When your LOWD first received their diagnosis, you were probably given some information or at least a brief description as to how the doctor believes they developed dementia. Often the doctor will talk about various parts of the brain BUT if you are like most Careblazers I have spoken to, you likely remember very little of this conversation. That is NORMAL. When you receive the diagnosis it is hard to take in much else. For this reason, I want to spend some time reviewing some basics about the brain and the impact of dementia on it.
If you would rather watch a video on this topic, click here.
If you remember, dementia is NOT a specific disease but rather a group of symptoms that impacts thinking in at least two areas such as attention, memory, language, or executive functioning to the point that it impacts someone’s daily functioning. Because dementia is not a specific disease, there are a lot of reasons someone may end up with these symptoms; however, ALL of these reasons have to do with how well the brain is working.
So Careblazers, in order to understand what happens in the brain for someone to develop dementia, we need to first understand some basic information about the brain. Because the brain is so complex and the way damage or disease can impact the symptoms we see in dementia, we are going to break this down into small pieces.
The brain is broken into two hemispheres, the right and the left. Each hemisphere has 4 lobes: the frontal lobe, the parietal lobe, the temporal lobe, and the occipital lobe. Each of these lobes has some specific functions and each lobe communicates with all of the others. Because the brain is so complex, today we are just going to talk about the lobes of the brain and how each one impacts the symptoms we see in dementia.
Let’s start with the frontal lobe. This part of the brain is located in the front part of the brain. More specifically, it is located behind your forehead. These two lobes are the largest lobes in your brain and have a role in a lot of areas of thinking. The frontal lobe is primarily known for its role in planning, organizing, problem-solving, and decision-making but it also plays a role in attention, memory, controlling behavior, emotions, and language.
You can see why this lobe is so important! So how does this information relate to dementia? As any type of dementia gets worse, it starts to impact all areas of the brain. So just because someone has not been diagnosed with a type of dementia that starts in the frontal lobe, does not mean that their frontal lobe will never be impacted. In dementia, we can often see the signs of frontal lobe damage in the behaviors such as poor decisions, having difficulty planning or organizing an activity, difficulty starting or completing tasks, or difficulty controlling emotions and behaviors. This lobe is also often responsible for many of the “difficult” dementia behaviors we talk about such as aggression and repetitive behaviors. There are some types of dementia that are believed to start in the frontal lobe, such as frontotemporal dementia. In this type of dementia, often the first sign of the disease process is a change in personality or a change in behavior.
The next lobe I would like to talk about is the parietal lobe. The parietal lobes are located directly behind the frontal lobes. This lobe takes in sensory information from all parts of the body and puts it together so we can make sense of it. The parietal lobes contain something known as the primary sensory cortex and it controls sensation or our sense of touch. This is also the area of the brain that tells us that some feels hot or cold and if something is painful. It helps us to put together information so that we can walk around without bumping into anything and so that we can tell which way is up. When this part of the brain is not working well, we see people being unable to locate parts of their body and, in some cases, we see people not able to recognize parts of their body. In dementia this can look like difficulty telling right from left, difficulty reading and writing, difficulty recognizing faces or objects, trouble coordinating movements to put on clothing or tie shoes, and clumsiness.
Next is the temporal lobe. This lobe is located behind the frontal lobes but under the parietal lobe. If the frontal lobe is located behind the forehead, the temporal lobe is located around your ears. The temporal lobe is the area of the brain typically known for memory. This is because the temporal lobe contains something called the hippocampus which is an area of the brain that helps us to create new memories and retain information. The temporal lobe is more than just memory though. It is involved with our ability to recognize and process sounds, understand speech, and produce speech. In dementia the impact of temporal lobe damage can be seen in memory loss. Have you noticed that your LOWD is really good at remembering old memories and not so great at remembering new things? That is because old, particularly old emotional memories, are stored in areas throughout the brain, so if one area of the brain, such as the temporal lobe is impacted, that memory is stored in other areas and can still be remembered. However, the temporal lobe is responsible for creating new memories. New memories are things such as the conversation you had yesterday, a new medical diagnosis, what they had for breakfast, how they slept last night. This information is more difficult to remember when the temporal lobe is not working properly. As I mentioned, the temporal lobe does more than just memory. It is also involved in understanding and producing speech. When your LOWD has difficulty with word finding or appears to have difficulty understanding what you are saying, this could be their temporal lobe.
The last lobe is the occipital lobe. This area is located in the back of your head. Ironically, this part of the brain is located the furthest from your eyes but is responsible for processing what you see! There are also special areas in the lobe that help us understand shapes and colors. In dementia this can lead to changes in how well someone understands things like the size, color, and shape of various objects.
Careblazers, the brain is very complicated. This was not meant to be an in depth review but rather to introduce you to each of the lobes of the brain. In many of my videos you have heard me talk about how dementia behaviors are not something that the person intends to do. Your LOWD is often not doing a behavior intentionally. My hope is that by understanding the brain a little bit more, you can gain a little bit more understanding of how this disease leads to the behaviors you are seeing.