Seven A’s of dementia

Dementia is a word that describes a variety of brain disorders.

Symptoms of these disorders include memory loss, confusion, difficulty speaking and understanding, and changes in mood and behavior. These symptoms may affect how a person can manage at work, in social relationships and in day-to-day activities. Sometimes symptoms of dementia can be caused by conditions that may be treatable, such as depression, thyroid disease, infections or drug interactions. If the symptoms are not treatable and progress over time, they may be due to damage to the nerve cells in the brain.

Seven A’s of dementia

One way of understanding how dementia affects the brain is to look at the seven A’s of dementia. Each A represents damage to a particular part of the brain. Please keep in mind that someone with dementia may not experience all of the A’s.

Anosognosia means that you can no longer realize there is something wrong. You might not understand why you have a memory problem or that you have a memory problem at all. You are in denial. But because the part of your brain that helps you reason is damaged, you do not realize that there is a problem.

Agnosia means you can no longer recognize things through your senses: sight, sound, taste, touch, and smell. You might not be able to sort out what you see or hear. You might have trouble recognizing familiar people. Your safety may be at risk if this part of the brain is affected because you might confuse objects and what they are used for.

Aphasia means you lose the ability to use language. This includes the ability to speak, understand, read and write. Although the ability to speak stays for some time after Alzheimer’s disease begins, the ability to understand what other people are saying may be affected earlier in the disease. If you cannot understand something, this can lead to misunderstandings between you and those around you. You might find yourself withdrawing from social interactions because you are worried that you will not understand others or that they may not understand you.

Apraxia means you have lost the ability to tell your body how to carry out purposeful movement. As well, if you have apraxia, you may also have trouble understanding terms such as back, front, up, down. When this happens, it becomes difficult to do things such as tying shoelaces, doing up buttons and zippers, and any activity involving co-ordination. The ability to move your body according to a certain pattern, such as coordinating hand and leg movement, also affects your ability to do specific activities such as driving.

Altered perception happens when you misinterpret the information your senses are giving you. For some people, this is a bigger problem in the late afternoon or early evening when light changes. Another important change is the loss of depth perception—the ability to see in three dimensions. It becomes harder to judge how high, deep, long, wide, near or far things are. For example, if the floor and furniture are the same colour, it may be difficult to judge when one is close enough to a chair to try to sit.

Amnesia means loss of memory. This is an important loss because everything we do depends on our ability to remember. At the beginning, short-term memory will be lost. Eventually long-term memory will go as well. A person with short-term memory problems loses the ability to remember what was just said. This explains why you might find yourself asking questions over and over again.

Apathy is not having drive or initiative. The part of the brain that helps you start to do something, either to carry out an activity or to communicate, is damaged. You might find that you have difficulty beginning activities. You may need someone else to give you cues (hints) to keep you involved in a conversation or a task.