Dementia vs Cognitive Impairments - Term Paper Example

There is oftentimes an aspect of difficulty to the distinction between the manifestations of dementia to the normal symptoms typical to the aging process. The neurodegenerative maladies that occur in both cases accounts for the similarities that make it difficult to classify among these ailments. Families of patients inflicted with such should be assured and educated to the accuracy of the diagnosis given by their physician. In such a way, this is important in the proper caring and administration of medicines of the person. Although this simultaneously involves the problem as those concerned seldom seek proper guidance as it has become a common practice to resolve into the belief that such changes are consequent to the aging process. There is a degree of negligent perception from the medical practitioner responsible for the patient and for the family of those who suffer that become complacent into thinking it is normal and to be expected. The Age Gap It is relative to our mortality that for the luckiest of us, we follow the cycle of life and we grow old and then wither. The lack of concern that society often disregards old people is nothing less than an irony of our life. We refuse to acknowledge older people as we dismiss them easily in favor of the everyday problems that we face and regard as matter of life and death. It is a bittersweet reality that whether we like it or not, we are one day to replace those older people as we age ourselves. In this we experience the same physical and mental problems that they endure in their life. It thus seems more than proper to be empathic in their complaints and gripes that may be possibly remedied with proper attention. The aging process entails many changes that occur and radically alters everyday living. Imperative changes in the body results to physiological mechanisms declining that are common as a person ages. These should be identified as it is helpful in the management of problems that arise with it. The least problematic of this is gestation as taste receptors are replaced on a regular basis disparate to neural cells. A somatosensory problem that compromises their ability to regulate their temperature is also diminished. This could affect their tolerance for pain which may hinder their capacity to recognize symptoms and result to problems progressing before detection. Another includes sensory deficiency in auditory and visual facility (How may sensory changes affect the everyday lives of older people?). It was found that 1 out 8 Americans over 65 have Alzheimer’s disease and this number is expected to double by 2050. A study conducted by Matt Spalding and Puran Khalsa involved 10 Pacific Institute therapist interns who were reviewed for their therapeutic treatment of patients with mild to severe cases of memory impediment. The institute is a benchmark in its program that prioritizes ‘humanistic value values over symptom checklists as the chief criteria’ and employs ‘Existential and Process-work approaches.’ This alternative method was found to be effective for the treatment of the patients with dementia regardless of age and gender. Ultimately, it proves that there are a number of approaches that can be tried out before adhering to conventional, drug-induced therapies Differentiating Age Degeneration and Dementia In the differentiation of normal aging symptoms and dementia it is important to take note of the differences as manifested between cognitive impairments and dementia. Correct diagnosis is invaluable in the correct implementation of patient care. It is important to consider that both varies and though they may have various similarities that therefore projects a correlation, the distinction is imperative. Because the indicators and probable causes are greatly the same, it follows that the variation is often overlooked. As both as common to the elderly, the function of the doctors to give an accurate prognosis is essential. A list of the distinguishing characteristics that differentiates typical aging from dementia includes; the ability to preserve daily functions independently while someone with dementia would become dependent on others. A person who complains of memory difficulty yet still able to give details of incidence of forgetfulness would be classified as age-related while those who complain only when asked and do not recall specific occurrences would be with dementia. If more apprehensive of memory loss than other members of the family rather than the other way around, then it is more likely to be typical of age. Significant loss of memory with regard to important events and dysfunction in oral activity is also common to dementia. An occasional dilemma in word-finding is typical while frequency in such problem is characterized of dementia. Someone who gets lost in recognizable areas and takes time to be able to return, finds difficulty in operating appliances, loses interest in socialization and fails to pass a performance test is positive to have dementia. While someone who only needs to pause to be able to remember, is competent yet unwilling to operate devices, maintains personal relationships and performs normally on an examination is someone who suffers from symptoms typical to people who are aging (US Department of Health and Human Services, 1996). In the next step for figuring out the actual problems of the patient, it is important to take into consideration the following matters for family members to determine whether it is dementia or not. The criteria includes; first, the presence of delirium and second, the inability to learn and absorb