Word salad dementia (Why it occurs)

Dementias involve a progressive loss of cognitive functions (memory, attention, language …) and adaptive skills. They can have origin in different causes, generally organic. Its progression ends up causing the patient an inability to carry out activities of daily life.

In this article we will learn about the clinical-anatomical classification of dementias: we list the dementias in each group and describe some of the most important. As we will see, the best known types of dementia are Alzheimer’s and Parkinson’s (with Alzheimer’s being the leading cause of dementia), although there are many more.

In addition, in this article we will talk about one of the symptoms present in dementia: language disorders, including the so-called “ Word salad ”

Word salad dementia

The word salad is characterized by the emission of words without any connection and, therefore, the speech becomes incomprehensible. It can occur in severely mentally handicapped people, including dementia and schizophrenia.

With the progressive increase in life expectancy and the decrease in the birth rate typical of our society, the average age of the population is gradually increasing.

Thus, little by little, a growing increase in the aging of the population is being seen, therefore some of the disorders related to or aggravated by age are becoming more and more frequent. Among them are dementias.

Dementia is understood to be the type of neurodegenerative disorder of organic origin which is characterized by a progressive loss of one or more mental faculties, which generally includes memory along with other capacities, which interfere with the correct vital functioning of the person and they cause discomfort and/or loss of autonomy.

The deficiencies detected represent a worsening with respect to the previous performance and do not only occur in a situation of altered consciousness.

It is a type of chronic, progressive and irreversible disorder (although in some cases the degenerative process may stop and there may even be a complete or partial recovery, such as those caused by hydrocephalus, poisoning or infections), produced by alterations in the body linked to a disease, substance use or deterioration and/or degeneration of the usual brain processes.

Furthermore, their effects may vary depending on the types of memory they affect the most.

Alzheimer’s dementia

It consists of a degenerative brain disease whose causes are unknown. Its onset is usually gradual, and implies a continuous, slow and progressive deterioration, with an average duration of 8-10 years. Currently, this disease has no cure. Three phases can be distinguished:

Its onset is generally sudden, and the main characteristic is a deterioration of recent memory (which is the part of memory that refers to what happens in the present moment, that is, you will have difficulty remembering daily tasks and to The learning).

In language, it is common to lose the richness of vocabulary because it has difficulties to find the words (anomie) that it tries to solve using circumlocutions (detours on the same topic) and paraphrasing (which consist of the substitution of one word for another in a similar context).

Changes in the personality may also appear, such as apathy (which is laziness or lack of interest in things), irritation, aggressiveness, rigidity (inability to make thinking flexible, that is, they are obsessed with an idea and for many reasons with he this idea does not change), etc.

Affective disturbances, such as anxiety or depression, may appear, produced because they are sometimes aware of the onset of the disease, especially because they notice memory problems. At this time, dementia patients and their families have to find an adaptation to the new life that awaits them: a challenge that involves stress and at the same time a lot of pain.

Lewy Body Dementia

Lewy Body Dementia is one of the most difficult to distinguish, as well as being one of the last discovered. This is so because it has symptoms shared with Dementia of the Alzheimer’s type and Parkinson’s Dementia and therefore its diagnosis is often confused with both, although it is currently considered the second most common type.

Therefore, its symptoms are mainly:

  • Aphasic-apraxo-agnosic syndrome: characteristic of Alzheimer’s, which consists of frequent forgetfulness, difficulty in performing simple tasks and difficulty in recognizing family members or objects. In this case it is characterized by pronounced variations in attention and alertness.
  • Recurrent complex visual hallucinations, also auditory hallucinations and delusions. Symptoms of REM sleep behavior disorder (which can be a very early manifestation) are common, as well as hallucinations in other sensory modalities, depression, and delusions.
  • Parkinsonian symptoms: as in Parkinson’s disease, which include tremors and stiffness of the limbs.

Spontaneous parkinsonism should begin after the onset of cognitive decline, and major neurocognitive deficits are seen at least 1 year before motor symptoms.

It must also be distinguished from neuroleptic-induced extrapyramidal symptoms – motor symptoms due to medications used for hallucinations and delusions – since up to 50% of individuals with Lewy body TNCs have significant sensitivity to these drugs.

They often suffer from repeated falls and syncope, which are temporary losses of consciousness that are accompanied by a momentary paralysis of the heart and breathing movements and which are due to a lack of blood supply to the brain, as well as transient episodes of loss unexplained consciousness.

Vascular dementia

Vascular dementia is caused by a series of small strokes (strokes) over a long period of time. These vascular accidents are blockages or interruptions of the blood supply to some part of the brain, causing neuronal death in the affected part.

For this reason, it is characterized by a deterioration in steps whose symptoms are difficult to predict since they depend on the affected brain area. Even so, in its beginning, it is characterized by frequent forgetfulness, orientation problems, and perhaps changes in personality or language difficulties.

Parkinson’s dementia

Parkinson’s dementia must be distinguished from Parkinson’s disease. Parkinson’s disease is characterized by tremors in the hands, arms, legs, jaw, and face, stiffness in the arms, legs, and trunk, slow movements, and problems with balance and coordination.

