Early indicators of dementia: 5 behaviour changes to look for after age 50
Calgary (Canada) (The Conversation): Dementia is often thought of as a memory problem, like when an elderly person asks the same questions or misplaces things. In reality, individuals with dementia will not only experience issues in other areas of cognition like learning, thinking, comprehension and judgement, but they may also experience changes in behaviour.
It's important to understand what dementia is and how it manifests. I didn't imagine my grandmother's strange behaviours were an early warning sign of a far more serious condition.
She would become easily agitated if she wasn't successful at completing tasks such as cooking or baking. She would claim to see a woman around the house even though no woman was really there. She also became distrustful of others and hid things in odd places.
These behaviours persisted for some time before she eventually received a dementia diagnosis.
Cognitive and behavioural impairment
When cognitive and behavioural changes interfere with an individual's functional independence, that person is considered to have dementia. However, when cognitive and behavioural changes don't interfere with an individual's independence, yet still negatively affect relationships and workplace performance, they are referred to as mild cognitive impairment (MCI) and mild behavioural impairment (MBI), respectively.
MCI and MBI can occur together, but in one-third of people who develop Alzheimer's dementia, the behavioural symptoms come before cognitive decline.
Spotting these behavioural changes, which emerge in later life (ages 50 and over) and represent a persistent change from longstanding patterns, can be helpful for implementing preventive treatments before more severe symptoms arise. As a medical science PhD candidate, my research focuses on problem behaviours that arise later in life and indicate increased risk for dementia.
Five behavioural signs to look for
There are five primary behaviours we can look for in friends and family who are over the age of 50 that might warrant further attention.
1. Apathy
Apathy is a decline in interest, motivation and drive.
An apathetic person might lose interest in friends, family or activities. They may lack curiosity in topics that normally would have interested them, lose the motivation to act on their obligations or become less spontaneous and active. They may also appear to lack emotions compared to their usual selves and seem like they no longer care about anything.
2. Affective dysregulation
Affective dysregulation includes mood or anxiety symptoms. Someone who shows affective dysregulation may develop sadness or mood instability or become more anxious or worried about routine things such as events or visits.
3. Lack of impulse control
Impulse dyscontrol is the inability to delay gratification and control behaviour or impulses.
Someone who has impulse dyscontrol may become agitated, aggressive, irritable, temperamental, argumentative or easily frustrated. They may become more stubborn or rigid such that they are unwilling to see other views and are insistent on having their way. Sometimes they may develop sexually disinhibited or intrusive behaviours, exhibit repetitive behaviours or compulsions, start gambling or shoplifting, or experience difficulties regulating their consumption of substances like tobacco or alcohol.
4. Social inappropriateness
Social inappropriateness includes difficulties adhering to societal norms in interactions with others.
Someone who is socially inappropriate may lose the social judgement they previously had about what to say or how to behave. They may become less concerned about how their words or actions affect others, discuss private matters openly, talk to strangers as if familiar, say rude things or lack empathy in interactions with others.
5. Abnormal perceptions or thoughts
Abnormal perception or thought content refers to strongly held beliefs and sensory experiences.
Someone with abnormal perceptions or thoughts may become suspicious of other people's intentions or think that others are planning to harm them or steal their belongings. They may also describe hearing voices or talk to imaginary people and/or act like they are seeing things that aren't there.
Before considering any of these behaviours as a sign of a more serious problem, it's important to rule out other potential causes of behavioural change such as drugs or medications, other medical conditions or infections, interpersonal conflict or stress, or a recurrence of psychiatric symptoms associated with a previous psychiatric diagnosis. If in doubt, it may be time for a doctor's visit.
The impact of dementia
Many of us know someone who has either experienced dementia or cared for someone with dementia. This isn't surprising, given that dementia is predicted to affect one million Canadians by 2030.
While people between the ages of 20 and 40 may think that they have decades before dementia affects them, it's important to realize that dementia isn't an individual journey. In 2020, care partners including family members, friends or neighbours spent 26 hours per week assisting older Canadians living with dementia. This is equivalent to 235,000 full-time jobs or
7.3 billion annually.
These numbers are expected to triple by 2050, so it's important to look for ways to offset these predicted trajectories by preventing or delaying the progression of dementia.
Identifying those at risk
While there is currently no cure for dementia, there has been progress towards developing effective treatments, which may work better earlier in the disease course.
More research is needed to understand dementia symptoms over time; for example, the online CAN-PROTECT study assesses many contributors to brain aging.
