The Memory Doc Blog  

The Memory Doc by Jill Joyce, PhD

Volume 1: 32                             

* Memory Thought: Serenity/Senility Prayer

* Mission Statement

* Terminology and Memory Loss Diagnoses

* List of Glossary Terms

* Memory Loss Glossary Defined

* The Most Severe Type of Memory Loss

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Serenity/Senility Prayer

God grant me the senility

to forget the people

I never liked anyway,

the good fortune

to run into the ones I do,

and the eyesight to tell the difference.

*********************************************

* Terminology: A Memory Loss Glossary

Hello again! The humorous Serenity/Senility prayer above

should be a clue as to where I'm going today.

If you've been here before, you know--it's hard for me to

tolerate the problems we can create by misusing labels

related to memory loss and cognitive disturbances.

The word "senility" is one of those misused terms.

Thus, I believe it's important that we understand what we

are dealing with--medically speaking--when there is a memory

loss concern.

So this week, just to get all of the formidable memory loss

labels out in the open, I'm providing a copy of the glossary

from my book "Don't Forget" (Appendix A).

As shown many times over, sometimes memory loss can be

humorous, but much of the time, it's just a very serious

matter.

Hopefully, this information will help you if you must deal

with a memory loss situation and assist you when you speak

to your doctor.

When I talk to people about memory loss, it seems one thing

most people don't understand is how many different variations

there can be that constitute this problem.

In fact, my dear friend and colleague Dr, Andrew Boswell

recently read through “Don’t Forget” and commented that

reading the glossary was very enlightening and helpful for

him. This prompted me to highlight the memory loss glossary for

all of you.

These specifics are not derogated only from problems common

to the elderly or to young people, to dementias or to head

trauma or even to post-traumatic stress syndromes, to ADHD,

ADD, or to learning disabilities.

No, these specifics are names, labels, and concepts used

to describe everyone of us whenever we manifest difficulties

and differences in our cerebral cortex.

These things can happen after surgery, stroke, head injury,

wrong medicines, toxins, diseases, drugs, alcohol abuse,

hormone imbalances, emotional abuse, psychological trauma

and even vitamin deficiencies. We can even be born with

and inherit some of these tendencies.

When focus and memory are thought to be the issues, the

difficulties described can run rampant among both the

elderly and school-aged children.

In many respects, these terms ought more rightly to be

thought of as aspects of our humanness that make us each

unique individuals instead of just deficiencies. Why? Because we all

possess some of these. Some of them we excel in. These represent

our strengths. Some that are commonly problematic for us are our

weaknesses. So, here we go.

Though the list may seem like just a lot of Greek, remember,

much of it is from the Greek language. But my definitions

will be in simple English. (This is a thorough but not

exhaustive list.)

**********************************************

* Terms (defined below)

 ~The Amnesias ~Aphasia ~Receptive Memory Loss 

 ~Auditory Discrimination ~Comprehension 

 ~Expressive Memory Loss ~Agnosia/Dysgnosia 

 ~Anomia/Dysnomia ~Apraxia/Dysarthrias

  ~Alexia/Dyslexia ~Gross/Fine Visual Discrimination

  ~Spatial Disorientation ~Acalculia ~Agraphia/Dysgraphia

  ~Agrammatism ~Astereognosis/Dysstereognosis ~Jargon

  ~Neologisms ~Paraphasias ~Perseveration 

 ~Global Memory Loss of Aphasia  

 ~Age-Associated Memory Loss (AAMI), 

 ~Age-Related Cognitive Decline (ARCD), and 

 ~Minimal Cognitive Impairment (MCI) 

**********************************************

*Memory Loss Glossary (from "Don't Forget: What Drug and

Insurance Co.'s Don't Want You To Know About Memory Loss")

~ AMNESIA: Inability to remember experiences before a head

trauma, also called "retrograde amnesia," or to remember

upcoming experiences after a head trauma, "anterograde

amnesia".

The anterograde amnesia category also affects learning of

new information. These persons can also experience

symptoms described throughout this glossary as "aphasic."

~ APHASIA: "Aphasia" is a language memory loss disturbance

that crosses over all necessary language modes.

The four main language modes (or modalities) include:

Understanding spoken language (reception), reading,

talking (expression), and writing (Schuell, 1974).

This glossary contains numerous characteristics of aphasia

memory loss unless otherwise specifed.

~ RECEPTIVE Memory Loss Aphasias: These are called 

decoding disorders and encompass difficulties in 

understanding and comprehension (De Vito, 1970).

