Mental decline, perception and creativity.

April 27, 2007 9:39 AM

Mental decline, perception and creativity. Layperson looking to understand the medical changes that happen during aging-related mental decline, mental illness and dementia -- and looking for any research or just speculation re. various ways "reduced function" might translate into "different/new function" or "different modes of perception."

(I'm getting plenty of info by Googling, but I'm asking here in case people want to point me to their favorite resources or add their own thoughts.)

I'm thinking about this because of a creative project I might get to do (making audio/music in collaboration with people who are in various stages of aging-related mental decline or illness).

I think (and I know other people think) concepts like dementia, mental illness and "reduced mental function" are sometimes very gross-motor, reductive ways of talking about the various changes that can happen as a brain ages. (So if these changes can lead to new ways of perceiving the world, then what are some useful ways people who are experiencing those things can interact/communicate with people who aren't?) I also don't want to romanticize; I know in many cases reduced function is medically just that, and I want to get as clear an understanding as I can of the various ways the brain declines in physical terms and why.

I have no medical training but I am technically/academically oriented, so in addition to lay-terms resources, it's fine to recommend journal articles or other things I might have to work/Google to figure out. Thanks for any thoughts!

posted by allterrainbrain to health & fitness (10 comments total)

The term mental illness is typically used to refer to mood disorders and disorders of thought that are separate and distinct from dementia, or diseases like Alzheimer's. Mental illness, in that sense, is not something that is typically seen as a result of aging, although the prevelance of certain disorders may be higher in aged populations.
posted by OmieWise at 9:48 AM on April 27, 2007

Thanks for clarifyng -- so let's eliminate "mental illness" from my question except in the sense that some types may be more prevalent in a population as it ages.
posted by allterrainbrain at 10:01 AM on April 27, 2007

Speculation here: Early memories seem to persist. I recently talked with a 91 year-old woman who grew up in Paris and had very clear memories of being bombed in WW1, and going down into the basement with the rats and dripping water. She must have been two at the time. She also related, with great emotion, a traumatic experience with her nasty stepmother when she was five. She was not as lucid about current events in her life. You might like the recent film Away from Her, which explores this topic. Spoiler: Best line of the film is when an Alzheimer patient (Julie Christie) is watching news footage of the war in Iraq, and says, "How could they forget Vietnam?"
posted by weapons-grade pandemonium at 10:01 AM on April 27, 2007

This piece in today's Slate might give you a quick summary of some of the points for further research.
posted by matildaben at 10:08 AM on April 27, 2007

Not sure if this is helpful, but one thing I kept coming across when researching psychological issues affecting the elderly was that doctors, family members, and therapists often dismiss forgetfulness, lack of motivation, etc. as normal, as something that's inevitable when people get old. It's not, really, and what seems to be a cognitive decline is often caused by depression/grief, physical illness (patients with heart disease have a huge incidence of depression, for example), or side effects of medications. But there's an ageist sense that old people *should* be depressed -- after all, they're gonna die soon! -- as well as a stigma within the elderly population about seeking mental health services, so healthcare providers might not think to ask about psychological problems, and the elderly patient won't bring them up, leading to treatable psychological problems being classified as "normal mental decline" and therefore going untreated.
posted by occhiblu at 10:14 AM on April 27, 2007

Yeah, early memories for sure. By the time he died my grandfather couldn't tell his three granddaughters apart, but he could still recite poems he'd learned in grade school. Which he did, at the dinner table, all the time. Once he'd get started on Hamlet's soliloquy he was like a runaway train. And he had an arsenal of twenty or so stories he loved to tell...once, my uncle said that we'd heard that one before and his response was "Damn it, I had to listen to my dad tell the same stories over and over again and damned if I'm going to let you get out of it." I don't think any of these stories took place much later than WWII.

The saddest thing about watching someone you love age is when it's clear they're as clever as ever at the core, but they can feel their memories going. My grandfather (and his parents before him) both wanted to die, and weren't shy about it, for years before they actually went - because they felt like if their brains and bodies weren't behaving as they ought, there was no point in persisting.
posted by crinklebat at 11:53 AM on April 27, 2007

I have seen one paper which I think essentially hypothesizes that most people will experience some form of Alzheimer's if they live long enough and that variations in the onset and progression rate for non-familial Alzheimer's depend upon which APOE gene variants you carry. I may be oversimplifying, but I don't have access to the article right now. (I think it was in the American College of Physicians "ACP Medicine" treatise.)
posted by caddis at 12:50 PM on April 27, 2007

If you choose to look for scholarly articles by Daniel Geschwind, MD, and his group down at UCLA, you will find a cornucopia of information on this topic. Some of it is very abstruse but a lot of it - like his studies on how creative artwork changes over time in artists with frontotemporal dementia - is immediately accessible and, needless to say, quite fascinating.
posted by ikkyu2 at 8:53 PM on April 27, 2007

How singing unlocks the brain

"People who have constant memory problems are so undermined by this, but somehow the memory for singing is preserved for ever in the brain and it gives people a lift when they can remember things".

posted by bleary at 6:31 AM on May 2, 2007

I've had International Workshop on Cognitive Prostheses and Assisted Communication on my to-read list for a while. The proceedings are online, and include Developing an engaging multimedia activity system for people with dementia.
posted by bleary at 6:38 AM on May 2, 2007