Understanding the Lost Cognitive Functions in Alzheimer's and Dementia | TLA039

Are you caring for a loved one with dementia? You don't have to figure this out all on your own. Welcome to Truth, Lies Alzheimer's, the show that helps you reimagine a new relationship with your loved one, a relationship a little more free of stress and anxiety. Join host Lisa Skinner and her 30+ years of experience as she guides you on a new path to a better relationship with those you care for. Here's Lisa.

Welcome back to another new episode of The Truth, Lies Alzheimer's Show. I'm Lisa Skinner, your host, and I am honored to continue our exploration of the multifaceted world of Alzheimer's disease. Where we will be delving into the complex and often misunderstood world of Alzheimer's disease. I'm here to help you navigate through the truth, the myths, and the challenges surrounding this condition. Join me as we explore the latest research, share personal stories, and provide valuable insights into living with Alzheimer's disease. And whether you're a caregiver, a healthcare professional, or someone who's been impacted by Alzheimer's disease, this show is dedicated to shedding light on the truth, dispelling those lies, and offering hope in the face of this challenging disease. So what I wanted to share with you today on today's episode is explaining and helping you have a better understanding of what cognitive functions people with Alzheimer's disease lose and why they lose these functions. So one of the first parts of the brain to be damaged by brain disease, especially Alzheimer's disease, this is the hallmark of Alzheimer's disease, is when these plaques and tangles form in the brain and they basically suffocate the neurons and do so much damage that the, those parts of the brain eventually just fail. So memory is the first part of our cognitive functioning that is impacted by Alzheimer's disease. Alzheimer's often first manifests as short-term memory loss, as we know, where the individuals may have difficulty remembering recent events, conversations, or appointments. As the disease progresses, long-term memory can also be affected, leading to challenges in recalling significant events and/or personal details. However, the long-term memory does stay intact for most of the disease and sometimes all the way through the disease. So when the short-term memory is failing, And as you're, as a person is progressing through the illness, it's working sometimes and other times it's pretty much short-circuited and it's, it's not working temporarily. And that increases over time. And as that happens, that person living with Alzheimer's disease, when their short-term memory has failed them, will pull from their long-term memories. And this is the reason why so many people so commonly talk about things from their past, like they're happening at that very given moment, the here and now, because they have gone back in time, kind of like push and rewind. And in their minds, they're living in a past part of their life until that short-term memory comes back. And this goes off and on, off and on, off and on until the end of the disease. And at that time, with many people who live with Alzheimer's disease, that short-term memory shuts off completely. And then they are permanently living back in a previous timeframe of their lives, and everybody ends up in a different place. Some go back to their childhood and they start asking, you know, where's my mommy and where's my daddy? And some are in their adolescent phase of their life. So they're teenagers. Some are in the prime period of their life. They're raising children and going to work. And the way you know what part of their lives they've kind of got stuck in after their short-term memory is completely gone or almost completely gone is you listen for the cues of what they're talking about and their conversation. The things that they're talking about are going to give you the clues to where they are in their timeline, uh, based on what they're asking for. It's time for me to go pick my daughter up. She'll be waiting for me. Well, obviously she's a mom raising children. So that's how you identify that. They lose their reasoning and judgment. So what that means is Alzheimer's can impair a person's ability to make sound decisions, to solve problems, and exhibit good judgment. This can lead to extreme difficulty in their ability to plan, in their ability to organize and carry out tasks that were once routine. So from balancing a checkbook to operating the— a simple appliance like a toaster that they've done for decades. They lose the ability to continue to do those simple daily tasks. As far as exhibiting good judgment, I'll give you an example that is very life-threatening and scary, but we were all taught growing up as children, when we cross the street, we need to look both ways to make sure a car's not coming and that we can safely go across that street. They lose that ability to make sound judgments. So all that learning leaves their, uh, the files in their brain. And it would not be uncommon for somebody living with kind of mid-stage to latter stage to leave their, their safe surroundings in their home or somewhere else. And just walk into a street without making sure there are not cars coming in their direction. It happens all the time. That's an example of no longer having the cognitive ability to use good judgment, safe judgment on things that we just do on a normal basis. They lose their ability to, for language and communication skills. Individuals with Alzheimer's may experience trouble finding the right words. We call that aphasia. Following or joining in conversations and understanding written or spoken language. So what happens is this can result in increased difficulty in expressing thoughts and emotions, and a lot of people actually lose their ability to articulate their wants and their needs. But they still trying to tell us things and communicate their wants and their needs. So they find alternative ways to do that. And this is what shows up in behaviors that we see anxiety and anger and screaming out things like that. They're trying to tell us something and it's up to us to