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Dementia Symptoms and Diagnosis
What other
dementia symptoms are there besides memory loss?
Dementia symptoms
include additional problems besides memory loss. Individuals with
dementia often exhibit difficulties in language, recognition, object
naming, and motor skills. An abnormality of language referred to as
aphasia, often occurs in individuals with vascular dementia which
involves the dominant hemisphere. Because this hemisphere controls
written, verbal, and sign language, these individuals may have
significant dementia symptoms which affect their interacting with
people in their environment. Individuals with dementia and aphasia may
exhibit scarcity of speech, poor articulation and a telegraphic
pattern of speech impairment (nonfluent , Broca’s aphasia). This form
of aphasia generally involves the middle cerebral artery with frequent
paralysis of the right arm and lower face. Despite their difficulty
with communication skills, individuals having dementia with
non-fluent aphasia, usually have normal comprehension and a relatively
good awareness of their language impairment. In addition to these
dementia symptoms, these individuals often present with significant
depression, anxiety, and frustration.
In contrast, when
an individual's dementia symptoms include fluent (Wernicke’s) aphasia,
they may be quite verbose and articulate, although much of the
language is nonsensical and includes multiple paraphasias as
neologisms and clang (rhyming) associations. Whereas, when the
dementia symptoms include nonfluent aphasias, they are usually
associated with discrete lesions, fluent aphasia can result from such
diffuse conditions as dementia of the Alzheimer's type. Fluent
aphasias, more commonly, occur in conjunction with vascular dementia
which is secondary to temporal or parietal lobe cerebral vascular
accidents (strokes). Because demented individuals with fluent aphasia
usually have impaired comprehension, they may seem apathetic and
unconcerned with their language deficits, if they are even aware of
them at all. They usually don't display the emotional distress of
individuals with dementia and nonfluent aphasia.
The dementia
symptoms of many individuals include an inability to recognize
familiar objects. Agnosia is a feature of a dominant hemisphere
lesion, which then involves altered perception despite normal
sensations, intellect and language, although the individual cannot
recognize familiar objects. This is in contrast to the dementia
symptom of aphasia, in which the individual may not be able to name
objects but can recognize them. The type of agnosia that an
individual may have, depends upon the areas of the sensory cortex that
is involved. Some demented individuals with severe visual agnosia
cannot name objects presented to them, match them up with samples, or
point to objects named by the examiner. Other individuals may present
with additional dementia symptoms such as auditory agnosia, and may be
unable to localize and distinguish such sounds as the ringing of a
telephone.
Dementia symptoms
may also include an inability to carry out selected motor activities
despite intact functioning, sensory function and comprehension of the
assigned task (apraxia). These individuals may display an inability
to carry out such functions as brushing their teeth, chewing food, or
waving goodbye when they have been asked to do so. The two most
common forms of apraxia in individuals with dementia symptoms, are
ideational and gait apraxia. Ideational apraxia is the inability to
perform motor activities that require sequential steps, and results
from a lesion in both frontal lobes or the complete cerebrum. Gait
apraxia on the other hand, often seen in such conditions as
normal-pressure hydrocephalus, is an inability to perform various
motions related to ambulation. Also, it results from conditions that
affect the part of the brain referred to as the cerebrum.
Some information from DSM-IV-TR Mental Disorders:
Diagnosis, Etiology & Treatment by Michael B. First and Allan Tasman
Additional information and
webpage By Paul Susic MA Licensed
Psychologist Ph.D. Candidate
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