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definitions
Anonymous
Posted: Tuesday, January 17, 2012 5:40 PM
Originally posted by: Zolly

Cognitive Impairment:
The impairment or disorder of thinking skills, that include language use, calculation, perception, memory, awareness, reasoning, judgement, and imagination.

Memory disturbance:
Also addressed as Memoray Impairment. The state in which an individual experiences the inability to remember or recall bits of information. May be attributed to pathophysiological causes.

Dementia:
A progressive, irreversible decline in mental function. Often referred to as Alzheimer's, Huntingtons, and Parkinsons.

Ref: Taber's Cyclopedic Medical Dictionary.
Internal Administrator
Posted: Tuesday, January 17, 2012 5:40 PM
Joined: 1/14/2015
Posts: 40463


Originally posted by: FFwife

what is the difference between cognitive impairment, memory distrubance and dementia?
Anonymous
Posted: Tuesday, January 17, 2012 5:40 PM
Originally posted by: Mimi S.

FF Wife,
Also consider that many doctors have problems telling the truth in terms you want to hear.
Aren't you waiting for more testing? Until then, try to relax and also get some exercise.

Do call the help line 1-800-272-3900 when you become overly concerned.
Anonymous
Posted: Tuesday, January 17, 2012 5:40 PM
Originally posted by: Lisa 428

Dear FFwife & Zolly,

The strange thing about all of this is that I had always thought that people with dementia didn't know that they had it.

I knew something was wrong with me. That's why I thought I couldn't have AD or dementia.

Boy, was I wrong!!!

Another problem with all of this is most people believe that. They believe that people that have dementia's/AD can't know that they have it. Wrong!!!!!!!



Unfortunately, many doctors feel that way too.
Anonymous
Posted: Tuesday, January 17, 2012 5:40 PM
Originally posted by: FFwife

Not one Dr has used the word Dementia or AD with me. All I get is Cognitive Impairment and Memory Disturbance with decreased visual spatial and executive thinking abilities.


Sure sounds like AD to me.
Anonymous
Posted: Tuesday, January 17, 2012 5:40 PM
Originally posted by: Be Strong 2

My wife knew she had it, was there when the doctor pronounced dx. She knew but was in denial, not believing that she really had a problem. We were, however, able to discuss it and talk about the future.

Now she definitely has anosognosia. She firmly believes she is OK, nothing is wrong, and the delusional tales she tells are the absolute truth. If there's a problem it's with everyone else.

So, I guess it's different with each person, and changes over time.

Bob Cool
Anonymous
Posted: Tuesday, January 17, 2012 5:40 PM
Originally posted by: Iris L.

quote:
Originally posted by FFwife:
Not one Dr has used the word Dementia or AD with me. All I get is Cognitive Impairment and Memory Disturbance with decreased visual spatial and executive thinking abilities.


Sure sounds like AD to me.


FFwife , you and I have the same diagnosis. I also have a diagnosis of lupus. 25% or more of lupus patients have cognitive impairment and memory disorders, but they're diagnosed by their rheumatologist and not by a neurologist. My rheulatologist said to me, "Have you seen lupus patients? They can't do ANYTHING!"

It was so common that we all used to laugh and joke about not remembering at my lupus support groups. Nevertheless, if anyone were to come and tell them that they showed signs of dementia, they would all freak out. Doctors couldn't handle a large group of young women in their offices freaking out because they've been told they have dementia.

If is sounds like AD to you, it's because it IS like AD but it doesn't meet all the criteria for AD.

What to do? Treat it and learn as much as you can so you can prepare yourself.

Iris L.
Anonymous
Posted: Tuesday, January 17, 2012 5:40 PM
Originally posted by: FFwife

Mimi,

I don't understand what you mean? They have problems telling the truth we want to hear? Can you explain?

They are now saying that since my PT/OT Tests have all shown significant improvement I may not qualify for the clincal study.

And I am trying to exercise. Today I did a hour on the WII, Yoga and strength training, and made two dozen apple cimmamon muffins using a new reciepe.
Anonymous
Posted: Tuesday, January 17, 2012 5:40 PM
Originally posted by: Mimi S.

Hi FF Wife,
Put yourself in the doctor's shoes. How would you do telling a patient that they had terminal cancer or terminal dementia? It's not easy.
Doctor's being trained these days, I do believe get more help in how to do this.

Now add to the mix, the knowledge that the patient also has a moderate to severe case of depression. Should you tell the person and risk making the patient more depressed? Does the patient have a loved one who will help give love to the patient?

It's not easy to tell the exact truth.

And if your tests are showing improvement: THAT'S SOMETHING TO REJOICE OVER!

Glad you were on the WII. How about getting outside/ he in PA it was a gorgeous fall day.

