Abstract
Senile dementia, Alzheimer dementia and Parkinson’s dementia are all forms of progressive mental illnesses. Therefore, they contain similar cognitive issues. Among the main one is mental capability. Learning and availability of lewy bodies in the brain are also other cognitive issues. The three cognitive aspects differ in the three diseases. This has affected the work of physical therapy assistants, and how they offer treatment. Physical therapists are now forced to learn extensively in the new aspects in their fields of interest.
Key words; dementia, senile, Alzheimer’s, Parkinson's, cognitive, physical therapists, mental
Introduction
There are quite a number of dementias that have been identified to date. Although they may have some similarity, they also have a particular characteristic that can e used to identify each type. In all types of dementias, there exist cognitive problems that include mental and learning problems. In some instances, the problems are minimal than in others. However, all these types of dementia are progressive, getting worse as they mature in the body.
The cognitive issues that surround Alzheimer, Parkinson’s and Senile dementias are mostly on learning, memory and forgetfulness. These are caused by a variety of factors. They affect the way therapy is carried out. This affects the way physical therapists treat the patients. This is because every patient has a variety of needs. This essay will analyze the cognitive issues in patients with Parkinson’s, Alzheimer and senile dementias. An analysis will be made on how these relate to physical therapy and the treatment offered.
Dementia with Lewy Bodies
Dementia with a lewy body is one that is a progressive degenerative syndrome of the brain (Bernard, Bruno, Francois and Yves, 1986). People with Alzheimer’s and Parkinson's disease have a higher susceptibility to this syndrome. The symptoms in the two dementias are also quite similar. However, in patients with senile dementia, the availability of lewy bodies implies something different.
Patients who have developed dementia with a lewy body end up having behavioural and memory problems. These problems are similar to those having Alzheimer and Parkinson’s disease (Harry, Nori and James, 2001). This is especially so when it comes to the retrieval of memory. In both cases, the patient experiences difficulties in retrieving information. This can be information as simple as the name or location.
The difference comes in the coordination of the mental and physical systems. In patients with Parkinson’s disease, the ability to coordinate the two systems keeps fluctuating over time. The patient is mostly incapable of such coordination. In patients with Alzheimer’s, the coordination degenerates progressively. In patients suffering from senile dementia, the mental capabilities also deteriorate progressively (Harry, Nori and James, 2001).
Depression and Dementias
In Parkinson’s, Alzheimer and senile dementia, there is a level of depression involved. Patients experiencing the above types of dementias are affected by a certain level of depression (Bernard, Bruno, Alaine and Yves, 1991). The characteristics of depression in the three dementias are almost similar. All the patients tend to want to keep to themselves while avoiding any form of social contact. In some instances, they even become violent.
The difference in dementia is quite evident in Parkinson’s disease. As Padraig, O'Suilleabhain, Victor, Carlos, Laura, Richard, Teodoro and Ramon, (2006) insist, progression of depression in Parkinson's disease varies from one individual to the other. They did a research on this fact, and it revealed that; patients with hyperhomocysteinemia are likely to be depressed and to perform worse mentally. On the other hand, normohomocysteinemic patients perform a little better mentally, and are less likely to develop depression at early stages of the disease.
For patients suffering from Alzheimer, depression is dependent on the stage of the disease. At early stages of the disease, depression is altogether absent in the patient (Padraig, O'Suilleabhain, Victor, Carlos, Laura, Richard, Teodoro and Ramon, 2006). This according to the authors is yet to be explained by the vast researches being conducted. For patients suffering from senile dementia, depression develops at an early stage. This depression eventually leads a patient to be incapable of performing any normal basic functions. This is especially true in patients with an elevated plasma hyperhomocysteinemia.
Homocysteine plays a leading role in patients with Alzheimer’s (Padraig et al, 2006). This is an amino acid that is involved in several metabolic pathways. It is linked to most diseases that affect the neurones connected directly to the brain. At elevated levels, homocysteine causes neurone loss (Padraig et al, 2006). As such, all the information being transported to the brain is minimized causing a memory loss and depression. Therefore, it should only occur at optimal levels.
