Our brain is like a big room with multiple filing cabinets, a desk with IN and OUT baskets on top, a wastepaper basket on the floor, and doors leading to other storage areas. When we see, hear, touch, smell, taste, or experience something, our brain stores that information to be filed like taking a piece of paper from the IN basket to the OUT basket or wastepaper basket to handle appropriately.
Short-term information like a phone number or a list of about 7 items are retained as short-term, often only lasting about 5 minutes or so in the brain, just like a note written to remind us of actions or to-do lists are usually discarded in the wastepaper basket when completed. All other data is stored as long-term often for a lifetime. Eventually, the filing cabinets contain our memories, stored by connections and cross-connections from one cabinet to another. Just like at home or at the office, as we need to move data to different areas for storage, our brain does the same thing and as studies show, stores memories in muscles and organs.
We have two basic types of storage: long-term and short-term. Information retention is based on how your brain works with storage. Most of us can remember things for a time, even into adulthood as memories. Some people have exceptional memories, including the ability to have phenomenal recall. Others have less ability to remember items to the extent that they can’t recall a series of numbers or items after some time has elapsed.
As we sleep, our brain takes the information from our OUT basket and stores it in a series of file drawers. These drawers are in a specific location in the brain and throughout the body in muscles and organs. These memories are stored with triggers so that they can be retrieved later. Our senses are a part of that triggering process.
Think of a discussion with new friends and one of them is named the same as your childhood best friend. You may be inclined to remember your old friend and compare her to the new one by using stored memories of your childhood. During that discussion, someone recalls a place they have visited, and you are flooded with memories of the same place. Your conversation mixes your memories with theirs.
Have you ever walked past a scent, and it immediately causes images of memories, good or bad, that smell? That is the process of our brain working with those IN and OUT boxes and the file drawers stored with all our memories. Aging does impact our memory recall somewhat, but usually, the memory will return, especially with internal or external prompts.
Smells, sounds, sights, and experiences are strong triggers, but as you age, some of those triggers are no longer connected to the memory and your brain takes a different path to find it. You may think you should know that face you are looking at but can’t quite put a name to it. Eventually, the name and face connect, and you remember. Your brain found the right filing cabinet.
However, dementia destroys the connections used by the brain and we slowly lose that functionality. Usually, short-term memory loss is first observed. We all forget from time to time, however, the memory returns with help or time. Misplacing keys is common, but we may find them in the most obvious place like in a coat pocket or on the dresser instead of their usual place. However, placing the keys in an inappropriate like in the refrigerator or hanging them on a hanger in the closet may be a sign of early dementia.
As the disease progresses, long-term memory is eventually impacted. They may find their keys hanging in the closet but don’t have a memory of putting them there or can’t understand why they are here in the first place or don’t recognize it is the wrong place for the keys to be. A person living with dementia loses those connections and if the brain can’t make that connection differently, those memories are lost forever.
Not only are the senses impacted, but language, logic, motor functionality, eating, dressing, and basic living skills also diminish. The connection in the brain that either got you to the memory or knowledge before, or to where the memory was stored is broken because that part of the brain is no longer working, and the connection no longer exists. There’s a void in the brain just like the filing cabinet that just disappeared.
Dementia causes atrophy (shrinkage) in the brain because of different factors. The final diagnosis is that dementia steals the brain. X-rays show voids in the brain as structures atrophy and disappear. Although the brain continues to make connections as we age, dementia causes irreparable damage to the process and the building blocks of connections, and the brain is no longer able to create those connections.
Another thing that dementia disrupts is the almost rote activities of daily life, like shaving and brushing your teeth each day. Putting clothes into the drawer in the same place is also part of the rote activity. We perform tasks repetitively and use repetition to keep everything in order and remember.
In a brain even with slight dementia can loses that practiced habit. You may know that the keys are used to start the car, but do not remember to place them in your purse or on the table. When you look for those keys, you find them in the refrigerator or in the pantry because you were putting away the groceries when you came home. At that moment, placing the keys with the groceries became part of that chore rather than the habit of placing the keys in the correct place.
When you wake up, you may remember that yesterday you made plans to meet a friend for dinner. Later that day you forget until she calls to confirm. Once reminded, you recalled the previously made plans. In a brain with dementia, memory is not even part of your knowledge base. You may not even remember you talked with your friend the day before.
A dementia brain may not be able to move short-term memory to long-term storage. There was no place to go, and the memory disappears from the dementia patient’s realm. Forgetting you talked with your friend earlier to make plans for lunch tomorrow may be a sign of early dementia, especially if you still can’t remember if given clues to trigger your memory. Not knowing your friend when she calls is a sign of advanced dementia. The part of the brain where that memory was stored may no longer function with, be connected to, or physically be in the rest of the brain.
Progress is often very slow, and changes may be hard to recognize, especially when the person has often contact with family and friends. Early warning signs include forgetting common words like “bird” “table” or “house.” Losing skills that were “second nature” is often an early sign of dementia like daily hygiene (brushing teeth or face washing), dressing, or feeding themselves.
Gradual changes in personality, traits, or actions are often the first signs of dementia. The most common signs are the inability of completing complex tasks like paying bills or driving to places visited regularly. Changes in judgment, multitasking, or spatial abilities are also indications of potential dementia.
The stigma attached to having dementia is not as common now as it was fifty years ago. Dementia is no longer a home-based disease. Those living with dementia are more apt to still be social, participate in home activities, and with help, function longer than before. But unfortunately, family members have a hard time recognizing and accepting the decline and often don’t seek medical help until it is too late to be effective in slowing the disease.
However, today more people are aware of dementia, more accepting of the disease, and more interested in learning more about dementia. Many people know of someone living with dementia. Studies show that 25% of those over 85 suffer from dementia. Dementia is the sixth leading cause of death in the elderly.
Researchers, scientists, and medical professionals are searching for better knowledge and understanding of this disease. There are public awareness programs to educate all levels of the populace. Although dementia usually physically affects those over 65, eventually, all family members suffer from the effects of dementia. Until we find a cure or can stop its rampage, learning all we can and understanding its symptoms will be our defense for now.