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The effects of emotional content on memory in patients with Alzheimer's dementia.

1. Introduction

Alzheimer's disease is an advanced neurodegenerative disorder that is marked by degradation of intellectual performance and alteration in personality. Interpersonal and social difficulties are frequently a characteristic of Alzheimer's disease. The deterioration of social abilities and social grasp (Lazaroiu, 2015) influences the handling of behavioral deficiencies. The interpersonal deficits with social performance (MacEwan, 2015) in Alzheimer's disease tend to be impacted by impaired emotional processing. Persons with Alzheimer's disease undergo far more widespread structural and morphological alterations in the brain than that indicated by normal aging. (McLellan et al., 2008)

2. Emotion Processing in Alzheimer's Disease

Unbalanced emotion processing and troubles with social interplays (Britzman, 2015) occur to changeable degrees in dementia, being specific aspects of frontotemporal dementia, but these shortfalls are likely to be moderate in Alzheimer's disease, indicating the various models of neurodegeneration identified in these disturbances. Corticobasal syndrome (CBS) is an unrepresentative parkinsonian disease clinically and pathologically associated with frontotemporal dementia. Corticobasal syndrome commonly appears as a motor disorder, even though cognitive and behavioral modifications are identified. Pathological alterations are identified in frontoparietal cortical areas and in the basal ganglia that are considerably entailed in emotion processing. Patients with corticobasal syndrome undergo extensive shortcomings in emotion processing that are associated with modifications in brain areas considered key for emotion processing. Corticobasal syndrome is clinically and pathologically associated with frontotemporal dementia. (Kumfor et al., 2014)

Demented elders are many times the only observers to their own maltreatment, but they are ridiculed and disregarded as untrustworthy. Patients with dementia often preserve particular cognitive function (cognitive reserve), while maintaining other certain cognitive losses. Memory for an emotional event is one of the retained cognitive capacities (Mircica, 2014) often preserved via the early phases of Alzheimer's disease and related dementias (ADRD). Elder abuse is a detrimental emotional event for individuals who experience it. Frequency of ADRD is directly related to age. The cognitive disorders and reliance on other individuals for their care and security leave older American patients with dementia liable to abuse. (Wiglesworth and Mosqueda, 2011) Emotional stimulation improves declarative memory in individuals. In Alzheimer's disease, memory impairment is a main characteristic. Less implication of emotion in general knowledge (Nica, 2015) would justify the less dynamic involvement of the amygdala in the latter. Within the amygdala, the lateral nucleus is the sensory boundary, which extends to the central nucleus in a roundabout way as being the basolateral nucleus, and the central nucleus is the motor boundary of the amygdala. Impairment in the hippocampus may be an essential requirement for the appearance of emotional memory shortfalls. The hippocampus may be entailed in features of declarative memory processing that are significant to emotional events, and is required for the declarative memory process, irrespective of emotional valence, as a basic memory system. Memory of real-life emotional events is flawed in patients with Alzheimer's disease, and emotional stimulation improves memory of all features of an event apart from aspects negligible to the person's existence. Emotional memory shortcomings in Alzheimer's disease are associated with the severity of amygdalar impairment and less so to the severity of hippocampal impairment (the amygdala has a decisive function in emotional memory in individuals). (Mori et al., 1999)

3. Behavioral and Psychological Symptoms in Alzheimer's Disease Patients

Alzheimer's dementia is the most ordinary type of dementia and encoding of unambiguous declarative information is the chief memory shortfall in it. Emotional stimuli are likely be better recalled (i.e., memory for them is both more precise and more swiftly handled) considering everything than neutral stimuli--the commonly called emotional memory advantage (EMA). Dissimilarities in encoding schemes may be one of the feasible workings behind the EMA. The latter can practicably be attributable to retrieval processes where emotion or state of mind may function as a retrieval hint, or it may be caused by modulation of reinforcement processes. One may count on identifying EMAs in patients with mild Alzheimer's dementia and less deterioration of the amygdala in contrast with individuals with severe Alzheimer's dementia and more significant deterioration of the amygdala. It may be hard to identify appropriate emotional memory assessments to utilize with patient groups as lists commonly employed in laboratories are frequently too long and intricate to be utilized with elderly individuals and demented patients. Employing emotional stimuli may assist in enhancing memory remembering (Lazaroiu, 2013) in the elderly admitting the individuals have been diagnosed with Alzheimer's dementia. (Nieuwenhuis-Mark et al., 2009) Patients with CBS commonly display a configuration of motor and sensory indications comprising uneven ideomotor and limb kinetic apraxia and cortical sensory impairment bringing about an alien limb. The model of neurodegeneration identified in CBS and its clinical coincides with frontotemporal dementia, indicate that shortfalls in emotion processing are plausible. Analogy of CBS with Alzheimer's disease, as a disorder control group, may secure that any emotion processing shortfalls identified in CBS do not simply indicate more unspecified cognitive disorder, as a consequence of neurodegeneration. Examination of the function of subcortical areas in emotion processing (Popescu Ljungholm, 2015) clarifies that the soundness of the basal ganglia and hippocampus are crucial for relevant emotion processing in CBS. (Kumfor et al., 2014)

