Dementia is a condition that affects the brain in ways that make it harder for a person to think, remember, and communicate. When someone has dementia, their ability to express thoughts can change a lot, especially when they are talking about medical topics or trying to explain how they feel about their health. This happens because dementia damages the parts of the brain that are responsible for language, memory, and understanding. As the disease progresses, these changes can become more noticeable and can make conversations about medical issues especially difficult.
One of the main reasons dementia makes it hard to express thoughts is because it affects the brain’s ability to process and organize information. For example, a person with dementia might know what they want to say, but they may struggle to find the right words or put their thoughts into a clear sentence. This is called aphasia, and it is common in many types of dementia, including Alzheimer’s disease. When someone is asked about their symptoms or medical history, they might give answers that are incomplete, confusing, or off-topic because their brain is having trouble connecting ideas and retrieving words [1].
Dementia also affects memory, which is very important when talking about medical issues. A person might forget details about their health, such as when they last took their medication or what symptoms they have been experiencing. They might repeat questions or stories, not realizing they have already said them. This can make it hard for doctors and caregivers to get accurate information, which is needed to make the right decisions about treatment and care [1].
Another challenge is that dementia can change a person’s ability to understand what others are saying. Even if they can speak, they might not fully understand medical terms or instructions. For example, a doctor might explain a new medication, but the person with dementia might not remember the instructions or might misunderstand what the medication is for. This can lead to confusion and frustration for both the person with dementia and the people trying to help them [1].
Emotions and behavior can also be affected by dementia, which can make it harder to express thoughts in a calm and clear way. Some people with dementia become anxious, agitated, or withdrawn, especially when they are in unfamiliar situations or when they are asked about things they do not understand. This can make it difficult for them to communicate their needs or concerns, and they might avoid talking about medical issues altogether [1].
Recent research has shown that the changes in the brain that cause dementia are not just about memory loss. Scientists have found that free radicals, which are harmful molecules produced in brain cells called astrocytes, can contribute to the development of dementia and make symptoms worse [1]. These free radicals can damage brain cells and lead to inflammation, which affects how the brain works and how a person thinks and communicates. When the brain is inflamed, it can be even harder for someone with dementia to express their thoughts clearly, especially about complex topics like their health [1].
Another important discovery is that a brain protein called OTULIN plays a role in controlling the expression of tau, a protein that forms toxic tangles in Alzheimer’s disease [2]. When OTULIN is not working properly, it can cause changes in gene expression and RNA metabolism, which can affect how brain cells function and communicate. This can lead to more severe symptoms of dementia, including problems with language and thought expression [2].
Dementia is also linked to other conditions that can affect communication, such as delirium. Delirium is a sudden change in mental state that can cause confusion, disorientation, and difficulty speaking or understanding language. People with dementia are more likely to develop delirium, especially when they are sick or stressed. This can make it even harder for them to express their thoughts about medical issues, and it can lead to misunderstandings and mistakes in care [3].
Scientists have also found that certain proteins, such as interleukin-6 and C-reactive protein, are increased in both delirium and dementia. These proteins are involved in inflammation and can affect how the brain works. When the brain is inflamed, it can be harder for a person to think clearly and express their thoughts, especially about medical topics [3].
Despite these challenges, there are ways to help people with dementia communicate better. For example, researchers have discovered that increasing the expression of a protein called Sox9 can help astrocytes, which are supportive brain cells, to clear away harmful amyloid plaques that are associated with Alzheimer’s disease [4]. This could potentially slow down the progression of dementia and help preserve the ability to express thoughts for longer.
It is also important to recognize that both genetic and lifestyle factors can influence how dementia affects a person’s ability to communicate. Some people may be more resilient to the effects of dementia because of their genes or because they have healthy habits, such as staying physically and mentally active. These factors can help protect the brain and make it easier for a person to express their thoughts, even as dementia progresses [7].
In summary, dementia affects the brain in many ways that make it harder for a person to express their thoughts, especially when talking about medical issues. Damage to brain cells, changes in gene expression, inflammation, and other factors all play a role in these communication difficulties. Understanding these changes can help doctors, caregivers, and family members support people with dementia and help them communicate their needs and concerns more effectively.
[1] Weill Cornell Medicine, Nature Metabolism, ScienceDaily
[2] Genomic Psychiatry
[3] News-Medical.net
[4] ScitechDaily
[7] NIH, PMC