information. What should be asked of a person capable of providing necessary information includes; their alertness and unbroken stimulation, their actual state of mind, aggravated medical conditions and their capacity to retain conversations, important social activities, objects and whether or not they repeat conversations. A meticulous review of medication of the patient is also necessary as there are a number of prescriptive drugs that may cause cognitive impairment. This should be analyzed suitably so that it may not be confused with degenerative psychological diseases (US Department of Health and Human Services, 1996). When symptoms point to the direction of dementia, it becomes the responsibility of the family members to determine the course of the prognosis. A person with dementia would exhibit aphasia, agnosia, apraxia and common executive functions. In detail, they may show struggle in getting dressed, driving, organizing and locating places. Coherence in thought would also be apparent to dementia patients as well as being disjointed in problems and emergencies and exhibiting inappropriate social behavior. Therefore, the person would be unable to function independently and would need to rely on the assistance and help of other family members to be able to live. (US Department of Health and Human Services, 1996). This would visibly alter their overall way of life as an outcome of the degenerative disease. Older People’s Mental Health (OPMH) advocates the need for personalized care for people who are suffering from dementia as they see it that it is not appropriate to label and categorize people into boxes. Every patient’s needs vary and delineating them into specified and constricted programs may not be beneficial for their improvement. They encourage what they call the ‘dementia pathway’ which has eight stages which are; 1. Prevention, 2. Awareness, 3. Recognition, 4. Assessment, 5. Diagnosis, 6. Case Mgmt & Treatment, 7. Crisis / Emergency care, 8. End of Life. Frontotemporal Dementia and Alzheimer’s Disease Other than dementia associated with Alzheimer’s disease, there are a number of other parallel diseases that causes it. The most occurring among these are frontotemporal dementia which includes Creutzfeldt-Jakob, Lewy body and Huntington’s disease. It is common to see that the major impact of dementia is the change in personality of the patient. As the disease develops, the patient is more likely to keep unto himself and anti-social behavior is manifested. Language is also a sign as some become mute and tendency towards failure of recognition is shown. This type of dementia occurs to 1 out of 5000 people and occurs to people under the age of 65, the common age group for dementia patients. It is the second most frequent type of dementia for such group. This is an inherited type of disease apparent as autosomal wherein a chromosome 17 abnormality has mutated (North West Dementia Center, 2005). What is Mild Cognitive Impairment? Another related aspect which is Mild Cognitive Impairment or MCI as reiterated by the Alzheimer’s Association is used to signify aptly distinguishable memory disorders from patients who have memory problems that are substantial in comparison to that which is characterized by normal aging yet cannot be qualified as dementia. This is reasonably newer than more commonly known diseases such as the two previously cited. It is as a matter-of-fact on its budding stage as a ground for research. Scientists are still on the verge of giving a solid working definition on what MCI is as there are still a plethora of questions that need to be addressed on this topic and it still remains an area for further study (2006). The American Academy of Neurology (AAN) issued guidelines for the recognition of memory loss which includes; firstly, the person’s own detection and complaint of memory loss seconded by another person, secondly, substantial memory problems identified through an assessment, recognizable loss of logical skills and apparent change in the person’s capability to perform his routine activities. Furthermore, the researchers have to ask questions which include the ability to distinguish normal from abnormal memory impairment. The level of significance before it can be attributed as mild dementia. The complexity is in searching for the abnormalities that separates it in other fields of thinking. Last in this line of queries and probably the most common problem that occurs, is also its categorization to normal aging or beyond (Alzheimers Associaion, 2006). The advent of MCI, although considered to be in its infantile stage, signifies the need for the development and research that is associated with this area of psychology. The problem that differentiates dementia and cognitive dysfunctions entails more than the recognition of the dissimilarity among the two and such that it is encumbered upon by the lack of necessity it curtails, then, further study and development is needed. It may be regarded that there are still missing pieces as to the seminal integration that starts from prognosis, therapy, medication, etc. then, it is safe to say that this is an area of concern that needs to be addressed. This includes the proper adherence to the adage that an ounce of prevention is better than a pound of cure, as it is often always true in medicine. Aging and Dementia The cognitive, behavioral and biopathological changes that are similar between dementia and normative aging indicates the problem of distinguishing between the two. The two forms that may be deemed as a continuum as it is difficult to remove the cloud of doubt between the symptoms of aging