Dementia Case Study: Cluster A

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Laura’s grandfather has begun having memory problems. First, he would constantly forget where he placed his keys or his wallet. Then he would have trouble remembering to pay the bills or cooking dinner. One day, Laura took him shopping, and in the middle of the trip, while they were both using the restroom, Laura’s grandpa left. Laura spent many hours searching for him in the shopping area, but to no avail, she could not find him. When she returned home, she found him sitting on the couch, and when she asked why he left her, he could not remember ever leaving the house for the shopping trip. As the days continued, the problems only accumulated, and communication became difficult as he failed to form words and coherent sentences. He could no longer understand jokes or abstract ideas. His reasoning skills declined, and soon he could not longer function. Laura’s grandfather is suffering from dementia, a neurocognitive disorder as classified by the DSM-5. It is one of the most common disorders found among the elderly population. Dementia is characterized by a gradual memory loss and a deterioration of cognitive functions such as reasoning and language skills. In addition to the cognition impairment and the loss of memory, personality traits and emotional responsiveness are also affected. Today dementia has become more of a prevalent problem in both developed and developing countries. Alzheimer’s Disease is the leading cause of dementia in more than 60% of the developed countries (Abe et al., 2015). Vascular dementia and dementia with Lewy Bodies follow in their prevalence rate (Abe et al., 2015). Dementia can first be described through neuropsychiatric symptoms. These symptoms include disturbances in behavior and mood (Porsteinsson & Antonsdottir, 2015). They may lead the patient to feel agitated, anxious, apathetic, and depressed. They affect levels of aggression and sleep disturbance. At times, they may lead the patient to a state of psychosis (Porsteinsson & Antonsdottir, 2015). Most patients in any stage whether early or later on exhibit at some point these neuropsychiatric symptoms. However, recently, much debate has risen over the controversy whether these neuropsychiatric symptoms are predictors of a progression of dementia or if they are biological or psychological consequences of the disorder. Scientists have been questioning if either interaction is present between the symptoms and the disorder. The Cache County Dementia Progression Study explores this puzzling question (Peters et al., 2014). Through a longitudinal study of patients with mild and severe Alzheimer’s disease, they found that the presence of neuropsychiatric symptoms was indeed a predictor of the development of dementia or a deterioration of it leading to death. Specifically, psychotic symptoms and aggression were better indicators of progression to a severe stage of dementia and potentially death (Peters et al., 2014). On the other hand, more mild neuropsychiatric symptoms such as depression and irritability were predictors of only an early death (Peters et al., 2014). While the neuropsychiatric symptoms may serve as signs of the progression of the disorder, abnormal premorbid personality traits also have an effect on how those symptoms are expressed in patients with dementia (Prior et al., 2016). …show more content…
If the patient already suffers from a personality disorder, the onset of dementia will serve to enhance or diminish the disorder. Patients in Cluster A have solitary/paranoid personality disorder. These patients tend to have an overwhelming tendency to be improperly suspicious of others. The personality traits of Cluster A were significantly associated with dementia’s symptoms of hallucinations, delusions, anxiety, and depression (Prior et al., 2016). Patients in Cluster C have avoidant/dependent personality disorder. In social situations, they face intense social discomfort and an irrational fear of negative evaluation. These patients also show a high level of timidity towards others and social situations. The Cluster C personality traits were more likely to be associated depression in those who also suffered from dementia (Prior et al., 2016). Overall, the abnormal premorbid personality traits particularly affected the expression of depression and other psychological symptoms in dementia. Dementia or neurocognitive disorder cannot be singularly diagnosed as one disorder, instead often times, it manifests itself in many forms. One subtype is vascular dementia or vascular neurocognitive disorder. Small vessel disease is the cause of subcortical ischemic vascular

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