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Memory, Dementia and Occupational Therapy


What is memory?

Memory is the ability of the brain to store, retain, and recall information and experiences. It is a fundamental cognitive process that allows us to learn new things, remember events and experiences from the past, and use this information to make decisions and solve problems.



There are several different types of memory, including:

Sensory memory: This is a brief (a fraction of a second) memory of sensory information, such as what we see, hear, or touch.

Short-term memory: Also known as working memory, this is the memory that we use to hold and manipulate information in the short term. It has a limited capacity and duration and is usually used to store information we currently use or process.

Long-term memory stores information over a more extended period, potentially for a lifetime. It is divided into two main categories: declarative memory (explicit memory), which stores information that we can consciously recall and describe, such as facts and events, and non-declarative memory (implicit memory), which stores information that influences our behaviour and habits, such as skills and procedures.



Approximately 597,000 people in Canada living with dementia in 2020. And an estimated 955,900 people are projected to live with dementia in 2030. - Alzhimer Society

Memory is an essential part of our lives and allows us to learn, adapt, and navigate the world around us. It is also a complex and multifaceted process that needs to be fully understood, and researchers are still studying how memory works and how it can be improved.


What happens to memory as people get older?

As people get older, they may experience some changes in their memory. These normal changes do not necessarily mean someone has a specific memory disorder. Some common changes that may occur include:


  1. Slowing of retrieval: It may take longer to recall information from memory, and people may have to think harder to retrieve information.

  2. Decreased memory for new information: It may be harder to learn and remember new information, especially if it is presented in a way that could be more meaningful and relevant.

  3. Increased difficulty with mental tasks: It may be harder to perform mental tasks that require a lot of processing or manipulation of information, such as solving complex math problems or learning a new language.

  4. Changes in the ability to multitask: It may be harder to multitask or switch between different tasks quickly.

  5. Some specific age-related changes may occur in some regions of memory. For example, semantic memory (memory for general knowledge and concepts) tends to decline with age. In contrast, episodic memory (memory for specific events and experiences) may be more affected by other factors, such as stress or health issues.

It is important to note that these changes in memory are not inevitable, and there are many things that people can do to help maintain their cognitive function as they age. These may include engaging in mentally stimulating activities, regular exercise, eating a healthy diet, and getting enough sleep.


What are cognitive impairment and dementia?


Cognitive impairment refers to a decline in cognitive function, the mental processes involved in acquiring and using knowledge, such as thinking, learning, and memory. Cognitive impairment can range from mild to severe and affect a person's ability to perform everyday tasks and activities.


Dementia is a term used to describe a decline in cognitive function that is severe enough to interfere with a person's daily life and activities. Dementia can affect memory, language, problem-solving, and other cognitive skills. Dementia is not a specific disease but rather a term used to describe a group of symptoms that may be caused by a variety of conditions, including:


  1. Alzheimer's disease (more information below) is the most common cause of dementia, accounting for 60-80% of cases. It is a progressive disease that affects brain cells, leading to a decline in cognitive function and, eventually, the inability to carry out everyday activities.

  2. Vascular dementia is the second most common cause of dementia and is caused by reduced blood flow to the brain, often due to a series of small strokes.

  3. Lewy body dementia: This type of dementia is caused by abnormal protein deposits in the brain called Lewy bodies. It can cause various symptoms, including cognition, movement, and behaviour changes.


Dementia is a serious and progressive condition that can significantly impact a person's quality of life and ability to function independently. There is no cure for dementia, but there are medications and other treatments that can help manage symptoms and improve quality of life.



56% of Canadians are concerned about being affected by Alzheimer’s disease, and 46% of Canadians admit they would feel ashamed or embarrassed if they had dementia. - Azheimer Society

Alzheimer's Disease


Alzheimer's disease is a progressive neurological disorder that affects brain cells and leads to a decline in cognitive function. It is the most common cause of dementia, accounting for 60-80% of cases.


