as only
slight declines in memory, attention, and concentration or rare episodes of
inconsistencies in behavior that are attributed to aging. Over time, increased
confusion and irritability in unfamiliar environments, poor judgment,
difficulty in abstract thinking, and personality changes may be seen.
Delirium is a transient alteration in mental status that is a common feature
of dementia. Signs and symptoms of delirium develop over a short period
of time. Once the underlying causes of delirium, such as medical problems,
stress, or medications, are identified and ministered to, delirium can
be reversed. Visual and auditory hallucinations, paranoia, and delusions of
persecution may be observed. Memory loss is another symptom of dementia.
People with dementia often forget how to perform activities of daily living
(ADLs) that they have been performing for years, such as dressing,
cleaning, and cooking. They may repeatedly ask the same questions, have
the same conversations, forget simple words, or use incorrect words when
speaking. They may become disoriented as to time and place and become
lost in familiar surroundings. Problems with abstract thinking may make
solving math problems and balancing a checkbook impossible. People with
dementia may misplace items and be unable to find them because the items
were put in unaccustomed places. Mood swings and drastic personality
changes, such as sudden, unexpected swings from calm and happy states to
tears and anger, are not uncommon in those with dementia.

Depression may be mistaken for dementia. Symptoms of depression
include feelings of profound sadness, difficulty in thinking and concentrating,
feelings of despair, and apathy. Severe depression brings with it an inability
to concentrate and a poor attention span. As the person with dementia
tries to conceal memory loss and cognitive decline, appetite loss, apathy,
and feelings of uselessness may ensue. In combined dementia and depression,
intellectual deterioration can be extreme. An older adult who is depressed
may also show signs of confusion and intellectual impairment even
though dementia is not present. These individuals are identified as having
pseudodementia. Depression, alone or in combination with dementia, is
treatable.