The increase in life expectancy is leading to an aging population and, with it, to an increase in the incidence of age-related neurodegenerative diseases. This category would include dementias, understood as a syndrome caused by a brain disease, generally chronic or progressive in nature, which leads to the alteration of higher cortical functions (memory, thought, orientation, comprehension, calculation, learning, and judgment), emotional and behavioral functions (Jurado, Mataró, & Pueyo, 2013).
Dementia in Neurodegenerative Processes
When talking about dementia, probably the first word that comes to mind is “memory” and, certainly, memory loss is one of the most prominent symptoms in neurodegenerative processes. Emotion is intimately linked with memory. This relationship is not exclusively supported by our own sensations and introspections, but rather they functionally act in parallel and anatomically are processes that take place very close to each other.
What is the Limbic System?
Eric Jensen said: “The limbic system, that primitive part of the brain that can neither read nor write, provides us with the feeling of what is real, true, and important.” This system is composed of a set of structures whose function is related to emotional responses, learning, and memory. Our personality, our memories, and ultimately the fact of being who we are, largely depend on the limbic system. The components of this system are the amygdala, hypothalamus, pituitary gland, hippocampus, septum, and cingulate gyrus.
If, in addition, we add that it is also responsible for visceral responses of fight, anger, flight, sexual responses, feelings, etc., it is to be expected that when there is a dysfunction in this system or its adjacent neural networks, the experience for the person suffering from it will be, at the very least, disconcerting, and that is what happens to someone suffering from cortical dementia (though not exclusively), such as Alzheimer’s or frontotemporal dementias.
While it is often tedious for family members and/or caregivers to deal with some of the behaviors of people suffering from these diseases, it is important to remember that behind these behaviors, there is a brain dysfunction. Prototypical manifestations of alterations related to the malfunction of the limbic system and its brain circuits would occur when they repeat the same questions over and over, wander or follow their family members everywhere, accumulate or hide objects, appear moody, irritated, sometimes aggressive, or express themselves obscenely, have daring or disinhibited behaviors, do not recognize family members or acquaintances, become agitated, nervous or fearful, and appear sad or uninterested in things.
How to Act in the Face of These Dysfunctions?
We must understand that these are behavioral disorders inherent to the disease. Asking about the same topics, repeating words and phrases may mean that the person does what they know how to do, that is, they have partial memories and use them as a reference to speak. They may also tend to accumulate objects that represent part of their biography or with which they identify, in an attempt not to forget who they are.
Reference family members constitute safety signals for them, meaning it brings them peace to be close to people they know, from whom they receive affection, and who help them interpret an now unknown environment, a product of the disorientation that memory loss entails, and that excess irritation, aggression, or emotional lability are closely related to the frustration generated by the limitations of the disease.
Furthermore, neurological involvement also implies that certain personality traits of the patient that were already present throughout their life tend to be exacerbated, as the dysfunction of the cortical areas that inhibit and regulate behavior in healthy individuals do not function properly, physically preventing them from controlling their negative emotions or disinhibited behaviors.