Aveneu Park, Starling, Australia

During environment.” (p. 1). The study done

During a study in 2017, participants were asked by Tsui and Kuh and Richards and Davis: Think to a time when you may have been unwell, perhaps while in a hospital. Sometimes a person’s memory, thinking, and concentration can get worse over hours and days due to an illness, for example, infection, operation, or due to medications. This is delirium. (p. 2)We all age, and sometimes with that aging our mind deteriorates. This can be as simple as not remembering where things are once in a while, or it can be as destructive as the brain disease known as dementia or alzheimers. Where, it’s not forgetting simple things, it’s forgetting an entire life beyond the moment the patient is in due to brain atrophy (alz.org, 2018, p. 1).  The relationship between a period of time where a person has an acutely disturbed state of mind where they are not greatly coherent and cognitive function is unknown at this time. We are beginning to go deeper into a pathology (cause of disease) that we are currently blind about. Revealing new parts of our memory and how it is stored, and why we can’t store it forever. The Alzheimer’s and Dementia Unit for Lifelong Health and Aging are investigating this disturbed state of mind and the possibility of it being a marker cognitive decline. Despite its connections with dementia, a brain disease that occurs in the later stages of someone’s lifespan, delirium can occur at any age. Though, it usually presents itself when a person has a chronic illness or another form of imbalance in the body, such as a mental illness. It shows relations with cognitive decline and may be on indicator of such. Much like how throwing up after a head injury is sign that the person has a concussion. One symptom of delirium is temporary cognitive impairment (Mayo Clinic, 2017, p. 1), this could be a connection to why people experience these symptoms chronically later in their lives. The Mayo Clinic in 2017 explains it further, “Delirium is a serious disturbance in mental abilities that results in confused thinking and reduced awareness of your environment.” (p. 1). The study done by Tsui et al. (2017) followed people as they aged, taking a baseline test at the age of 53 for cognitive function and then testing the ones that reported symptoms of delirium at age 69. Delirium shares symptoms with dementia, a brain disease that causes cognitive function to decline at a much faster rate than what is normal for an older adult. So much that they have stated,”Dementia and delirium may be particularly difficult to distinguish, and a person may have both. In fact, frequently delirium occurs in people with dementia” (Mayo Clinic, 2017, p. 2). If a person frequently has both, and the symptoms are very similar, it’s possible that one is a prerequisite to the other. Delirium is when a person has an acute disturbance that is characterized by symptoms. According to the Mayo Clinic (2017), “This may appear as: poor memory, particularly of recent events. Disorientation, for example, not knowing where you are and who you are. Difficulty speaking or recalling words.” (p. 1)  For example, not being able to remember what the word is for something that takes someone to a higher floor, (elevator).  There is no proof that delirium directly affects cognitive decline or vice versa, however, one cannot deny that there seem to be relations between the two. If someone doesn’t want to ever experience cognitive decline, then the answer is simple; don’t age. Ever. Aging is what begins cognitive decline. It becomes more difficult to actively remember new information and process it. Episodic memories are very specific, Glisky (2007) says it “refers to memory for personally experienced events that occurred at a particular place and a particular time.”(p. 5). This particular type of memory is how someone can recall the Christmas of ’99, where grandma revealed some secrets they wish they didn’t know about——now or ever. During aging, this type of memory is the first to go. So maybe grandma won’t remember spilling her secrets anyway. Glisky (2007) writes that “Aging principally affects episodic memory” (p. 7). There are different areas of the brain that are responsible for the different types of memory. Aging deteriorates this part first since it is the most complicated and develops slower than any other type. It is also the hardest to maintain. She writes, “Episodic memory may be distinctly human; it is the most advanced form of memory and is the ontogenetically (over our lifespan) the latest to develop. It also seems the most susceptible to brain damage and the most affected by normal aging” (Glisky, 2007, p. 5). During the study done by Tsui et al. (2017) participants were tested by being given a “15-item word-learning task” (p. 2). This could test a part of their episodic memory, since they would have to maintain the words in their head. Despite the fact that episodic memory and aging are strongly connected, different cognitive functions interact more than most know. Episodic memory and processing speed are called in the study 2 “key domains of cognition” (source put on bib sheet). Episodic has already been discussed, but processing speed is how it sounds. It is how quickly someone can take in information and understand it enough to complete a task. Testing those is a possible way to show connections between delirium and subsequent cognitive decline. Scientists haven’t given assessments of cognition before and after delirium to see its effects. They have done other tests that are similar, but the particular one done in the study above is special. They say that this is to further explore that “delirium has been linked with subsequent cognitive decline and incident dementia” (Tsui et al., 2017, p. 2). This connection could lead further to the pathology of dementia. They say the purpose of the study was “to investigate the association between reported delirium symptoms and change in two key domains of cognition—episodic memory and processing speed” (Tsui et al., 2017, p. 2). Symptoms of delirium have lead to some decline, so these associations lead to a correlation vs causation debate. Experiencing these symptoms could lead to some that are more permanent. This study is an attempt to find out if and why this is happening. The test done by Tsui et al. (2017)  was done over a period of several years. This is due to the fact that it takes time to do a study such as this one, to see visible changes in cognitive function takes years. So participants would have to be allowed time for their symptoms to show and change more dramatically, so the data could be interpreted with changes that could be used to draw solid conclusions. To find the demographic the study needed, the group kept track of willing participants over time as they aged, they said they had “A sample of 5362 participants born in March 1946” (Tsui et al., 2017, p. 2). After a period of time, the organization had check-ups done on all the participants, administered by a medical professional. There were “2090 who responded to a question about delirium symptoms” (Tsui et al., 2017, p. 2). The questions allow participants to report their symptoms personally and speak about the experiences they may have had in the time they aged. These self-reported symptoms could be used to critique the study since there is a chance that all the subjects have never experienced real delirium, since even the sharpest of memories can be manipulated by time and probing from interviewers. The subjects were then given tests that are frequently used to measure cognitive function, they assessed the episodic domain with a “15-item word-learning task” (Tsui et al., 2017, p. 2) as mentioned above. The other main area of cognition, “visual search speed was assessed by crossing out the letters P and W” (Tsui et al., 2017, p. 2) in a large group of letters, like a word search but far worse. It was found that delirium symptoms might affect a person even younger than previously theorized. It was discussed that “Self-reported symptoms of delirium were associated with lower search speed at age 69 and faster decline in this domain since age 53” (Tsui et al., 2017, p. 3).  A conclusion was made that people with delirium symptoms had lower scores on the cognition tests, so it can be assumed they had a lower level of cognition. Delirium and cognitive decline are connected in one way or another. Maybe just by symptoms or maybe by signals of the something much bigger than we can currently comprehend. Delirium could be the foundation for what starts memory loss, whether it is assisted by disease in the brain or not. Knowing warning signs, such as experiencing certain symptoms, for anything can change how we begin to treat a disease. Like most things, finding the disease sooner can be big head start in treatment, so knowing if delirium is a very early warning sign can help thousands keep their memory and coherency longer. Studies like this also further our understanding of how our most complicated organ, the brain, functions and interacts with our conscious and unconscious self.

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