“. . . patients who show some impairment of ability

to understand spoken language.

This memory loss impairment is characterized by reduced

comprehension of spoken words, by reduction of the

auditory retention span, and usually, in addition,

by some impairment of the ability to discriminate

between similar auditory patterns” (Schuell, 174, p. 93).

~ AUDITORY Discrimination: The inability to discriminate

between identical and dissimilar auditory signals has been

called “auditory discrimination.”

Sometimes, this discrimination can be so severely

impaired in a patient that “. . . much of the language

they hear is virtually unintelligible to them”

(Schuell, 1974, p. 93).

This has been clearly demonstrated to be “not related to

hearing loss but instead to interferences with the

processing of the complex patterns of acoustic stimuli

that language presents to the ear” (Schuell, 1974, p. 92).

~ “COMPREHENSION is not an all-or none phenomenon. Many

aphasic patients comprehend frequently used words but

fail to understand words used less often” (Benson, 1985,

p. 24).

~ EXPESSIVE Memory Loss Aphasias: These are encoding

disorders and encompass the difficulties in verbalizing

and speaking (De Vito, 1970).

First, memory loss/aphasic patients have difficulty in

“word finding” as a result of their weak vocabulary.

Their speech is fragmented and disjointed due to a

condition known as “anomia” (to be explained below)

and, of course, due to reduced attention span and

lack of focus.

Patients with severe “word finding” problems talk in

single words first, followed later by phrases and

short sentences (Schuell, 1974).

~ AGNOSIAS: “Agnosia” bears resemblance to the

difficulties of poor discrimination and poor reception

just discussed, but implies a more total “absence of

knowledge” (Reitan & Wolfson, 1992, p. 295).

In aphasia, agnosia is an “ . . . impairment of ability

to recognize the symbolic meaning of stimulus material”

as in reading, writing, listening, or speaking (Bauer &

Rubens, 1985; Reitan & Wolfson, 1992, p. 295).

~ AUDITORY agnosia applies “ . . . to the total inability

to differentiate all varieties of sound,” from fine speech

sounds to grosser environmental noises (Spreen et al.,

1995, p. 430).

This also occurs in auditory discrimination, but at a

less severe level. Other “agnosias” also bear mentioning.

~ VISUAL agnosia, an inability to diffferentiate visual

information and symbols affects reading ability.

~ TACTILE agnosia affects the reception of information

touched and felt by the skin in and about the environment.

~ DYSGNOSIA: “In contrast to "agnosia," "dysgnosia" 

represents a partial rather than complete loss of the symbolic

significance of information reaching the brain” (Reitan

& Wolfson, 1992, p. 301).

~ ANOMIA: This is a form of "aphasia" in which the ability

to retrieve common vocabulary words is affected and is also

referred to as a “word finding difficulty” (Benson, 1985,

p. 24).

This aspect of aphasia most makes an aphasic individual

like a visitor in his or her own culture. He or she is

familiar with the language and often understands much

more than others realize, but cannot find the words.

Again, he or she is like “someone trying to use a language

that he or she once knew but now recalls only imperfectly”

(Schuell, 1974, p. 87).

"Anomia" is undoubtedly the most common and well-known

linguistic memory loss difficulty and is caused by the

overall reduction of available vocabulary.

Also, because of the reduced verbal attention span,

“The aphasic patient can only hold a limited number

of words in his [or her] mind at a time” (Schuell,

1974, p. 90).

Words that are most frequently used in the language will

be the “words aphasic patients can use first,” recover

most easily, and use most often thereafter (Schuell,

1974, p. 90).

“Anomia” occurs across all language modalities:

understanding, reading, talking, and writing (Schuell,

1974).

~ DYSNOMIA: [Partial] “Impairment of the ability to

name objects, resulting from a brain lesion” (Reitan

& Wolfson, 1992, p. 301).

Again, as in the use of the terms aphasia/dysphasia,

this term, “dysnomia”, could probably be used more

accurately than “anomia” in describing that condition.

However, “anomia” has been the commonly accepted term

used to describe partial loss of the ability to name

objects.

~ APRAXIA and DYSARTHRIA: These are motor disorders

and may coexist with aphasia, but are not due to aphasia.

The muscle weakness of “dysarthria” or the lack of voluntary

motor control of “apraxia,” which has been described as an

"inability to carry out motor activities on verbal command,"

may be occurring simultaneously with the aphasia (Benson,

1985, p. 24).