Dementia is a degeneration of intellectual capacity entailing relevant disorder of memory and not less than one other cognitive function, bringing about a lack of ability to execute routine activities. The type of memory function that is examined to diagnose dementia is dissimilar from the types of memories brought about by someone undergoing elder abuse (emotional memory is relinquished in numerous patients with dementia). When emotion associates with memory, the recollections are more prominent. Attention is a unconnected cognitive construct required for the constitution of recollections. Emotions and emotional memories have positive or negative valence. The memory impairment of Alzheimer's disease is related to impairment to the hippocampus that damages encoding or retention of new memories. (Wiglesworth and Mosqueda, 2011)

4. The Emotional Memory Effect in Aging and Alzheimer's Disease

Efficient communication and suitable interplay necessitates a capacity to identify and respond to the perceived state of other individuals. The most achievable information indicating a person's affective state is the one transmitted via the facial expression. Prototypical expressions are quickly recognizable and pronounced confusion is uncommon among properly functioning grown-ups. Any aged disorder, like that identified for sad, anger and fear, may not be the consequence of them being more difficult expressions to identify. Particular emotions have also been related to specific brain areas. Incompletely separable neural routes are entailed with the processing of certain emotions. The effect of normal aging on brain areas involved in emotion processing (Popescu, 2015) may clarify the impediment undergone with the identification of particular facial expressions. Individuals experiencing Alzheimer's disease may undergo a peculiar disorder in the capacity to handle affective information, this exhibiting a damaged capacity to identify facial displays of emotion. Granted the favored effect of aging on the identification of particular expressions (St John, 2015), the neurodegeneration related to Alzheimer's disease impacts some emotions more than others. (McLellan et al., 2008) Patients with Alzheimer's disease display relevant emotion processing shortfalls only. The emotion processing shortfalls identified in CBS are more prevalent than those identified in Alzheimer's disease. Besides, they are caused by both shared and different cortical and subcortical areas that are involved in emotion processing. Impediments in comprehending crafty social signals, in concert with a diminished potential to be involved meaningfully in social interplays may influence the whole state of mind and conduct of patients with CBS. The shortfalls in emotion processing may also be instrumental in an absence of insight in them. CBS influences not only motor and cognitive capacities, but also considerably affects emotion processing. (Kumfor et al., 2014)

Emotional memory may be relinquished in ADRD, notwithstanding the impairment of verbal or declarative memory that is the indication of the disorder. Relinquishing emotional memory in ADRD may depend on visual and/or autobiographical memory. Dementias are marked by differentially maintained cognitive function and by distinctive relinquishing of brain arrangements that account for cognitive function related to emotional and autobiographical memory. Numerous individuals with dementia have cognitive hesitancy for recollect events from the past that include emotional content. Phase of the dementing disease is a determinant in dependability of emotional memory, and may imply that the individuals with dementia can observe their own life events. (Wiglesworth and Mosqueda, 2011) Most "disease-altering" experimental interventions for Alzheimer's disease have been unsuccessful in proving clinical advantages in persons with typical Alzheimer's disease. Depression or depressive symptoms may indicate (1) a risk determinant for dementia, (2) a prodromal stage of dementia or (3) an outcome of the dementia neurodegenerative processes. The kind of dementia is determined by the moment when depression happens during life. Depression that occurs first in late life may display an early indication of dementia, specifically of Alzheimer's disease. Modified perception and communication capacities (Howe, 2015) may intensify some emotional reactions. Memory impairment may diminish the capacity to feel emotions, which may generate the occurrence of apathy and depression. Raising knowledge of impacted systems in Alzheimer's disease development advances our comprehension of its pathophysiology and enables us to establish new candidate biomarkers for its diagnosis. (Laske et al., 2015)

5. Conclusions

Behavioral complications are generally considered a characteristic of the dementia, and not a consequence of the interplay of the individuals and their social context. There is a noticeable link between affect, cognition and behavioral adjustment. Persons with Alzheimer's disease display important shortfalls in emotion processing capacity, by comparison with sound older adult check-ups (Harris and Peeples, 2015), mainly for prosodic undertakings. While individuals experiencing mild-to-moderate Alzheimer's disease may be damaged on duties of general cognitive capacity, they preserve much of their potential to identify non-verbal emotional hints in faces and voices. The relative conservation of emotion processing and emotional display (Petcu, 2014) backs the increasing amount of psychological interventions being provided to persons with Alzheimer's disease. (Bucks and Radford, 2004)

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RALUCA ANDREEA ANCA LUPU-STANESCU

raluca_stanescu1380@yahoo.com

University of Bucharest
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Author:Lupu-Stanescu, Raluca Andreea Anca
Publication:Review of Contemporary Philosophy
Article Type:Report
Geographic Code:1USA
Date:Jan 1, 2015
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