Wish I were around to help you get rid of some of those muffins.
Anonymous
Posted: Tuesday, January 17, 2012 5:40 PM
Originally posted by: FFwife

So when i asked the Dr(s) if I had AD they said NO. They all want to blame it on depression So what i find myself analyzing everything i do and say.


Deep down there is a voice telling me it isnt depression and that is what fuels the anxiety and depression
Anonymous
Posted: Tuesday, January 17, 2012 5:40 PM
Originally posted by: Iris L.

quote:
Originally posted by FFwife:
made two dozen apple cimmamon muffins using a new reciepe.


FFwife, are you exercising your hand to your mouth? Big Grin Yum! Save a couple for me!

Iris L.
Anonymous
Posted: Tuesday, January 17, 2012 5:40 PM
Originally posted by: Mimi S.

FF Wife,
Do listen to Iris. She has much to offer.

You might want to go back and read her posts addressed to you.
Anonymous
Posted: Tuesday, January 17, 2012 5:40 PM
Originally posted by: FFwife

Iris, I love that you took the time to explain to me all the things the DR couldnt. I do have one question or point of disagreement. When you write "Often the decline in memory has qualities that specifically indicate the dementia syndrome of depression rather than dementia from another cause. Patients with this syndrome are usually extremely distressed by their deficits in intellectual functioning. This is in contrast to the picture usually seen in patients with Alzheimer's disease, who are sometimes unaware of their memory problems in the early stages and often attempt to make light of them or cover them up. Depressed patients, on the other hand, seem to dwell on their memory problems and, like Pearl, see every missed answer as confirmation of their "hopeless" condition.

Most if not all of the folks on this chat are aware of their diagnosis and do not cover it up but acknowledge it and are saddened and depressed by it.

The rest of the report was very helpful. Thanks so talking the time to share.
Anonymous
Posted: Tuesday, January 17, 2012 5:40 PM
Originally posted by: Iris L.

quote:
Originally posted by FFwife:
So when i asked the Dr(s) if I had AD they said NO. They all want to blame it on depression So what i find myself analyzing everything i do and say.


Deep down there is a voice telling me it isnt depression and that is what fuels the anxiety and depression



FFwife, I resisted a diagnosis of depression for my cognitive impairments because I wasn't SAD. You have be sad to be depressed, right? Wrong! (I've seen the best psychiatrists and psychologists that come out of UCLA, UC Irvine, USC, and Natl Institutes of Mental Health at Bethesda, MD.)

Here is what I learned about depression just last month, in fact. It's part of the reason why I was finally able to return to these message boards after a year's absence due to a deep depression.

This is taken from "Depression The Mood Disease" Third Edition A Johns Hopkins Press Health Book by Francis Mark Mondimore, M.D. a psychiatrist and member of the faculty of the Johns Hopkins University School of Medicine. www.press.jhu.edu

from page 108 Variations, Causes, and Connections:

"The collection of symptoms and findings typical of Alzheimer's disease is actually seen in many different conditions. Memory loss, loss of the ability to concentrate, disorientation--for example, not knowing what day it is--these are all symptoms of the psychiatric syndrome known as dementia. The patient with dementia is perfectly alert but experiences a decline in all intellectual functions. Dementia is usually progressive and often irreversible. But not always.

"Dementia can be seen in a number of brain diseases such as Parkinson's disease or repeated strokes; even brain injury from an automobile accident can cause the syndrome. One of the commonest causes of dementia in the elderly is Alzheimer's disease, now thought to be caused by the degeneration of a single brain center.

"As the field of geriatric medicine has developed, it has become clear that many conditions that had often been dismissed as normal concomitants of aging are not normal at all, but instead are due to disease processes. It has also become clear that many of these diseases are treatable, making it all the more important that the physician look for them in evaluating the elderly patient.

"As the field of geriatric psychiatry developed, the term pseudo-dementia of depression came to be used to describe a condition often seen in elderly persons suffering from major depression. It was noted that depressed elderly people often have a decline in intellectual functioning that looks exactly like dementia. In fact, in more and more articles in the professional journals the "pseudo" is being dropped and the memory problems, confusion, and concentration problems are being called simply the dementia syndrome of depression.

"Often the decline in memory has qualities that specifically indicate the dementia syndrome of depression rather than dementia from another cause. Patients with this syndrome are usually extremely distressed by their deficits in intellectual functioning. This is in contrast to the picture usually seen in patients with Alzheimer's disease, who are sometimes unaware of their memory problems in the early stages and often attempt to make light of them or cover them up. Depressed patients, on the other hand, seem to dwell on their memory problems and, like Pearl, see every missed answer as confirmation of their "hopeless" condition.

