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 Ph.D. Licensed Psychologist