The main symptoms of Alzheimer's disease are memory loss and a decline in cognitive function. These symptoms typically appear slowly and gradually worsen over time. Other common symptoms may include the following:

  • Difficulty with language and communication

  • Difficulty with problem-solving and decision-making

  • Changes in mood and behaviour

  • Difficulty with coordination and movement

The exact cause of Alzheimer's disease is not fully understood, but it is believed to be related to a combination of genetic, environmental, and lifestyle factors. Age is the most significant risk factor for developing Alzheimer's disease, and the risk increases with age. Other risk factors may include a family history of the disease, head injury, high blood pressure, and unhealthy lifestyle habits such as smoking and poor diet.



There is no cure for Alzheimer's disease, but there are medications and other treatments that can help manage symptoms and improve quality of life. These may include medications to help with memory and cognitive function and non-pharmacological treatments such as cognitive-behavioural therapy and occupational therapy. It is essential to seek medical evaluation and treatment as soon as possible if you or a loved one is experiencing symptoms of Alzheimer's disease.


What are some risks factors for dementia?


There are several risk factors for dementia, including:


  • Age: The risk of developing dementia increases, which is more common in people over 65.

  • Family history: A history of dementia increases the risk, particularly for a parent or sibling with the condition.

  • Head injury: Severe or repeated head injuries, especially those that result in a loss of consciousness, increase the risk of developing dementia later in life.

  • Cardiovascular risk factors: Certain cardiovascular risk factors, such as high blood pressure, high cholesterol, diabetes, and obesity, may increase the risk of developing vascular dementia, the second most common cause of dementia.

  • Smoking and alcohol use: Smoking and heavy alcohol have been linked to an increased risk of dementia.

  • Lack of mental and physical activity: Engaging in mentally and physically stimulating activities may help protect against the development of dementia.

  • Poor diet: A diet high in saturated fats and sugar and low in fruits, vegetables, and whole grains has been linked to an increased risk of developing dementia.


How to prevent cognitive decline and dementia?

While it is not possible to completely prevent cognitive decline or dementia, there are many things that people can do to help maintain their cognitive function as they age. These may include:

  • Engaging in mentally stimulating activities: Engaging in activities that challenge the brain, such as reading, puzzles, or learning a new skill, may help to maintain cognitive function.

  • Getting regular exercise: Regular physical activity has been shown to positively affect cognitive function and reduce the risk of cognitive decline and dementia.

  • Eating a healthy diet: A diet rich in fruits, vegetables, whole grains and low in saturated fat and sugar has been linked to a lower risk of cognitive decline and dementia.

  • Getting enough sleep: Adequate sleep is vital for maintaining overall health and well-being, including cognitive function.



How is dementia diagnosed?


Dementia is usually diagnosed based on a combination of medical and cognitive assessments and a review of the person's medical history and symptoms. No single test can diagnose dementia, and the diagnosis is typically made after a thorough evaluation by a healthcare professional.


The process of diagnosing dementia usually involves the following:


  1. Medical evaluation: A healthcare professional will perform a physical examination and may order laboratory tests and imaging studies, such as a brain scan, to rule out other conditions that could be causing the symptoms.

  2. Cognitive assessment: The healthcare professional may use various cognitive tests to assess the person's memory, language, problem-solving, and other cognitive skills.

  3. Interviews with the person and their family or caregivers: The healthcare professional may ask the person and their family or caregivers about their symptoms, medical history, and daily functioning.

  4. Rule out other conditions: The healthcare professional will consider other conditions that could be causing the symptoms, such as depression, medication side effects, or an underlying medical condition.


Once a diagnosis of dementia is made, the healthcare professional will work with the person and their family to develop a treatment plan that may include medications, therapy, and other support services. It is essential to seek medical evaluation as soon as possible if you or a loved one is experiencing symptoms of dementia, as early diagnosis and treatment can help improve the person's quality of life.



