What is dementia?
“A clinical syndrome caused by a wide range of diseases that affect the brain”
“Impairment of memory, thinking, orientation, comprehension, calculation, learning capacity, language and judgement”
What are the 5 areas impairment can occur in dementia?
- Language
- Memory
- Visuospatial Skills
- Emotion or Personality
- Cognition (thought processes, agonosia, impaired orientation or executive functioning)
How do we classify dementia?
(3 areas)
- Cortical v sub-cortical
- Remediable v Irreversible
- Early v Late onset
What are the stages of onset in dementia?
- Early stage
- Middle stage
- Late stage
- Terminal stage
What are the cortical causes of dementia?
- Alzheimer’s Disease
- Dementia with Lewy bodies
- Pick’s disease/Frontotemporal Dementia
What are the sub-cortical causes of dementia?
- Parkinson’s disease
- Wilson’s disease
- Huntington’s disease
- Progressive Supranuclear Palsy (PSP)
What are the other causes of dementia?
- Intra-cranial conditions (tumours, hydrocephalus)
- Head injury
- Korsakoff’s/Wernicke’s Syndrome
- Alcohol-induced dementia
- Chronic drug use
- Boxer’s syndrome
What infections/diseases can cause dementia?
- Creutzfeldt-Jakob disease
- Neurosyphillis
- AIDS dementia complex
What are the symptoms of Alzheimer’s Disease?
- Struggle to remember what they’ve done or said
- May repeat themselves in conversation
- More recent memories are typically lost first
- Older memories can remain for longer (remember childhood better)
- Brain has reduced neurotransmitter which means cells communicate with one another less effectively
- Reduced emotional control
What are the symptoms of Dementia with Lewy bodies?
Difficulties with:
- Movement
- Concentraion
- Alertness
- Hallucinations
- Problems with sleep - disrupted sleep and vivid dreams
What are the symptoms of Pick’s Disease?
Behaviour:
- Loss of inhibitions
- Loss of interest and motivation
- Loss of sympathy and empathy
Language:
- Slow, hesitant speech
- Impaired understanding of complex sentences
- Circumlocution/WFD
What are the symptoms of multi-infarct dementia/vascular dementia?
- Slowed thinking
- Slowed problem solving
- WFD
- Planning/organisation
- Concentration
What causes Alzheimer’s disease?
- Thought to be caused by the formation of deposits of protein in the brain called plaques and tangles that function abnormally in brains with Alzheimer’s
What causes dementia with Lewy bodies?
- Lewy bodies are tiny clumps of proteins in nerve cells that prevent nerves communicating, leading to cell death
- Symptoms worsen as more nerve cells are damaged
What causes Pick’s Disease/Frontotemporal Dementia?
- A range of conditions that damage the cells in the frontal and temporal lobes
- Frontal lobe damage causes changes in personality and behaviour
- Temporal lobe damage can cause problems with language
What causes multi-infarct dementia/vascular dementia?
- Caused by problems with the blood supply to the brain, denying cells of oxygen and nutrients
What impact can dementia have on semantics?
Errors in:
- Naming
- Empty language
- Moving onto comprehension difficulties
- Lack of output
Cause:
- Attention deficits
- Perceptual deficits
- Poor lexical access
- Disorganised semantic representations
What impact can dementia have on pragmatics?
Errors:
- Irrelevant speech
- Lack of reference
- No consideration of the needs of the listener
- Inappropriate topic change
- Lack of initiation
- Poor coherance
- Speaking at language level but not communication - no purpose/lacking content
What impact can dementia have on syntax?
- Generally intact
- Some difficulties as in normal ageing (unfinished sentences, difficulties in the later stages of dementias
What impact can dementia have on phonology?
- Generally intact until the late/terminal stages
What communication difficulties occur in the early stages of Alzheimer’s Disease?
- WFD
- Circumlocution
- Repetition of ideas
- Empty language
- Good basic understanding but poor inferencing
- Can converse in most social situations
- Fluent
- Aware of difficulties
What communication difficulties occur in the middle stages of Alzheimer’s Disease?
- Increase in jargon words
- Mild to moderate comprehension problems
- Fluent but inappropriate/empty content
- Poor topic maintenance
- Poor use of pronouns
- Reduced awareness
What communication difficulties occur in the late stages of Alzheimer’s Disease?
- Uninterpretable speech
- Incoherant
- Breakdown in pragmatic functions
- Echolalic and perseverative
- Non-fluent
- Poverty of output
What communication difficulties occur in the terminal stages of Alzheimer’s Disease?
- Mute or echolalic
- Palilalia
- Auditory comprehension is severely impaired
- No social interaction
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W1 - Briefing6
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W1 - Psych. Impact3
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W2/3 - Developmental Stammering24
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W3 - Acquired Stammering6
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W3 - Cluttering8
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W4 - Selective Mutism8
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W5 - DLD10
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W6 - Receptive Language5
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W7 - Expressive Language4
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W8 - Impact of Lang. Difficulties10
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W9 - Pragmatics5
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W10 - ASD5
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W10 - Speech Sound Disorders18
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W13 - Literacy Impairment11
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W13 - Dementia25
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W14 - Impact of Food & Drink Difficulties4
