The 8 A's of Dementia

Updated: Aug 30


Dementia describes a variety of brain disorders, and the 8 A’s of dementia refer to a group of symptoms that commonly appear in individuals with dementia. The 8 A’s consist of: anosognosia, agnosia, aphasia, apraxia, altered perception, amnesia, apathy and attentional deficits. Loved ones with dementia may not always show or experience each A, because the signs of dementia appear different for every person. Knowing the 8 A’s of dementia allows for a simple way to remember this group of symptoms so you can identify them in your loved one if needed.


1. Anosognosia

Is when the individual can no longer recognize change and that there is something wrong. It is possible that they are unable to understand why they have cognitive problems or that they are experiencing any problems at all. Because the part of the brain that aids in reasoning is damaged, they do not see the changes in their abilities that others may see.


2. Agnosia

Agnosia occurs when a person can no longer recognize things through their senses: sight, sound, taste, touch, and smell. They might be unable to sort out what they see or hear, and might have trouble recognizing familiar people. The safety of your loved one may be at risk if this part of the brain is affected because they might confuse objects and what they are used for.


3. Aphasia

A person experiencing aphasia loses the ability to use and/or properly decode language. This includes the ability to speak, understand, read and write. Although this person may retain the ability to speak for some time, the ability to understand what other people are saying may be affected early in the disease. If they cannot understand what is being said to them, this can lead to misunderstandings between you and your loved one.

You might see them withdrawing themselves from social interactions. This can happen because they are worried that they will not understand others or that others may not understand them. Alternatively, your loved one may progressively lose their ability to speak or express themselves the way they used to or want to, but their comprehension may remain intact for much longer.


4. Apraxia

Apraxia occurs when a person has lost the ability to tell their body how to carry out purposeful movement as well as trouble understanding terms such as back, front, up, down. When this happens, it becomes difficult to do small tasks such as tying shoelaces, buttoning and zipping clothing, and any activity involving coordination.

The ability to move the body according to a certain pattern, such as coordinating hand and leg movement, also affects the ability to do specific activities such as driving. Apraxia may also affect speech, where the signals are not sent correctly from the brain to the muscles and as a result they might have difficulty producing words or say words they did not intend to say at all.


5. Altered Perception

Altered perception is when the information from your 5 senses is misinterpreted. For some people, this is a bigger problem in the late afternoon or early evening when light changes which is often referred to as “sundowning.” The loss of depth perception is another important component to altered perception. This affects the ability to see in three dimensions. It becomes harder to judge how high, deep, long, wide, near or far things are. For example, if the floor and furniture are the same color, it may be difficult to judge when one is close enough to a chair to try to sit.


6. Amnesia

Amnesia is the loss of memory. This is an important loss because most things we do depend on our ability to remember. For example, a person with short-term memory problems loses the ability to remember what was just said. This explains why you might find your loved one asking questions over and over again. Earlier in the disease, a person's short term memory will be affected and as the disease progresses, long-term memories will become harder to retrieve.


7. Apathy

Apathy is the inability to take initiative. The part of the brain that helps you start to carry out an activity or to communicate, is damaged. You might see that your loved one has difficulty beginning activities. This might require someone else to give them cues or hints to keep them involved in a conversation or a task.


8. Attentional Deficits

Attentional deficits occur when a complex attention span is lacking. This is important because paying attention or focusing is required when trying to accomplish any task. The lack of attention occurs outside the context of a delirium, which is a sudden change in thinking or acting. For example, a person who is unable to focus may not be able to have a complete conversation or speak with someone without getting easily distracted.

If you notice any of these A’s start appearing in your loved one, it’s time to create a personalized care plan. We can assist you in this process.


Karla Frese, Certified Dementia Practitioner, calls the initial discussions regarding care support and changes, “Courageous Conversations.” It is important to encourage caregivers and family members to see the present reality — to see their loved one NOW rather than what once was — allowing the family to begin accepting, adapting, modifying, and learning about, “what’s next.” The more you plan ahead and create a safe environment the better the outcomes will be for everyone.


They are an affordable and comparable alternative or complement to Independent and Assisted Living in Lincoln, Nebraska, and provide additional support when needed for those already living in a senior community. For more information visit www.homecarepartnersofnebraska.com or call 402-780-1211.


For more information or to start service, please Contact Us today.


Sources: Alzheimer’s Society, Dementia Simulation Toolkit



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