A sign of something serious
Many people who find that their memories are beginning to let them down worry that they are developing a serious disease of the brain. They may harbour the suspicion that they are becoming senile or are developing Alzheimer’s disease. Indeed, for some people, this is the worst aspect of a failing memory. The inconvenience and embarrassment that result from a poor memory may worry them far less than the fear that their increasing memory lapses are a symptom of senility or dementia. They feel that they could cope with their memory problems as long as they knew that they were not going to become demented.
In the first part of this booklet, we described the normal changes in memory capacity that happen as we get older. We tried to be reassuring and point out that an increasing number of memory lapses are simply something you have to learn to live with. But sometimes changes in mental function are a sign that something more serious than simple ageing is happening to the brain, and in the next few pages we discuss the sort of things that you or the person you are worried about should take along to your doctor.
CASE HISTORY: DEMENTIA
Ralph Emerson retired from his job at the town hall a few months before his 65th birthday. At first, he and his wife, Lydia, had been busy doing all the things they had always promised themselves that they would do when they had time. Ralph redecorated the house and Lydia made new curtains. They kept fit by going swimming twice each week and took up new hobbies. Lydia discovered that she had a talent for painting in water colours and Ralph taught himself to make frames for her pictures. They went off on holiday to places that they had always wanted to visit and, one winter, they went to visit their eldest daughter and her family in Australia. For a few years Lydia thought that she had never known Ralph so happy. Gradually, however, she became aware that he wasn’t quite his usual self.
Since retirement, it had become Ralph’s habit to do the weekly shopping. Lydia had been delighted to have someone take over a chore that she had never much liked. Ralph rather enjoyed it, taking a pride in getting the best value for money and showing off his bargains with schoolboy pleasure to his wife when he returned. But, over the past months, he seemed to have become a spendthrift.
On several occasions he had come home with too many vegetables and expensive cuts of meat that were too big for the two of them to eat. Once he had bought tins of pet food – and they didn’t even have a cat or dog. Ralph also began to forget things although Lydia had given him a shopping list.
Lydia decided that she needed to go to the supermarket with him. They did their shopping and queued up at the checkout. When it was time to pay, Ralph got out his wallet. But he looked unsure what to do next. Lydia was horrified to see that Ralph couldn’t work out how much money to give the woman at the till. She had to take over and count out the notes herself.
Ralph began to change in other ways too. He had always been a good-natured man even when he had been under pressure at work, but now, it seemed to Lydia, he was often moody and bad tempered.
Little things seemed to upset him and he reacted to minor irritations with uncharacteristic outbursts of bad language. Some of their friends commented on the change in Ralph’s personality too, so she knew it wasn’t just her imagination.
As time went on, Lydia got more and more worried about her husband. Tasks that he had previously accomplished without difficulty were now beyond him, and he no longer had the ability to concentrate on anything for any length of time.
When he tried to make a frame for a picture that Lydia had painted, it turned out the wrong size. And absurdly he blamed Lydia for using too large a piece of paper rather than himself for not measuring accurately.
Lydia also noticed that he had completely run out of energy and drive. He no longer suggested going on outings to do the sort of things that they had so enjoyed together in the past. Indeed, he didn’t really like leaving the house, and Lydia suspected that he became frightened and bewildered as soon as he was any distance from home. Several times neighbours had found him apparently lost in a nearby street and had to lead him home.
Even at home he showed little interest in what was going on. He appeared to read the newspaper over breakfast as he had always done, but she noticed that later in the day he had no recollection of any of the headlines. When old friends came to visit, he took little part in the conversation. Sometimes, in fact, he didn’t even seem to know who they were.
Ralph’s dementia began at an unusually young age – it is rare in people under the age of 70. But his decline illustrates many of the changes in personality and mental function that are common in the early stages of this disease. It also shows the striking difference between the very common memory lapses that come with ageing and the devastating impact of dementia.
Memory lapses are embarrassing and a nuisance, but the individual’s personality and ability to solve the problems of everyday life remain the same. Dementia is quite different. Ralph’s symptoms have been brought about by disease, which causes a deterioration in almost every aspect of brain function.
