Student’s Name : Khanh Gia Nguyen
Frontotemporal dementia (FTD) is a broad terminology for several rare groups of uncommon brain disarrays that affect the brain’s frontal and temporal. The brain’s frontal is generally linked with language., behavior and personality attacks the limbic system by degenerating the frontal lobes, and the results vary depending on the part of the brain that is most affected. Generally, the common signs and symptoms include oscillating moods akin to bi-polar patients, drastic personality changes, memory loss. As a result, the patient loses the social, moral code and, in others, impaired language capabilities (Olney, 2017). The limbic system or the paleomammalian cortex is located just below the medial part of the temporal lobe. Its functions are connected to learning abilities, flight or flight stimuli, memory, hormone production key in regulating the autonomic nervous system., motivation and reward, hunger and thirst.
Consequently, when FTD affects it, one experiences irregular emotional disruptions such as anger. Usually, FTD is often misclassified while as a psychic problem while it is not. This paper will expound on how frontotemporal dementia affects the limbic system and dementia patients’ response environment.
How dementia affects the limbic system
The hippocampus-The hippocampus is located deep in the brain’s temporal lobe and performs memory and learning. It is prone to damage by various stimuli. It is among the first areas of the brain affected by dementia, leading to a patient’s loss in generating new memories and involving the brain faculty that makes it possible to learn further information. A patient may find a hard time remembering what they did very recently, say if they brushed their teeth in the morning but remember what happened 20 years ago in preschool. The difference is that long-term memories do not rely heavily on the hippocampus compared to short-term memories. The trait above is highlighted in patients who tend to repeat details in conversations they just had.
Amygdala – The Amygdala in the brain steers the fight or flight stimuli in one’s body and is closely associated with the stress and fear emotions; also, it plays a chief role in the memory faculty. In a dementia patient, the amygdala is usually affected much later after the hippocampus. Consequently, the patient is likely to remember specific emotional facets of an event even when they do not remember the outstanding facts about that particular event .hence, the patient’s behavior is driven more by fleeting feelings rather than by logical reasoning (Lorusso & Bosch, 2018).
Limbic cortex- As the damage caused by frontotemporal dementia spreads further across the brain, more areas are affected, including the cortex. The cortex, the outermost brain layer, atrophies, further results in the loss of long-term memories and the brain’s general shrinkage. As the damage spreads to the brain’s left hemisphere, a patient may struggle to find the correct word for something and result in frustration. The impairment is because the left hemisphere is connected to the linguistic memory or one’s language control. Further, damage to the visual cortex, the brain’s largest cortex, creates visual impairment to the patient; thus, the patient finds it hard to recognize familiar faces such as those of the spouse and children. However, since the hearing component is separate from the visual part, the patient may realize the speaker once they hear their voice. Also, simple objects become harder to identify. Notably, the dementia patient may acknowledge someone at an emotional level even when they can not discern them.
Parietal lobe – When the damage spreads to the parietal lobe, the patient may find it hard to discern distances correctly, and using the stairs may prove difficult.
Hypothalamus – Dementia’s effect on the hypothalamus leads to the patient losing weight, oscillating body temperatures at extreme levels. In some severe cases, the patient experiences insomnia due to the disrupted sleep cycles.
How dementia physically affects the brain and alters brain functioning
Intelligence, judgment, and behavioral challenges – A dementia patient’s decision-making capabilities are likely to be imparted since FTD affects most brain faculties involved in memory, comprehension, and processing. However, this does not overtly rule that the patient can still make decisions; the only difference is the quality of those decisions and the train of thought in processing them. Impaired judgment is also commonplace in dementia patients. Usually, the patients fall into the traps of unscrupulous individuals who strip them of their money and valuable possessions. Also, the victims give away money without first critiquing the situation; further, caring for pets becomes exhausting since the patient can barely look after themselves. Due to the affected emotional capabilities, patients may act irrationally and neglect the moral code more out of impulse than will; most response is due to emotions rather than logically thinking through events, the most common emotional response being anger (Reyes, 2017). Consequently, most people find dementia patients tiresome to look after, which and a general nuisance.
Affected language expression – dementia patients find a hard time looking for the appropriate words to say in a conversation, medically known as anomia. This is because the semantic part of the brain is damaged. Consequently, the patients use lesser words than usual which significantly impacts their self-expression. The most conversation gradually morphs into vague phrases. In older people, they end up sounding like children trying to learn a language but louder than usual.