"ECT seems to be particularly effective in the elderly. It works quickly, and it also has a diagnostic use. If an elderly person shows symptoms of dementia and also of major depression, a single ECT treatment can sometimes sort out the diagnosis. Remember, I said earlier that people with brain injury were especially prone to prolonged confusion following ECT treatments. If someone has Alzheimer's disease, ECT will make the confusion much worse (temporarily); in those with the dementia syndrome of depression, ECT will make it better."

(bolding is mine for emphasis
italics were from the author
Pearl is a patient in the book
ECT is electro-convulsive therapy, or shock treatment for intractable depression)



FFwife, for me, this was my first confirmation in writing that depression could indeed be responsible for my cognitive impairments, memory impairments, and executive function impairments. Why couldn't these jokers, I mean doctors, have said this to me? Perhaps they didn't know. Or perhaps they didn't look at me as "elderly". (Question--what's the definition of elderly? Ten years older than your OWN age!)

I was 37 when I first began to lose my memory. They said it was "adjustment disorder" and I was told to paint my nails and do other feminine activities to counteract the testosterone-overloaded world I had been working in as a medical doctor. This from a woman neurologist. This sounds pretty scientific, doesn't it? Hint to future patients: Nail polish won't help your memory. Try some Exelon or Aricept.

FFwife, I wrote this out so you can see that if your doctors have diagnosed you as depression, that is what you have. Talk with them about dementia or pseudo-dementia of depression. They probably won't know what you're talking about. If you know anyone who can read medical journals, begin searching psychiatric journals yourself if you're really interested. I'm satisfied in my diagnoses and treatments. I see nothing to add for myself except a good therapist or support group to help me deal with all the challenging changes. But drug-wise, I'm good. Perhaps one day I might consider adding Axona or some other nutritional supplement.

In your case, I would recomment CBT--cognitive behavior therapy--to get control of your anxiety and depression. Look for a good anti-depressant that is not too stimulating for you, and after a few months of GOOD anti-depression treatment consider adding some of the memory medications. Discuss all of this with your doctor and your DH. Read The Alzheimer's Action Plan. It's written by a couple of the nation's experts in AD.

The doctors of the Depression book go on to talk about how the treatment of depression must be chronic. FFwife, you may always be somewhat like this. You must come to terms with it. That's where a GOOD COMPETENT therapist can help you. You won't get anywhere if your anxiety and depression remain untreated or only partially treated.

Search around your community for a good anti-depression program. Some hospitals and mental health centers have day programs like they have for dementia patients, but the focus is on depression and anxiety.

Remember, some of this is determined by trial and error and a tincture of time. Give things a chance to work, but you must let them work.

Iris L.
Anonymous
Posted: Tuesday, January 17, 2012 5:40 PM
Originally posted by: Mimi S.

Thanks Iris.
I do know that the Memory Clinic nearest to me does have Cognitive Therapy. Doing the therapy under the watchful eye of a technician, who reports to the doctor, will have the added effect of immediate adjustment to your needs and abilities.
Anonymous
Posted: Tuesday, January 17, 2012 5:40 PM
Originally posted by: Mimi S.

quote:
In your case, I would recomment CBT--cognitive behavior therapy--to get control of your anxiety and depression.

The above is from Iris's writings. Now that I reread it, I'm not sure that it is the same.

I think I'll step back and not confuse you further. Please, listen to Iris.
Anonymous
Posted: Tuesday, January 17, 2012 5:40 PM
Originally posted by: FFwife

MiMi, what do you mean by cognitive therapy? I do PT/OT where we work on deduction puzles, and sequencing and other mind exercises?

OOr are you referring to somthing else?
Anonymous
Posted: Tuesday, January 17, 2012 5:40 PM
Originally posted by: younghope1

quote:
Originally posted by FFwife:
Not one Dr has used the word Dementia or AD with me. All I get is Cognitive Impairment and Memory Disturbance with decreased visual spatial and executive thinking abilities.


Sure sounds like AD to me.


FFwife as you have stated your Doctors HAVE NOT used the word AD with you but instead COgnitive Impairment. That means there is a chance that the cognitive impairment will lead to AD, BUT, NOT ALWAYS. The more stress and worry you cause yourself, the more you are harming yourself mentally. You are your own worst enemy. Step back, take a deep breath and count to 10 slowly.

Tracy
Anonymous
Posted: Tuesday, January 17, 2012 5:40 PM
Originally posted by: Iris L.

quote:
Originally posted by FFwife:
I do have one question or point of disagreement. When you write "Often the decline in memory has qualities that specifically indicate the dementia syndrome of depression rather than dementia from another cause. Patients with this syndrome are usually extremely distressed by their deficits in intellectual functioning. This is in contrast to the picture usually seen in patients with Alzheimer's disease, who are sometimes unaware of their memory problems in the early stages and often attempt to make light of them or cover them up. Depressed patients, on the other hand, seem to dwell on their memory problems and, like Pearl, see every missed answer as confirmation of their "hopeless" condition.

