July 20, 2013

"There are also large numbers of people with pseudodementia."

"These people may seem to be demented, but the brain is normal."


And: Just as I'd thought.


Ann Althouse said...

I'm trying a little commenting this morning. Read the comments instructions above. There are also comments on the previous 2 posts.

Rusty said...

I forgot what I was going to say.

Ann Althouse said...

I'm fascinated by the way it's okay to use "demented" -- it's a technical term -- in some contexts.

Gahrie said...

I'm fascinated by the way it's no longer okay to use "moron" or "retarded"-- they are technical terms -- in some contexts.

David said...

From one of the letters: "The sad truth is that we all forget, and it becomes harder to lay down new memories as we get older."

Memory is selective, often unconsciously so. Could it be that as we age we select more distant memories for emotional and psychological reasons? My life has smoothed out as I have aged. My decisions are less impactful. There are fewer responsibilities and therefore less choices. Life gives just as much pleasure and still exacts pain, but the pleasures and pains seem less intense. I have learned better how to avoid wounding myself and others. This is largely due to restraint, which may just be lessened energy.

I awoke last night and began thinking of the life altering decisions (or non decisions) I had made over time. There were so many, several not recognized as such when I made them. Life now is less likely to be badly disturbed, other than by the inevitabilities of decline and death.

A few years ago I took an IQ test. Untimed. With the timer off, I scored the same as I did decades ago. Had the usual time factor been included, the score would have been considerably lower.

I find none of this disturbing. I have lived longer and in better health than most of my ancestors (father dead at 49, male grandparents in their 50's). Moving slower, I am less likely to trip and fall.

Julie C said...

I've been dealing with my mother's dementia for years. She's in hospice care now, at the end of this horrible journey.

I think people get confused about Alzheimer's and dementia in general. It isn't as much about memory, at least at first, as it is about behavior. My mother's personality changes came first, and were very bewildering for those of us who'd known her well for decades. Then the memory started to go.

And it's not a case of "where'd I put my keys?" It's looking straight at your husband of 50 years or one of your children and not knowing who they are. She can remember her address from a house we lived in when I was a baby, but she can't recognize me as that baby grown up. Or looking at a common household object and having no idea what it is.

caplight45 said...

Interesting comments given the credentials of the responders. I found the comments about the dementia industry particularly noteworthy.

There are so many more sensory inputs today with computers, smart phones, cable TV, texting, email etc that I wonder if some of the seeming loss of function isn't some type of input overload.

And of course the NYT has to find or trend or create one.

traditionalguy said...

Dementia is first noticed by those around the sufferer that have seen a serious decline in their cognitive ability coupled with an Alfred E. Newman grin all of the time. An example that comes to mind is Secretary of State John Kerry.

A crucial time came for a long time friend of mine came when she drove her car and could not remember the way home again.

She is still friendly when we meet at her daughter's home, but all she ever says to connect to me is that I have beautiful blue eyes.

I was there when her youngest son died young of a congenital heart defect, and I was there when her husband, my best friend, died of a blood clot. So maybe it is best that her painful memories are erased.

edutcher said...

Dementia is really a technical term for health people and is used to cover the gamut of such afflictions, physiological and otherwise.

John Lynch said...

The worst thing about dementia is losing your rights as a human being.

My wife's grandfather had to go through that. Now he's living in what's essentially a prison because he kept wandering off.

Life is tragic.

Ann Althouse said...

Comments are on moderation now, so they won't appear immediately.

66 said...

Trying hard to not break the comment rules while struggling with my pseudodementia. May have already failed. Where am I again? Nothing seems certain (except that this post is headed for deletion).

katelynskorner said...

Ask a frazzeled new mother with a six week old baby and sleep deprivation if she forgets things. A stressed brain a flood with stress hormones sometimes acts in a demented manner. I know I've experienced fleeting pseudo dementia.

Oh yes, let's not forget the early morning brain before coffee.

Deirdre Mundy said...

Since Dementia is in the DSM-5, is it really fair to call something 'pseudo-dementia' if the person acts demented but it doesn't show up on a brain scan?

I mean, a lot of our diagnostic procedures for mental illness are strictly behavioral-- There's no brain-test for depression. The person just appears depressed. ADHD is the same way. Autism also falls into this category.

It seems like most 'diseases of the mind' are actually 'diseases of behavior.'

And even for something like Alzheimers, the tests don't seem conclusive. For instance, by brain scans, Terry Pratchett should be in a nursing home babbling to himself in nonsense. Instead, he's blind but coherent.

I think the phenomena of pseudo-dementia shows that we don't REALLY understand the science of dementia.

erikarndt said...

Doesn't all behavior originate in the brain? Behavior issues are a reflection of a problem in the brain chemistry for various reasons, I believe. Isn't true dementia a shrinkage of brain tissue, so to speak? Loss of gray matter can be seen on MRI's. A brain flooded with stress hormones actually make children's brains develope differently, I'm fairly certain it makes adults brains react differently. I'm not a professional, these are just some things read in science journals.

Mark said...

Dierdre, the only conclusive tests for Alzheimer's are done post-death. We can dream, but it is unlikely there will be any reliable test as the plaques and other markers in the brain are really only best observed via scalpel.

Very much like the changes that happen to NHL and NFL players after all those hits to the head. Once opened up, the damage is clear ... but never until then.