This is not to be confused with any forms of paralysis to

the speaking mechanism.

Although “dysarthria” and “apraxia” are a result of stroke

or head trauma, these disorders can exist alone or in

combination with the memory loss of aphasia.

Typically, “right hemispheric lesions” are responsible for

these motor deficits and “do not cause aphasia [memory

loss] in most people” (Kertesz, 1985, p. 48).

In addition, the level of impairment of the articulation

affected by “dysarthria” and “apraxia” is "not correlated

with the severity of language deficit" (Schuell, 1974,

p. 97).

~ ALEXIA: Loss of the ability to read and understand the

symbolic significance of words. This is more commonly

and appropriately coined “dyslexia.”

~ DYSLEXIA: “Impairment (due to a brain lesion) of reading

ability and the understanding of the symbolic significance

of words. A symptom of [aphasia] dysphasia” (Reitan &

Wolfson, 1992, p. 301).

All aphasia memory loss patients will show some reduction

Of reading vocabulary and in verbal attention span. This

Will affect retention and integration of what they read.

~ VISUAL Discrimination, (Fine and Gross Levels): Inability to

discriminate between visual symbols.

Some patients will have a more marked impairment of

that could cause confusion in reading between letters and

words that look alike called “FINE visual discrimination.”

As severity increases, “GROSS visual discrimination” could

be affected and cause patients not to recognize that letters

are actually different from another or to see words or lines

on a page.

~ SPATIAL Disorientation, a loss of sense of direction or

position, may cause a person not to keep his or her place

and follow well while reading (Schuell, 1974, p. 94).

~ VISUAL Field Neglect also coined VISUAL Field Defect.

The person may be unable to see well either to the left

or to the right (Schuell, 1974, p. 94) in attempting to

read written material.

~ ACALCULIA: A disturbance of the ability to do mathematics

as related to the loss of memory and communication skills.

~ AGRAPHIA/DYSGRAPHIA: “A loss of ability to form letters

when writing, resulting when a brain fails to understand

words used less often” (Benson, 1985, p. 24).

~ AGRAMMATISM: A disturbance of the ability to properly use

well-known grammatical forms. One common example is the

confusion between pronouns informing others of gender,

like using ‘him’ for ‘her’ or ‘she’ for ‘he,’ etc.

~ ASTEREOGNOSIS: “Inability to identify objects through the

sense of touch” (Reitan & Wolfson, 1992, p. 296).

~ DYSSTEREOGNOSIS: “Impairment of ability [a partial 

inability] to recognize objects through touch” (Reitan & 

Wolfson, 1992, p. 301).

~ DEMENTIA: “Significant deterioration of intellectual and

cognitive functions (Reitan & Wolfson, 1992, p. 300).

~ ASSOCIATED Deficits that often overlap aphasia memory

losses include:

~ DYSPHAGIA: difficulty in swallowing

~ RIGHT-left confusion in reading and writing

~ CONSTRUCTIONAL deficits in connecting language ideas.

~ FRONTAL lobe deficits of distractibility, poor

attention, personality changes, and loss of motivation.

~ JARGON: Connected speech utterances having little or no

meaning.

~ NEOLOGISMS: Made up words.

~ PARAPHASIAS: Word substitutions that have a similar sound

to the target word. (E.G. Did you take the dog outside? Yes,

the dog beeped and booped.)

~ PERSEVERATION: Abnormal and severe disability in 

repetition of words or parts of words; sounds similar to 

stuttering.

**************************************************

* The Most Severe Type of Memory Loss (after head-injury, 

stroke, etc.)

GLOBAL Memory Loss of Aphasia: A total loss of language,

in which both expressive and receptive language of all

varieties are seriously impaired (Benson, 1985; Damasio,

1981; Peach, 1987).

These patients understand little or nothing, speak only in

stereotypical utterances, if that, and as a rule, have limited

recoveries (Kertesz & McCabe, 1977).

Global aphasia represents the most severe form of memory 

loss aphasia and has the poorest prognosis.

However, global patients have been known to make dramatic

recoveries with treatment, especially during the initial

six months to a year after the disorder ensues.

The probability of improvement often seems limited due to

their apparent lack of response, but ongoing attempts at

language stimulation can be rewarded suddenly and

significantly.

However, there are never any guarantees and because of

that concern, many researchers believe that the majority

of global patients do not improve immensely.

As researcher and therapist of this population for 20 years,

I concur, global memory loss aphasia is the most difficult

type of rehabilitative memory loss to conquer.