This type of dementia is characterized by the typical tremors of Parkinson’s disease together with the cognitive slowing down of higher functions and very important emotional alterations, being typical to find a severe depressive picture in these patients.

It differs from the previous ones in that the aphasic-apraxo-agnosic syndrome does not appear as in Alzheimer’s and that hallucinations and delusions are not as prominent or common as in Lewy Body Dementia. Noting, however, the cognitive slowness and body tremors.

In this article I have described the most common irreversible dementias, but others are also known such as Frontotemporales – the most common of this type being Pick’s Dementia-, Huntington’s Disease, dementia due to HIV, dementia caused by Prions, among other.

Word salad and other speech disorders in dementia

The word salad is characterized by the emission of words without any connection and, therefore, the speech becomes incomprehensible. It can occur in severe mental handicaps. It is called schizophasia in schizophrenics.

The impairment of language is one of the consequences widely corroborated as one of the alterations of dementias.

In the already early year 1907, Alois Alzheimer confirmed the disruption of language and its manifestation, as one of the elements underlying the disorder.

Among the difficulties projected by the language of the patient, it is broken down into aphasia, anomia, automatisms, paraphasia, circumlocution, stereotypies and echolalia.

All these phenomena are being introduced into the language of the patient, increasing the gaps and the advances of progressive cognitive deterioration.

Thus, one of the early manifestations of the disorder entails naming problems, the difficulty of evoking that word that designates the given object, located in a semantic memory deficit.

In this way, various authors maintain a deficit in the access or recovery of information, these access problems make it difficult for the patient to understand, elaborate and name said object, the evocation is seriously affected as well as the selection process, recovery and production.

In other words, the subject is an anomic being, totally disconnected from the signifier attached to the object, exempt from nomination, unable to evoke the corresponding name of the indicated object, constituting this limitation in the most common of aphasic disorders.

Being aphasia a language disorder caused by a brain injury, in a subject who previously had language, there is the ambiguity of terms uttered in the specialized literature to classify this syndrome, they stand out among nominal aphasia, anomic aphasia and amnestic aphasia, in this first phase of nominative difficulty.

The evolution of the problems derived from the cognitive deterioration of dementia, causes a gradual degeneration in the language of the patient.

The limitations begin to hinder the communicative processes of the patient with her environment, characterizing these exchanges as frustrating, generators of anxiety, isolation and depressive emotional reactions.

The processing disability, the memory gaps (semantic and operational), the same cognitive deficit and the growing communicative decline, require from the caregiver a special dedication, linked to paying greater attention and the use of verbal or non-verbal strategies (gravitating to the degree deficit suffered by the patient).

FAQS: Word salad dementia

What is word salad a symptom of?

The word salad is generally associated with a manic presentation of bipolar affective disorder and other symptoms of serious mental illness, such as psychosis, including schizophrenia.

What is a word salad example?

‘’Does not want; I need a girl bad people; I need to come with me It is easy; You don’t have to be a gunman. Heritage, power, political parties; I know the colors; people look at you, blow; there is another good one, flame blows Mafia’’

What are the 7 stages of dementia?

Phase 1. Asymptomatic.

Phase 2. Benign forgetfulness.

Phase 3. Mild cognitive impairment.

Phase 4. Diagnosis of Alzheimer’s dementia.

Phase 5. Moderate phase.

Phase 6. Moderate severe phase.

Phase 7. Very serious phase.

Is saying the wrong word a sign of dementia?

Not necessarily but, if someone fails to understand or enter a conversation, repeats questions, phrases and phrases, and has trouble speaking or finding the correct words, early signs of dementia can be seen.

What is word salad in narcissism?

When threatened, narcissists / psychopaths / sociopaths use what is called the “word salad” in an attempt to manage the situation to their greatest advantage.

In this article we learned about the clinical-anatomical classification of dementias: we list the dementias in each group and describe some of the most important. The best known types of dementia are Alzheimer’s and Parkinson’s (with Alzheimer’s being the leading cause of dementia), although there are many more.

In addition, in this article we talked about one of the symptoms present in dementia: language disorders, including the so-called “ Word salad ” 

If you have any questions or comments please let us know!

References

Förstl, H. & Kurz, A, (1999). Clinical features of Alzheimer’s disease. European Archives of Psychiatry and Clinical Neuroscience 249 (6): 288-290.

Tay, L., Lim, W. S., Chan, M., Ali, N., Mahanum, S., Chew, P., … & Chong, M. S. (2015). New DSM-V neurocognitive disorders criteria and their impact on diagnostic classifications of mild cognitive impairment and dementia in a memory clinic setting. The American Journal of Geriatric Psychiatry, 23(8), 768-779.

Jung, C. G. (2015). Psychology of dementia praecox (Vol. 1294). Princeton University Press.

Jefferies, E., Patterson, K., Jones, R. W., & Lambon Ralph, M. A. (2009). Comprehension of concrete and abstract words in semantic dementia. Neuropsychology, 23(4), 492.