Identifying those at risk for dementia by recognising later-life changes in cognition, function as well as behaviour is a step towards not only preventing consequences of those changes, but also potentially preventing the disease or its progression. (The Conversation)
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No propaganda on Earth can hide the wound that is Palestine: Arundhati Roy
Full text of Arundathi Roy's speech delivered at the British Library on October 10th, 2024
'I refuse to play the condemnation game. Let me make myself clear. I do not tell oppressed people how to resist their oppression or who their allies should be.'
London: Writer and activist Arundhati Roy has been awarded the PEN Pinter Prize 2024, an annual award established by English PEN in memory of playwright Harold Pinter. Shortly after being named for the prize, Roy announced her intention to donate her share of the prize money to the Palestinian Children’s Relief Fund. In her acceptance speech, she recognized Alaa Abd el-Fattah, the British-Egyptian writer and activist, as a ‘Writer of Courage’ with whom she would share the award. The speech was delivered on the evening of October 10, 2024, at the British Library.
Full text of the speech:
I thank you, members of English PEN and members of the jury, for honouring me with the PEN Pinter Prize. I would like to begin by announcing the name of this year’s Writer of Courage who I have chosen to share this award with.
My greetings to you, Alaa Abd El-Fattah, writer of courage and my fellow awardee. We hoped and prayed that you would be released in September, but the Egyptian government decided that you were too beautiful a writer and too dangerous a thinker to be freed yet. But you are here in this room with us. You are the most important person here. From prison you wrote, “[M]y words lost any power and yet they continued to pour out of me. I still had a voice, even if only a handful would listen.” We are listening, Alaa. Closely.
Greetings to you, too, my beloved Naomi Klein, friend to both Alaa and me. Thank you for being here tonight. It means the world to me.
Greetings to all of you gathered here, as well to as those who are invisible perhaps to this wonderful audience but as visible to me as anybody else in this room. I am speaking of my friends and comrades in prison in India – lawyers, academics, students, journalists – Umar Khalid, Gulfisha Fatima, Khalid Saifi, Sharjeel Imam, Rona Wilson, Surendra Gadling, Mahesh Raut. I speak to you, my friend Khurram Parvaiz, one of the most remarkable people I know, you’ve been in prison for three years, and to you too Irfan Mehraj and to the thousands incarcerated in Kashmir and across the country whose lives have been devastated.
When Ruth Borthwick, Chair of English PEN and of the Pinter panel first wrote to me about this honour, she said the Pinter Prize is awarded to a writer who has sought to define ‘the real truth of our lives and our societies’ through ‘unflinching, unswerving, fierce intellectual determination’. That is a quote from Harold Pinter’s Nobel Prize acceptance speech.
The word ‘unflinching’ made me pause for a moment, because I think of myself as someone who is almost permanently flinching.
I would like to dwell a little on the theme of ‘flinching’ and ‘unflinching’. Which may be best illustrated by Harold Pinter himself:
“I was present at a meeting at the US embassy in London in the late 1980s.
“The United States Congress was about to decide whether to give more money to the Contras in their campaign against the state of Nicaragua. I was a member of a delegation speaking on behalf of Nicaragua but the most important member of this delegation was a Father John Metcalf. The leader of the US body was Raymond Seitz (then number two to the ambassador, later ambassador himself). Father Metcalf said: ‘Sir, I am in charge of a parish in the north of Nicaragua. My parishioners built a school, a health centre, a cultural centre. We have lived in peace. A few months ago a Contra force attacked the parish. They destroyed everything: the school, the health centre, the cultural centre. They raped nurses and teachers, slaughtered doctors, in the most brutal manner. They behaved like savages. Please demand that the US government withdraw its support from this shocking terrorist activity.’
“Raymond Seitz had a very good reputation as a rational, responsible and highly sophisticated man. He was greatly respected in diplomatic circles. He listened, paused and then spoke with some gravity. ‘Father,’ he said, ‘let me tell you something. In war, innocent people always suffer.’ There was a frozen silence. We stared at him. He did not flinch.”
Remember that President Reagan called the Contras “the moral equivalent of our Founding Fathers.” A turn of phrase that he was clearly fond of. He also used it to describe the CIA-backed Afghan Mujahideen, who then morphed into the Taliban. And it is the Taliban who rule Afghanistan today after waging a twenty-year-long war against the US invasion and occupation. Before the Contras and the Mujahideen, there was the war in Vietnam and the unflinching US military doctrine that ordered its soldiers to ‘Kill Anything That Moves’. If you read the Pentagon Papers and other documents on US war aims in Vietnam, you can enjoy some lively unflinching discussions about how to commit genocide – is it better to kill people outright or to starve them slowly? Which would look better? The problem that the compassionate mandarins in the Pentagon faced was that, unlike Americans, who, according to them, want ‘life, happiness, wealth, power’, Asians ‘stoically accept…the destruction of wealth and the loss of lives’ – and force America to carry their ‘strategic logic to its conclusion, which is genocide.’ A terrible burden to be borne unflinchingly.