figure out what that something is. They lose visual perception. This surprises a lot of people. Alzheimer's can actually impact a person's ability to interpret visual information, leading to difficulties with spatial awareness, recognizing objects, and navigating their surroundings. So let me give you a quick example of that. So as far as visual perception, when people are suffering from Alzheimer's disease, they eventually lose their depth perception. So it is known that if you put their food on a white plate and the tablecloth is white, they would have a very difficult time or could not at all seperate the plate from the table and just see it as one big thing. So a remedy for that is to color contrast the color of the plate with the color of the table or the tablecloth. So if you have a white tablecloth, maybe you wanna put the food on a red plate and then they can stink, distinguish, uh, the plate from the actual table. And so that's a, that's a, a good example of how they lose visual perception of recognizing objects, things like that. I'll just give you another quick example of recognizing objects. A lot of people, men especially, have a very difficult time being able to differentiate toilets from the rest of the, from the floor. And they, and that causes them to basically miss their aim. So again, if you have a toilet seat that is a different color from the floor, the tile, they would be able to make that out much easier than if everything is the same, same color and it just all blends in through their through their perception. They lose attention and concentration abilities. People with Alzheimer's, they struggle to maintain focus on things, to stay attentive, to process information, which can hinder their ability to engage in conversation and follow instructions and complete tasks. They also lose their ability to do what we call task sequence and eventually will need help with that. Now, in the beginning, you can help them by prompting or cueing them, but eventually that's not going to work for them either, so it'll have to be taken over by a caregiver. Brushing your teeth is a good example. We've been doing it all our lives. We know that we could probably do it in our sleep. You could walk into the bathroom. The first thing you do is you turn on the water, you pull your toothbrush out of the holder, you put the toothpaste, and then you start brushing. And it's all that whole entire task is done in a learned sequence. A person, once they get to about the mid-stage of Alzheimer's disease, they can no longer perform tasks in their correct order or sequence. So you might have to say, okay, now you put the toothpaste on, on the toothbrush, and then maybe even demonstrate. And then eventually they probably will need to have somebody do that for them. These cognitive functions are affected by the hallmark brain changes associated with Alzheimer's disease. And as I mentioned, these include the accumulation of abnormal protein deposits called amyloid plaques and tau tangles, as well as the loss of connections between the nerve cells. These changes, what happens is, and this is why we see the things we see with this disease, These changes disrupt the communication and functioning of our brain cells, leading to the cognitive decline observed with Alzheimer's disease. This is all part of the disease. Additionally, as the disease progresses, these cognitive deficits can significantly impact an individual's independence and quality of life, highlighting the need for ongoing research, improved care strategies, and effective treatments for Alzheimer's disease. Now, I've been doing this for professionally for 30 years. I've had 8 of my own family members live with one of the brain diseases that causes dementia. My very first experience dates back about 50 years when my grandmother started telling me that birds were living in her mattress and coming out at night and pecking her face, uh, telling me that rats were invading her home. And she points to the walls and said, see, they're running along the walls and insisting that men were stealing her jewelry, which is part of the changing brain. We see a lot of paranoia and suspicious behavior. With this disease. So these are all very, very common things that accompany Alzheimer's disease and some of the other brain diseases that cause dementia. And if we are aware of these things, we will know what to expect. And when they do happen, we'll recognize them as being part of the disease. And then to just take that one step farther, there are best practices and effective responses that we as loved ones and caregivers can learn that can minimize a situation from escalating into a really serious situation. We call those serious situations catastrophic reactions. So to minimize catastrophic reactions, which are like meltdowns that you'll see in people suffering from Alzheimer's disease. There are things that you can learn. We've talked about them before, but I'll continue to bring them up so they'll eventually become second nature to you. And what that's going to do for everybody is provide a better quality life for the person living with the dementia. It's going to provide a better quality of life for the caregiver and the family members, and really then focus on what's most important. And that is obvious. It's spending quality time with the person you care for or your loved one without all the added stress and anxiety that comes from all the expect— unexpected things that show up and not being prepared to know how to properly handle them. So that's what I have to share with you, uh, on today's episode. And I look forward to seeing you back next week for another new episode of the Truth, Lies Alzheimer's Show. Thanks.

Thank you for listening to Truth, Lies Alzheimer's. We hope you found something in today's episode that helps. We understand that caring for a loved one with dementia can be the challenge of a lifetime, but you don't have to do it alone. If you're ready for exclusive access to even more great content and resources, head on over to Facebook and join Lisa Skinner's Minding Dementia support group, where a community of like-minded caregivers Rivers, and we're here to help.