Skip to main content icon/video/no-internet
icon backReturn to Entries

Dementia

A common concern of an attorney when working with older adults is those adults' capacity to make decisions for themselves. This concern arises due to common misperceptions about what normal aging entails and the prevalence of cognition-affecting diseases that occur in older adulthood. This entry will address definitions, causes, and prevalence of cognitive impairment and dementia, warning signs of which an attorney should be aware, ideas of capacity and competency in dementia, methods for interviewing older adults (healthy and with dementia), and ideas regarding who should be consulted when cognitive impairment is suspected.

Types of Cognitive Impairment

Cognitive impairment is an umbrella term for all of the disease processes that affect the ability to think properly. Legally, cognitive impairment could have an effect on one's ability to make decisions for oneself. A specific type of cognitive impairment that affects mainly older adults is dementia. Dementia is a psychiatric diagnosis based on decline in cognition and in behavioral functioning. There are several types of dementia, with varying medical causes, that impair brain functioning. Some types of dementia are irreversible, while others can be treated. While dementia does not affect most older adults, the prevalence becomes noticeable in people in their sixties and roughly doubles with each additional decade, reaching between 20 percent and 25 percent of people in their eighties.

The most common type of irreversible dementia seen in older adults is Alzheimer's disease (AD), which accounts for at least half of the dementias of late life. Alzheimer's disease is caused by a build-up in the brain of certain proteins that produce plaques and tangles. The next most frequent type of dementia is vascular dementia, which any of several cardiovascular problems, including strokes, may cause, with the effects varying by size, location, and timing of the stroke. Other dementias occur in older adulthood, including frontotemporal dementia, Parkinson's dementia, and Lewy body disease. Estimates of the proportion of dementias accounted for by the diseases other than AD vary considerably.

Treatment

Contrary to popular belief, some types of dementias are reversible. The causes of these dementias are varied, but they include overmedication and interactions between medications, infections, heart disease, malnutrition, endocrine imbalances, and electrolyte imbalances. If recognized early enough, physicians and psychologists often can treat these disorders medically and the older adult can recover considerable cognitive functioning, often returning to premorbid levels of cognitive ability.

Although these diseases can involve a wide variety of losses of intellectual functioning, a common symptom in older adults is memory loss. Knowing whether the dementia is treatable is best determined by a physician or psychologist (specifically a geriatrician, neuropsychologist, or geropsychologist), but there are a few things an attorney can watch for in determining whether a person is suffering from cognitive impairment.

Lawyers and Aging Clients

It is helpful to know some facts about normal aging. As nearly everyone ages, there is a degree of cognitive deterioration; more specifically, a slowing down of cognitive processing, difficulty in attentional focus, and less capacity for working memory. One often notices these changes as nameand word-finding problems, slower comprehension, and so on. Normal aging does not result in diminished legal competency, but it can cloud the issue of capacity—especially if the older client complains of such changes or becomes very worried by them. Changes in cognition beyond what is normal aging are frequently due to a disease process, and professional assessors can often determine this.

...

  • Loading...
locked icon

Sign in to access this content

Get a 30 day FREE TRIAL

  • Watch videos from a variety of sources bringing classroom topics to life
  • Read modern, diverse business cases
  • Explore hundreds of books and reference titles

Read next

More like this

Sage Recommends

We found other relevant content for you on other Sage platforms.

close

Have you created a personal profile? Login or create a profile so that you can save clips, playlists and searches

close
close
close Signed In to profile You are signed in as:
close
Logged in Institution Institution