Reward, motivation, and addiction challenges- In dementia patients, processing reward is complex. As a result, motivation is secondary in their interaction .this trait is mainly caused by a parallel condition known as apathy. Compensation involves stimuli of anticipation and processing the reward when it arrives, and reevaluation of the situation for future reference; unfortunately, in dementia, the brain faculties that process these stimuli are affected. Thus, motivation is a foreign concept to the patients. Addiction recovery in dementia patients is an uphill task by all standards; with damage to cognition, memory, and perception, recovery may be difficult for them.
Emotional responses; formation of sensory memories
Dementia patients usually have little to no control over their emotions since severe oscillation from extremely happy to sad to boiling anger in short bursts of time. Consequently, patients live in guilt and fear of the future and the effect of the mood swings on their immediate family or caregivers. The frustration of forgetfulness is usually overwhelming, and the backlash heavy on the people the patients.
Fight or flight; response to anger and fear emotions
With the amygdala damaged, a patient’s emotional headquarters is also damaged because it is here that emotions are processed fear, happiness, sadness, and so on. Dealing with emotions calls for the fight or flight response; when someone is stressed out, the fight response may be lashing out or breaking stuff; the flight response may be bottling up the emotions leading to depression. Patients living with dementia have these capabilities damaged, and as a result, they find it hard to process their feelings, thus the socially inappropriate behavior.
Importance of studying the effects
With the impulsive mannerisms that dementia patients uncontrollably portray, it is paramount that caregivers and close family and friends understand the effects of dementia. This will help them empathize and give more personalized care to the deserving patients and support them in the most loving way possible. Also, being there for the patient will help ease memory loss’s frustration by offering prompts to the bits of memory they remember to get to the eureka moment. Notably, understanding the effects gives a better chance of understanding the optimal therapy and treatment to offer the patients and consequently improve their quality of life two-fold. If a patient makes mistakes, understanding them will be a better response instead of bashing them for crude behavior.
The patient’s response to the world
The primary response of dementia patients includes oscillating mood swings, which may lead to irritability. General memory loss and impaired semantic faculties usually lead to immense frustration. Notably, socially inappropriate behavior fuels guilt and shame, especially in front of familiar faces, family, and friends (Finney & Mendez, 2017). Consequently, the guilt and shames morph into depression and social withdrawal to avoid future scenarios of those mentioned above. Resultantly, one’s self-esteem becomes deflated, and confidence is lost.
Studying dementia is imperative to shedding light on the care routines to give dementia patients the quality of life dictated by human decency. As expounded above, the effects of dementia, such as extreme emotional mood swings and aggression coupled with compulsive tendencies, call for an understanding caregiver and empathy of the highest degree (Craig et al., 2018). With the correct form of treatment and therapy, caregivers can manage the condition logically. The care will assure the dementia patients control of their behavior and a hold on their self-esteem, and boost their confidence levels. The knowledge of the best ways of managing dementia patients aids caregivers avoids blaming the victim. As a result, they stay reassured and reflect on a kinder demeanor which makes emotional changes such as aggression less of a problem.
Craig, C., Hiskey, S., Royan, L., Poz, R., & Spector, A. (2018). Compassion-focused therapy for people with dementia: A feasibility study. International Journal of Geriatric Psychiatry, 33(12), 1727-1735.
Dyer, S. M., Harrison, S. L., Laver, K., Whitehead, C., & Crotty, M. (2018). An overview of systematic reviews of pharmacological and non-pharmacological interventions for the treatment of behavioral and psychological symptoms of dementia. International psychogeriatrics, 30(3), 295-309.
Ebert, A., Huggins, M., Wagner, H., Lightcap, Z., Muir, T., Faulkenberry, M., & Fiske, A. (2020). The Effects of Dementia Knowledge on Dementia Worry, Attitudes, Social Comfort, and Affect. Innovation in Aging, 4(Suppl 1), 286.
Finney, C. M., & Mendez, M. F. (2017). Diogenes syndrome in frontotemporal dementia. American Journal of Alzheimer’s Disease & Other Dementias®, 32(7), 438-443.
Lorusso, L. N., & Bosch, S. J. (2018). Impact of multisensory environments on behavior for people with dementia: a systematic literature review. The Gerontologist, 58(3), e168-e179.
Olney, N. T., Spina, S., & Miller, B. L. (2017). Frontotemporal dementia. Neurologic clinics, 35(2), 339-374.
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