Psychological Effects of Dementia

Question

How does dementia affect a patient psychologically?

Answer

As all forms of dementia have a direct and profound effect on the brain that intensifies as the dementia patient ages and the disease progresses, the primary set of changes that can be recognised in patients are psychological in nature. These usually manifest as memory problems that impact on the patient’s ability to care for him or herself and navigate the world. Initially they may struggle to perform or manage complex tasks to the degree that they were formerly able, become lost when traversing areas they were familiar with, struggle to find certain words in expressing themselves, repeat themselves, and require reminders to take medication or perform household activities. Incorrect temporal recollection of certain memories can occur, with events of the distant past being believed to have happened a short time before; it is common for the patient to become convinced of the reality of dream or fantasy events as well. Towards the middle and late stages of dementia, these memory impairments can worsen to the point of the rapid loss of new information, and even of old information as the patient fails to recognise acquaintances or to perceive common dangers. The problems in memory go hand-in-hand with a range of progressing cognitive defects that undermine executive function and behavioural consistency.

As the ravages of dementia gradually compel the patient to relinquish their autonomy, their responses to the situation may incur more general psychological-behavioural consequences like depression, anxiety, apathy, anger and denial. Delusions may progress to becoming hallucinations. Eventually, all personal conceptualisations of their worldly identity may become unstable and lead to a total psychological change in the patient from prior to the onset of the disease.

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