Most if not all of the folks on this chat are aware of their diagnosis and do not cover it up but acknowledge it and are saddened and depressed by it.



FFwife, I did not write the above. The author, a psychiatrist from Johns Hopkins University, wrote it. I think he was making a distinction between the level of anxiety about memory loss in depressives vs AD patients. I wrote it to you so you can bring it up for discussion with your doctors.

As far as CBT goes, it is NOT OT/PT (occupational therapy/physical therapy). Cognitive Behavioral Therapy is a type of interaction between psychiatrist or psychologist or other trained mental health provider and patient. The purpose is to get the patient to realize the irrationality of some of her thoughts, and also how to change her behavior.
Example:
Patient: "I keep losing my keys so I'm afraid I must have Alzheimer's."
CBT Therapist: "There are many reasons why you could keep losing your keys. (cognitive)
Why don't we think of ways to help you keep track of your keys better. You could have only one place for your keys and always keep them there." (behavioral)

CBT requires that the patient has insight into her behavior and thoughts. Playing games and doing puzzles don't require insight. CBT usually lasts for 8-12 weeks and involves dealing with a specific problem. It is not the same as life-long psychoanalysis, or marriage or family counseling.

Iris L.
Anonymous
Posted: Tuesday, January 17, 2012 5:40 PM
Originally posted by: clave

Iris, I don't know if a patient would be willing to subject him/herself to ECT simply to discount true dementia. While supposedly ECT only carries temporary memory loss as the predominant side effect, I do recall reading about how one patient finds the procedure discomforting.
Anonymous
Posted: Tuesday, January 17, 2012 5:40 PM
Originally posted by: Iris L.

I think this disease should be re-named "neurotransmitter deficiency disorder" instead of depression. People can understand a diagnosis of "dementia due to neurotransmitter deficiency disorder". The public don't believe depression is serious enough to cause Alzheimer's-like dementia.

Iris L.
Anonymous
Posted: Tuesday, January 17, 2012 5:40 PM
Originally posted by: Mimi S.

Last night, our local PBS station had an 'Ask the Doctor" hour long episode on Cognitive Behavioral Therapy, so I understand it a bit better.(It might be available for on-line screening, check out WVIA) Two panelists were active in our local Aliz. Chapter, but did not, as promised, spend much time relating the therapy to Alzheimer's.

They did however make great claims for its worth in mild and moderate depression. The use of meds in conjunction with the therapy can increase it's effectiveness.

The therapy is time limited. About 16 weeks should normally be the longest. It is not 'sit and chat' therapy. It is very focused. The participant will have homework to do which will be discussed at the next session. So, I gather the participant must want to improve and be willing to 'walk the walk.'

Iris, is my understanding on track? I may see one of the panelists at an affair tomorrow night and so might be able to talk further with him.
Anonymous
Posted: Tuesday, January 17, 2012 5:40 PM
Originally posted by: Iris L.

Mimi, your understanding IS right on track.

If you read this post in time, ask the psychologist why CBT isn't use more in early stage patients to help them cope with their diagnosis?

What's the status of dementia syndrome of depression? Is this reversible or not? How is the best way to treat it?

Iris L.
Anonymous
Posted: Tuesday, January 17, 2012 5:40 PM
Originally posted by: Iris L.

Clave, by the time the psychiatrist offered ECT, there should be many more signs of intractable depression, persistent vegetative state (not wanting to move or eat), and suicidal ideation or threats. ECT is for extreme cases. It's a way of jump-starting the brain out of the depths of depression. It doesn't cure depression, the patient is not in the deep, deep depression anymore. I've seen it work before.

Iris L.
Anonymous
Posted: Tuesday, January 17, 2012 5:40 PM
Originally posted by: clave

Yes, I recall a psychiatrist making the claim in a documentary on depression that "ECT is still the single, most effective treatment for severe depression." Ironically, there is no specific scientific understanding of why it works, only speculation.
Anonymous
Posted: Tuesday, January 17, 2012 5:40 PM
Originally posted by: Iris L.

That's okay, Mimi. Did you enjoy yourself at the reception? What was the topic? Was any new information introduced?

Iris L.
Anonymous
Posted: Tuesday, January 17, 2012 5:40 PM
Originally posted by: Mimi S.

iris, Sorry but neither of the people of the panel were at the reception.
I think there was an association for that profession. You could try googling.
Anonymous
Posted: Tuesday, January 17, 2012 5:40 PM
Originally posted by: Mimi S.

Actually, it was a reception to introduce PA new CEO to the area community.