Overview
When most people think of dementia they immediately think of Alzheimer’s Disease, but this is not the only form of dementia. Dementia is a general term used to describe a gradual decline in multiple areas of cognition. One of these areas of decline is usually memory. It is important to note that dementia is a disease process and not an automatic condition of ageing. A few years ago, one of my undergraduates told me that prior to my class she had thought, “Alzheimer ’s Disease was pronounced, ’Old Timer’s Disease,’ and that it happened to everybody as they grew older. Quite a frightening thought and one possible basis for the ageism that the elderly often encounter.
The following are descriptions of the five most common types of dementia that can affect the elderly.
Alzheimer’s Disease (AD)
AD, being the most common of the dementias, accounts for fifty percent of the dementia cases. AD begins with a gradual, but steady decline in recent memory. As the disease progresses other cognitive deficits become apparent such as difficulty making decisions or initiating activity. Interestingly, long term memory remains relatively intact until the very last stages of the disease. Vocabulary and musical ability stay remarkably at pre-disease levels because these areas of the brain remain relatively untouched by the disease.
Case Examples: Musical Ability
I once witnessed a woman in the later stages of AD entertaining the other nursing home residents by playing her concertina. She was incontinent, could barely talk and never knew where she was, but she could still play the music she had loved her whole life.
When I was working with AD patients, friends would often say: “Oh, that must be such depressing work.” No, I assured them. I had never had work that was so happy. I know for a relative to watch the personality of the elder person they have loved to begin to drastically change is devastating. But for a professional who never knew the person before AD the situation is quite different. True, there were times when these women suffered -- when they searched for the home of their youth and couldn’t find it or called out to a long deceased parent--but there were other times, too. Often they displayed the most wonderful sense of fun.
