Abstract
A case presentation indicating the importance of “happiness” in childhood causing memory block until the patent presented with probable mixed vascular and neurodegenerative memory loss at 60 years of age is presented to highlight the role of emotional factors in causing the disease. The question of whether Alzheimer’s disease is an adaptability disorder is raised, given the patient blocked out her memory of her childhood experience. The importance of “happiness” as a treatment goal raises issues of advocacy and Guardianship as well as capacity, which is addressed by actual case reference and court action in defence of the patient’s rights to have their wishes respected and observed. Functional mental capacity assessment, using the Functional Mental State Measure (FMSM) gives a greater indication of neuronal reserve than standard cognitive testing, as it helps to unravel the dilemma associated with pure cognitive assessment in Alzheimer’s Disease as well as vascular dementia patients and patients who, despite retained and intact functional capacity and ability to express their wishes, i.e. “best interest”, are “wrongly” placed under Guardianship. A General Systems approach, which recognises functional interaction as optimal and withdrawal or inadequate and/or inappropriate response as not, provides further understanding of the relationship between emotional factors, memory and neurodegenerative (Alzheimer’s) disease.
Highlights
Since the Nun study [1], linguistic ability at base-line has been the focus of attention in terms of development of Alzheimer’s Disease though terms of happiness used is found to be associated with longevity [2]
The Scottish tracking study shows that perceived health manifests with less memory impairment and disability in old age [3]
The Folstein Mini-Mental State test score was 21/30 in May, 24/30 on retesting in September that improved with an acetylcholinesterase inhibitor (AChEI) or anti-cholinesterase to MMSE 27/30, with loss of short-term word recall, but feeling better
Summary
Since the Nun study [1], linguistic ability (as an index of cognitive performance) at base-line has been the focus of attention in terms of development of Alzheimer’s Disease though terms of happiness used is found to be associated with longevity [2]. In an interactive human situation this may apply either to the giver or receiver, or to both It may present as a behavioural or memory disorder, whereas adequate and appropriate responses to environmental changes, challenges or stressors, to which the organism, or person, with or without aid, responds results in functional interaction and happiness. Cellular, including genomic, epigenetic, transcriptional, metabolic subcellular and cellular mechanisms may be affected or be involved in a reinforcing way, either as a result of the behavioural response or in response to emotion that triggers it
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