How is dementia treated?


There is no cure for dementia, and the main focus of treatment is on managing the symptoms and improving the person's quality of life. The specific treatment plan will depend on the underlying cause of dementia and the person's individual needs.

Several medications can help improve memory and cognitive function in people with Alzheimer's disease, the most common cause of dementia. These medications are called cholinesterase inhibitors and work by increasing the levels of acetylcholine, which is involved in learning and memory. Non-pharmacological therapies are designed to help manage the person's symptoms and improve their quality of life. They may include cognitive-behavioural therapy, occupational therapy, and physical therapy. Supportive care may include help with daily tasks, such as bathing and dressing, and emotional and social support for the person and their caregivers.


What is the role of occupational therapy and people with dementia?

Occupational therapy is a form of therapy that helps people with physical, mental, or developmental disabilities to lead independent and productive lives. In the context of dementia, occupational therapy can help people with the condition maintain their physical and cognitive skills and continue participating in meaningful activities.


Occupational therapy can help people with dementia to improve their functional skills, such as bathing, dressing, and grooming, and to adapt to changes in their physical or cognitive abilities. Occupational therapy can help people with dementia to find joy and meaning in activities, such as hobbies, and to continue participating in these activities as their abilities change.

Improving safety can help people with dementia stay safe at home by identifying and addressing safety hazards and providing guidance on adapting the home environment to meet their changing needs. Occupational therapy can provide education and support for caregivers of people with dementia, helping them to understand the person's needs and to develop strategies to support their loved one's independence and well-being.

Occupational therapy can be a valuable component of treatment for people with dementia, helping them to maintain their skills, participate in meaningful activities, and stay safe and independent in their daily lives. Occupational therapists typically provide them with specialized training and experience working with people with dementia.



The annual cost of dementia to the Canadian economy and healthcare system is over $10.4 billion - Azheimer Society


How do occupational therapists improve functional skills?

Occupational therapists use various techniques to help people with dementia improve their functional skills, such as bathing, dressing, and grooming. Some specific strategies that an occupational therapist may use to improve functional skills include:

Task analysis involves breaking down a complex task into smaller, more manageable steps and teaching each step individually. This can help people with dementia to better understand the task and to perform it more independently.

Adaptive equipment: Occupational therapists may recommend and provide adaptive equipment, such as dressing aids or bathing aids, to help people with dementia to perform daily tasks more efficiently.


Environmental modifications: The therapist may suggest modifications to the home environment, such as installing grab bars or making items more accessible to help people with dementia to perform tasks more safely and independently.

Sensory integration: Occupational therapists may use sensory integration techniques, such as providing sensory input through touch or movement, to help people with dementia better process and respond to their environment.


Cognitive rehabilitation: Occupational therapists may use cognitive rehabilitation techniques, such as memory strategies and problem-solving activities, to help people with dementia improve their cognitive skills and perform daily tasks.

Occupational therapists are trained to assess the functional skills of people with dementia and to develop customized treatment plans that address their individual needs and goals. The therapist will work closely with the person with dementia and their caregivers to develop strategies that help them maintain their skills and independence.

References

Dementia numbers in Canada. (n.d.). Alzheimer Society of Canada. https://alzheimer.ca/en/about-dementia/what-dementia/dementia-numbers-canada


Public Health Agency of Canada. (n.d.-a). Dementia: Overview - Canada.ca. https://www.canada.ca/en/public-health/services/diseases/dementia.html


What is dementia? (n.d.). Alzheimer Society of Canada. https://alzheimer.ca/en/about-dementia/what-dementia

What Is Dementia? | CDC. (n.d.). https://www.cdc.gov/aging/dementia/index.html

What Is Dementia? Symptoms, Types, and Diagnosis. (n.d.). National Institute on Aging. https://www.nia.nih.gov/health/what-is-dementia