But I hasten to add, ongoing treatment, in the face of

periods with little response, is often the missing variable

in the equation that could correct this form of aphasia

memory loss.

The reason for this lack of therapy is apparent. There are no

guarantees of success. However, there are no guarantees of

failure either.

It is fair and has not been unusual practice in the past

to give at least six months of retraining about 3-5 days

per week before deciding to stop therapy in such cases.

**********************************************

These are only some of the labels used by medical

practitioners to describe disorders that include

memory loss.

If there's one thing I could wish for all of us now, it

would be that we take really good care of ourselves to

avoid these problems.

The medical world can only play a small part in the future

to help us with these. It used to help and has the technology

through therapy to help. But managed care insurance systems

have removed the correct therapies for memory loss, learning,

and cognitive concerns. Thus, my interest in prevention measures

continues to grow!

Stay well,

Dr. Jill

E-Mail: drjjoyce@att.net 
http://www.thememorydoc.com
Toll free: 1-561-200-9380
 
 

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rememlo brain ailments  memory loss brain alzheimer's stroke ADD ADHD focus recall naming word finding forgetting forget forgotten distractibility distractible hyper anxious anxiety mood mood disorders ability recall recollection lost words word finding confusion forgetfulness confusion anti aging head injury prevention recovery maintenance aphasia dysphasia alexia dyslexia agnosia apraxia anomia amnesia recollection direction loss absent minded childhood focus attention disorders  absent-minded brain ailments  memory loss prememlo memory loss brain alzheimer's stroke ADD ADHD focus recall naming word finding forgetting forget forgotten distractibility distractible hyper anxious anxiety mood mood disorders ability recall recollection lost words word finding confusion forgetfulness confusion anti aging head injury prevention recovery maintenance aphasia dysphasia alexia dyslexia agnosia apraxia anomia amnesia recollection direction loss absent minded  childhood focus attention disordersabsent-minded brain ailments  memory loss prememlo memory loss brain alzheimer's stroke ADD ADHD focus recall naming word finding forgetting forget forgotten distractibility distractible hyper anxious anxiety mood mood disorders ability recall recollection lost words word finding confusion forgetfulness confusion anti aging head injury prevention recovery maintenance aphasia dysphasia alexia dyslexia agnosia apraxia anomia amnesia recollection direction loss absent minded absent-minded  childhood focus attention disorders memory loss prememlo brain ailments memory loss brain alzheimer's stroke ADD ADHD focus recall naming word finding forgetting forget forgotten distractibility distractible hyper anxious anxiety mood mood disorders ability recall recollection lost words word finding confusion forgetfulness confusion anti aging head injury prevention recovery maintenance aphasia dysphasia alexia dyslexia agnosia apraxia anomia amnesia recollection direction loss absent minded absent-minded   childhood focus attention disorders memory loss prememlo memory loss brain alzheimer's stroke ADD ADHD focus recall naming word finding forgetting forget forgotten distractibility distractible hyper anxious anxiety mood mood disorders ability recall recollection lost words word finding confusion forgetfulness confusion anti aging head injury prevention recovery maintenance aphasia dysphasia alexia dyslexia agnosia apraxia anomia amnesia recollection direction loss absent minded absent-minded  childhood focus attention disorders  childhood focus attention disorders brain ailments memory loss prememlo memory loss brain alzheimer's stroke ADD ADHD focus recall naming word finding forgetting forget forgotten distractibility distractible hyper anxious anxiety mood mood disorders ability recall recollection lost words word finding confusion forgetfulness confusion anti aging head injury prevention recovery maintenance aphasia dysphasia alexia dyslexia agnosia apraxia anomia amnesia recollection direction loss absent minded absent-minded  childhood focus attention disorders childhood focus attention disorders brain ailments memory loss prememlo memory loss brain alzheimer's stroke ADD ADHD focus recall naming word finding forgetting forget forgotten distractibility distractible hyper anxious anxiety mood mood disorders ability recall recollection lost words word finding confusion forgetfulness confusion anti aging head injury prevention recovery maintenance aphasia dysphasia alexia dyslexia agnosia apraxia anomia amnesia recollection direction loss absent minded absent-minded  childhood focus attention disorders memory loss prememlo brain ailments memory loss brain alzheimer's stroke ADD ADHD focus recall naming word finding forgetting forget forgotten distractibility distractible hyper anxious anxiety mood mood disorders ability recall recollection lost words word finding confusion forgetfulness confusion anti aging head injury prevention recovery 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