And here we are, all these years later, more than a year into yet another genocide. The US and Israel’s unflinching and ongoing televised genocide in Gaza and now Lebanon in defence of a colonial occupation and an Apartheid state. The death toll so far, is officially 42,000, a majority of them women and children. This does not include those who died screaming under the rubble of buildings, neighbourhoods, whole cities, and those whose bodies have not yet been recovered. A recent study by Oxfam says that more children have been killed by Israel in Gaza than in the equivalent period of any other war in the last twenty years.
To assuage their collective guilt for their early years of indifference towards one genocide – the Nazi extermination of millions of European Jews – the United States and Europe have prepared the grounds for another.
Like every state that has carried out ethnic cleansing and genocide in history, Zionists in Israel – who believe themselves to be “the chosen people” – began by dehumanising Palestinians before driving them off their land and murdering them.
Prime Minister Menachem Begin called Palestinians ‘two-legged beasts’, Yitzhak Rabin called them ‘grasshoppers’ who ‘could be crushed’ and Golda Meir said ‘There was no such thing as Palestinians’. Winston Churchill, that famous warrior against fascism, said, ‘I do not admit that the dog in the manger has the final right to the manger, even though he may have lain there for a very long time’ and then went on to declare that a ‘higher race’ had the final right to the manger. Once those two-legged beasts, grasshoppers, dogs and non-existent people were murdered, ethnically cleansed, and ghettoised, a new country was born. It was celebrated as a ‘land without people for people without a land’. The nuclear-armed state of Israel was to serve as a military outpost and gateway to the natural wealth and resources of the Middle East for US and Europe. A lovely coincidence of aims and objectives.
The new state was supported unhesitatingly and unflinchingly, armed and bankrolled, coddled and applauded, no matter what crimes it committed. It grew up like a protected child in a wealthy home whose parents smile proudly as it commits atrocity upon atrocity. No wonder today it feels free to boast openly about committing genocide. (At least The Pentagon Papers were secret. They had to be stolen. And leaked.) No wonder Israeli soldiers seem to have lost all sense of decency. No wonder they flood the social media with depraved videos of themselves wearing the lingerie of women they have killed or displaced, videos of themselves mimicking dying Palestinians and wounded children or raped and tortured prisoners, images of themselves blowing up buildings while they smoke cigarettes or jive to music on their headphones. Who are these people?
What can possibly justify what Israel is doing?
The answer, according to Israel and its allies, as well as the Western media, is the Hamas attack on Israel on October 7th last year. The killing of Israeli civilians and the taking of Israeli hostages. According to them, history only began a year ago.
So, this is the part in my speech where I am expected to equivocate to protect myself, my ‘neutrality’, my intellectual standing. This is the part where I am meant to lapse into moral equivalence and condemn Hamas, the other militant groups in Gaza and their ally Hezbollah, in Lebanon, for killing civilians and taking people hostage. And to condemn the people of Gaza who celebrated the Hamas attack. Once that’s done it all becomes easy, doesn’t it? Ah well. Everybody is terrible, what can one do? Let’s go shopping instead…
I refuse to play the condemnation game. Let me make myself clear. I do not tell oppressed people how to resist their oppression or who their allies should be.
When US President Joe Biden met with Prime Minister Benjamin Netanyahu and the Israeli war cabinet during a visit to Israel in October 2023, he said, ‘I don’t believe you have to be a Jew to be a Zionist, and I am a Zionist.’
Unlike President Joe Biden, who calls himself a non-Jewish Zionist and unflinchingly bankrolls and arms Israel while it commits its war crimes, I am not going to declare myself or define myself in any way that is narrower than my writing. I am what I write.
I am acutely aware that being the writer that I am, the non-Muslim that I am and the woman that I am, it would be very difficult, perhaps impossible for me to survive very long under the rule of Hamas, Hezbollah, or the Iranian regime. But that is not the point here. The point is to educate ourselves about the history and the circumstances under which they came to exist. The point is that right now they are fighting against an ongoing genocide. The point is to ask ourselves whether a liberal, secular fighting force can go up against a genocidal war machine. Because, when all the powers of the world are against them, who do they have to turn to but God? I am aware that Hezbollah and the Iranian regime have vocal detractors in their own countries, some who also languish in jails or have faced far worse outcomes. I am aware that some of their actions – the killing of civilians and the taking of hostages on October 7th by Hamas – constitute war crimes. However, there cannot be an equivalence between this and what Israel and the United States are doing in Gaza, in the West Bank and now in Lebanon. The root of all the violence, including the violence of October 7th, is Israel’s occupation of Palestinian land and its subjugation of the Palestinian people. History did not begin on 7 October 2023.
