| Behavioral Manifestations of Alzheimer's Dementia |  |
Alzheimer's Dementia has a combination of cognitive and
behavioral manifestations. Cognitive impairment is the core
problem which includes memory deficits and at least one of
the following: aphasia or language problem, agnosia or
problems with recognition, apraxia or motor activity
problem, and impairment in executive functioning (e.g.
planning, abstract reasoning, and organizing).
As the disease advances, the cognitive decline becomes
associated with behavioral manifestations. What are these
behavioral manifestations of dementia?
Behavioral syndromes in Alzheimer's can be grouped into two
categories: psychological and behavioral. Major
psychological syndromes consist of depression, anxiety,
delusions, and hallucinations.
Depression in dementia is very common. Up to about 87% of
patients develop some form of depression. It is
characterized by tearfulness or crying episodes, feelings of
sadness, and neurovegetative signs and symptoms such as
inability to sleep, lack of appetite, poor energy, and
thoughts of death. Irritability is also common. Depression
can occur even in the early or mild phase of the illness.
About 50% of demented patients show delusions or false fixed
beliefs. Such delusions include beliefs that a relative is
stealing, that a spouse is just an impostor or is having an
affair with a neighbor, or that friends and relatives are
conspiring to cause trouble.
Moreover, many patients with dementia may experience
hallucinations. Most of these hallucinations are visual -
seeing strangers in the house, an animal or insects in the
living room, people in the bedroom or on top of the TV set.
Occasionally, auditory hallucinations may be experienced -
hearing footsteps or knocking on the door or even people
singing church hymns.
Regarding major behavioral syndromes associated with
dementia, these problems include agitation, verbal
outbursts, repetitive behavior, wandering, and aggression or
even violence. Agitation can be manifested by pacing back
and forth, restlessness, and inability to sit still.
Verbal outbursts consist of day-long screaming or occasional
yelling at someone. Repetitive behavior is manifested by
closing and opening a closet or a purse or a drawer. Asking
questions repetitively for instance about a relative's visit
is very common.
Wandering can happen especially at the late stages of the
illness. If doors are left unlock, some patients wander away
from the house. Hence, safety level becomes an issue.
Aggression likewise may occur. Hitting the caregiver or
throwing things are some complaints. Destroying things
although rare can also ensue. A gentleman for example hit
the wall with a cane and broke the window by smashing a
chair.
Although difficult to deal with, most of these behavioral
consequences of dementia can be treated especially if
recognized and addressed early.
About the Author:
Copyright©2004. All rights reserved. Dr. Michael G. Rayel -
author (First Aid to Mental Illness-Finalist, Reader's
Preference Choice Award 2002), psychiatrist, and inventor of
Oikos Game: A Personal Development and Emotional Skills
Game. To receive free newsletter, visit www.drrayel.com. For
more information about Oikos Game, visit http://www.oikosgame.com.
His books are available at major online bookstores.
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