Learning and Dementia
In Parkinson’s, Alzheimer’s and Senile dementias, the cognitive capabilities are interfered with. The process of learning is interfered with due to the loss of neurones transferring information to the brain (Bernard, Bruno, Alaine and Yves, 1991). Depression is also another factor that affects the process of learning. Research conducted through the years reveals that learning is affected differently in the three types of dementia.
If Alzheimer and Parkinson’s diseases are identified at an earlier stage, it is easy to teach the patient how to perform some functions. However, most of these diseases are identified at an advanced stage when most of the necessary neurones have been lost. As such, the process of learning becomes quite difficult if not impossible. If the two diseases can be identified at an early stage, it is easier for the patient to undergo therapy that involves learning concepts. Sometimes, senile dementia occurs sporadically. In such an instance, the patient may lose all their cognitive capabilities making learning impossible. However, if the occurrence is a slow progressive one, then the patient is capable of relearning old concepts. They can also learn new concepts. This study is still being conducted. Researchers are trying to identify a simpler way of making patients learn and remember a few basic concepts.
How the Characteristics Relates To Physical Therapy Assistants and How the Patient Is Treated
The differences in symptomatic characteristics call for a deeper understanding by physical therapy assistants (Linda and Robert, 2001). The work of a physical therapist makes it mandatory for them to have extensive knowledge on available treatments, and how these treatments are offered. It is also paramount for them to have knowledge on the current trends on the various forms of dementia. Patients will always be unique in their needs. This is why alternative treatments are required. However, it is the work of the therapist to identify activities for specific patients.
Through the years, the symptoms of dementia have undergone an all round transformation (Harry, Nori and James, 2001). As such, the physical therapy assistants have had to undergo extensive training on the new symptoms and how to deal with them. The aim of most of these treatments is to improve memory. Lot of training and extensive studying is involved for the therapy assistants. This is especially so considering that the patient remains fully dependent on the therapist during the sessions.
For a physical therapist, ever patient remains a challenge (Harry, Nori and James, 2001). This is because patients are not similar. Treatments work differently for various patients. Initially, it was the therapist who would come up with a treatment plan for a patient. However, owing to the dynamism currently experienced in this field, a therapist is now required to discuss the various forms of treatment with the closest family members before instituting it. This is also what happens in patients who are not responding well to other forms of therapy. At the same time, technology has allowed these diseases to be identified at early stages making the process of treatment easier in some cases (Linda and Robert, 2001).
Conclusion
Parkinson’s, Alzheimer’s and Senile dementias have several similar cognitive issues. For instance; patients suffering from the three types of dementias experience depression. This may occur at different stages of the disease, and be of varied strength. Patients with Senile dementia are more likely to be affected by depression than the rest of the two. When it comes to learning, patients with senile dementia may experience a lot of difficulty. Also, this is dependent on the stage at which the disease is diagnosed at. If any of the dementias is recognized at an early stage, then the process of teaching and learning is a little simplified. The symptoms of the various forms of dementia are dynamic. They keep changing over time and this affects how physical therapy is offered. For instance; physical therapy assistants are supposed to know how to offer therapy to patients. As such, they have to be updated on the current on goings in their field of interest. They also need to know the new types of treatments available. This requires constant training and studying. They also have to keep informing the relatives on the methods of therapy that are available. As a result, learning becomes a part of their daily routine.
References
Bernard, P., Bruno, D., Alaine, P., and Yves, A. (1991). Severity and specificity of cognitive impairment in Alzheimer’s, Huntington’s and Parkinson’s diseases and progressive supranuclear palsy. Neurology. 41(5), 634-643.
Bernard, P., Bruno, D., Francois, L., and Yves, A.(1986). Heterogeneity of cognitive impairment in supranuclear palsy, Parkinson’s disease and Alzheimer’s disease. Neurology. 36(9), 1179.
Harry, C., Nori, G., and James, W. (2001). Dementia: Alzheimer’s and other dementias at your finger tips. New York: Class Publishing.
Linda, C., and Robert, W. (2001). Cognitive rehabilitation in dementia: a special issue of neuropsychological rehabilitation. Chicago: Psychology Press.
Padraig E. O'Suilleabhain, M., Victor, S., Carlos, H., Laura, L., Richard B, D., Teodoro B., and Ramon D. (2006). Elevated plasma homocysteine levels in patients with Parkinson’s disease. Motor, affective and cognitive associations. Neurology. 61(6), 865-868.
