Do people with PSP develop dementia? Dementia is a term that refers to the loss of cognitive functioning to the extent that it impacts a person’ s daily life. There are different types of dementia, and different diseases can cause dementia. In Alzheimer’ s disease, the most common cause of dementia, the cognitive impairment is primarily in the area of memory. People with PSP can experience changes to cognitive function, especially in more advanced stages of disease. This is usually in the areas of organization and processing of thoughts, planning, multitasking, attention, and word-finding. Sometimes people with PSP are initially misdiagnosed with Alzheimer’ s disease, or may be diagnosed with frontotemporal dementia, which is a different type of dementia.
Aphasia is a cognitive deficit affecting communication, including finding words, expressing thoughts, and understanding language. Different neurological conditions can cause aphasia. Some people with PSP can experience aphasia. The severity can vary greatly, and for some, it can be an early symptom of PSP.
For many families of someone with PSP, the most challenging aspects of cognitive impairment with PSP are impulsivity, poor judgment, and lack of insight into their cognitive or physical challenges. As examples, someone may jump up from a chair quickly, without waiting for assistance or using a walker, or may eat large portions of food very quickly. Some families have also shared that their loved one with PSP developed a tendency for impulsive and compulsive shopping. A big point of contention for families and healthcare providers alike is when a person with PSP is adamant they can still drive or do other things safely when it is apparent to others that they are unsafe. Impulsivity coupled with imbalance is the primary reason that people with PSP fall.
Apathy can also be a cognitive symptom with PSP, causing people to have less motivation to partake in activities. Cognitive changes in PSP can lead to social withdrawal or irritability, especially when they make communicating thoughts and participating in conversations more difficult.
Even in later stages of PSP, a person can often still respond to a question with accuracy and detail, but because of slowed processing speed, it may take several seconds or minutes and great effort to get out a thought. People with PSP and families can ask people to be patient when communicating. It can also be helpful to work with a speech-language pathologist on strategies to compensate for and adapt to cognitive changes and make communication easier.
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What happens to someone with PSP over time? The name of the disease includes the word“ progressive” because, unfortunately, early symptoms get worse and new symptoms develop over time. After five or six years, on average, the imbalance and stiffness worsen to make walking very difficult or impossible. Difficulty with eyesight, speech, and swallowing are additional important features of PSP that eventually occur in most patients. Not everyone experiences all of the symptoms of PSP, and the appearance and progression of these symptoms varies greatly among individuals.
Research has shown that someone with PSP lives, on average, about eight to ten years after the onset of symptoms. Injury from falling is one of the most common complications in PSP. Another is infection, particularly pneumonia and urinary tract infections. Your doctor may recommend regular evaluations of your swallowing function, assessments by a physical therapist and adaptive equipment to improve your safety with ambulation, a consultation with a urologist if challenges with urinary function arise, and other preventative measures.