I ask you, which of us sitting in this hall would willingly submit to the indignity that Palestinians in Gaza and the West Bank have been subjected to for decades? What peaceful means have the Palestinian people not tried? What compromise have they not accepted—other than the one that requires them to crawl on their knees and eat dirt?
Israel is not fighting a war of self-defence. It is fighting a war of aggression. A war to occupy more territory, to strengthen its Apartheid apparatus and tighten its control on Palestinian people and the region.
Since October 7th 2023, apart from the tens of thousands of people it has killed, Israel has displaced the majority of Gaza’s population, many times over. It has bombed hospitals. It has deliberately targeted and killed doctors, aid workers and journalists. A whole population is being starved – their history is sought to be erased. All this is supported both morally and materially by the wealthiest, most powerful governments in the world. And their media. (Here I include my country, India, which supplies Israel with weapons, as well as thousands of workers.) There is no daylight between these countries and Israel. In the last year alone, the US has spent 17.9 billion dollars in military aid to Israel. So, let us once and for all dispense with the lie about the US being a mediator, a restraining influence, or as Alexandria Ocasio-Cortez (considered to be on the extreme Left of mainstream US politics) put it, ‘working tirelessly for a ceasefire’. A party to the genocide cannot be a mediator.
Not all the power and money, not all the weapons and propaganda on earth can any longer hide the wound that is Palestine. The wound through which the whole world, including Israel, bleeds.
Polls show that a majority of the citizens in the countries whose governments enable the Israeli genocide have made it clear that they do not agree with this. We have watched those marches of hundreds of thousands of people – including a young generation of Jews who are tired of being used, tired of being lied to. Who would have imagined that we would live to see the day when German police would arrest Jewish citizens for protesting against Israel and Zionism and accuse them of anti-Semitism? Who would have thought the US government would, in the service of the Israeli state, undermine its cardinal principle of Free Speech by banning pro-Palestine slogans? The so-called moral architecture of western democracies – with a few honourable exceptions – has become a grim laughingstock in the rest of the world.
When Benjamin Netanyahu holds up a map of the Middle East in which Palestine has been erased and Israel stretches from the river to the sea, he is applauded as a visionary who is working to realize the dream of a Jewish homeland.
But when Palestinians and their supporters chant ‘From the river to the sea, Palestine will be free’, they are accused of explicitly calling for the genocide of Jews.
Are they really? Or is that a sick imagination projecting its own darkness onto others? An imagination that cannot countenance diversity, cannot countenance the idea of living in a country alongside other people, equally, with equal rights. Like everybody else in the world does. An imagination that cannot afford to acknowledge that Palestinians want to be free, like South Africa is, like India is, like all countries that have thrown off the yoke of colonialism are. Countries that are diverse, deeply, maybe even fatally, flawed, but free. When South Africans were chanting their popular rallying cry, Amandla! Power to the people, were they calling for the genocide of white people? They were not. They were calling for the dismantling of the Apartheid state. Just as the Palestinians are.
The war that has now begun will be terrible. But it will eventually dismantle Israeli Apartheid. The whole world will be far safer for everyone – including for Jewish people – and far more just. It will be like pulling an arrow from our wounded heart.
If the US government withdrew its support of Israel, the war could stop today. Hostilities could end right this minute. Israeli hostages could be freed, Palestinian prisoners could be released. The negotiations with Hamas and the other Palestinian stakeholders that must inevitably follow the war could instead take place now and prevent the suffering of millions of people. How sad that most people would consider this a naïve, laughable proposition.
As I conclude, let me turn to your words, Alaa Abd El-Fatah, from your book of prison writing, You Have Not Yet Been Defeated. I have rarely read such beautiful words about the meaning of victory and defeat – and the political necessity of honestly looking despair in the eye. I have rarely seen writing in which a citizen separates himself from the state, from the generals and even from the slogans of the Square with such bell-like clarity.
“The centre is treason because there’s room in it only for the General…The centre is treason and I have never been a traitor. They think they’ve pushed us back into the margins. They don’t realize that we never left it, we just got lost for a brief while. Neither the ballot boxes not the palaces or the ministries or the prisons or even the graves are big enough for our dreams. We never sought the centre because it has no room except for those who abandon the dream. Even the square was not big enough for us, so most of the battles of the revolution happened outside it, and most of the heroes remained outside the frame.”
As the horror we are witnessing in Gaza, and now Lebanon, quickly escalates into a regional war, its real heroes remain outside the frame. But they fight on because they know that one day—
From the river to the sea
Palestine will be Free.
It will.
Keep your eye on your calendar. Not on your clock.
That’s how the people – not the generals – the people fighting for their liberation measure time.
Source: The Wire
