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"I have Dementia. My eyes do see, my ears do hear. I am still me. So let's be clear. My memory may fade, my walk may slow. I am ME inside, don't let me go."


By the end of this chapter, readers will be able to:

  1. Understand the underlying assumptions and key tenets of atypical cognitive changes across the life span.

  2. Describe the prevalence, etiology, and symptoms of key cognitive conditions including neurodegenerative disorders, and mental health conditions.

  3. Discuss the current pharmacological and nonpharmacological treatment protocols for managing and coping with the symptoms of cognitive conditions.

  4. Describe the importance of understanding, examining, and intervening on the illness experience of individuals with cognitive conditions.

  5. Identify strategies to assist individuals with cognitive conditions to live as independently as possible and in achieving the highest quality of life possible.

Clinical Vignette

Henry Webster is a 65-year-old man who recently lost his wife after 40 years. Overall, Henry is in good physical shape; he likes to keep active by swimming and taking long walks in the park. Lately, however, he has been less motivated to swim or go on walks. He also is less interested in socializing with friends and family. Henry still works full time but does not seem as enthusiastic as he once was in his work as an engineer. Although he hasn't made any significant mistakes at his job, his work performance has deteriorated. Henry's children have noticed subtle differences in him as well, including changes in his personality, energy level, and his mental sharpness. Some of Henry's family and friends think these changes are a passing phase due to the recent loss of his wife; others think this is part of the normal aging process; and yet others think these may be early symptoms of something more serious.

  1. Why do you think Henry is experiencing these changes?

  2. What strategies can you think of to begin to determine what is contributing to these subtle changes in cognition?

As discussed in Chapter 7, the majority of older adults experience healthy cognitive aging across the life span and do not experience significant declines in cognitive abilities that impact day-to-day functioning. However, some older adults will experience changes in their cognition that negatively affect their daily lives. These changes in cognitive functioning are not considered part of the healthy, normal aging process but rather are pathological in nature.

The preceding case vignette highlights the importance of seeking medical attention when one encounters even subtle changes in cognitive and day-to-day functioning, including slight differences in motivation, personality, socialization, and work performance. All too often individuals or family members may attribute these changes to the normal process of aging. However, it is imperative to conduct a thorough evaluation to discern whether these subtle changes are associated with the aging process or are early symptoms ...

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