and dementia is because they are both most common to the 65 and up age group. It is therefore confused and misguided to delineate in a matter of simple elimination what both may or may not have. Huppert and Brayne conclude that there are two conclusions to be made from these observations. One is that it would be hard to identify changes that are associated with dementia for mild to early onset for those who are significantly of old age. People and medical authorities would tend towards having an excuse that it is just common cognitive and memory loss associated with old age for those aged 90 and up. Since the accepted onset of dementia is for ages 40-90, then those who are beyond that age would automatically be concluded as age-related cognitive problems. It becomes an assumption that it is aging and dementia combined as perception follows that later in life, dementia is sure to hit everyone after they reach a certain age. Another observation is that there is a requisite to observe older people to be able to understand the nature of the disease. Deductively, if it is a common illness to an age group then preventive measures would be more practical than research. Most information is related to Dementia of the Alzheimer’s Type or DAT, which should scrutinize the distinction between the two issues at hand. The classification of whether there is a continuum or not between dementia and normal aging is the foundation on which the issue treads. Research shows that it is more likely to connect the two. Such that the continuum model suggests that dementia is an extreme manifestation of aging. It is oxymoronic in such a way that it is a ‘normal’ abnormality among older people. The variation lies in the difference as to the degeneration among older people. How is it that some show swift symptoms of cognitive loss common to their age while others do not? The difference in the distinction to the diversity among the age group also makes it challenging to figure out what is normal and abnormal. Alongside the premise of the continuum is absence of quantifiable divergence between those with mild dementia and those with typical aging dilemmas (Huppert & Brayne). The discontinuity or disease model on the other hand proposes that it is a distinct disorder that can be discriminate from what is normal. This suggests that there are markers that could be qualified to determine the type of dementia. The negative aspect of this hypothesis is that there is yet to be a functional differentiation. Research that aim to seek and prove this idea in sentient patients coincide within age controls. It is in the post-mortem investigations that yield the difference in chemistry and pathology of the patients. Probably the main basis for the validity of the model is that there is the possibility of DAT occurring to those who are under the specified age group (Huppert & Brayne). Another model is Mortimer’s elegant model which combines the two as an explanation. The disease model and continuum model is amalgamated. It suggests that brain capacity to retain information is diminished with age and that the tendency of dementia is pathological. Those who acquire Alzheimer’s disease at middle age are caused by the ‘reduced reserve capacity resulting from familial/genetic factors which may be evident at birth’ (Huppert & Brayne). The Cause for Concern It is within our human capacity to care for other individuals regardless of the age. It is not a matter of age wherein we are willing to compromise any person’s quality of life. Early diagnosis and correct prognosis is part of our responsibility as human beings and as an integral part of the medical profession. It is unacceptable to be contented with anything just because it is easier. The same goes for the differentiation between normal aging and dementia. The knowledge that comes with knowing what is the true illness or lack thereof of a patient is important in determining the proper attention that is due to them regardless of their age. Not because they no longer hold the same value in society they once have does not signify that they do not deserve the best quality of health care. We are to be emphatic and sympathetic as they represent the future as we are now. It is therefore common sense not to be complacent when there is uncertainty. Further studies on the matter gives light to what are still incomprehensible and thus it is indispensable. Not because it is normal does not mean it needs not to be explored. Whatever the issue is, cause for concern is perceptible because it involves human lives. It thus becomes accountability to the patient and his family to provide accuracy of information. There can never be a substitute to our humanity and what is typical is not always correct as we have seen time and again, in science and in life. Bibliography Alzheimers Associaion. (2006). Retrieved October 7, 2009, from www.alz.org: www.alz.org How may sensory changes affect the everyday lives of older people? Huppert, F. A., & Brayne, C. What is the relationship between dementia and normal aging? NHS Cornwall and Isles of Scilly in partnership with Cornwall. (2008). Older people’s mental health newsletter. Cornwall: Cornwall & Isles of Scilly PCT. North West Dementia Center. (2005). Frontotemporal dementia- fact sheet. Manchester: PSSRU. Spalding, M., & Khalsa, P. Aging matters: humanistic and transpersonal approaches to psychotherapy with elders with dementia. US Department of Health and Human Services. (1996). Differentiating normal aging and dementia. AHCPR clinical practice guidelines . Yurica, C. L., & DiTomasso, R. A. (n.d.). Cognitive distortions. 117-122. Read More