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Telephone Use | What's Happening in the Brain

There are many reasons that a person might have difficulty in using the telephone, because it is a complex task that requires many different brain functions to be operating properly. For example, recognizing the numbers on the keypad, getting the correct sequence, remembering the numbers, having the attention to continue the conversation, having the language to understand what is being said, and to express what one wants to say are each skills that must be employed. Importantly, too, in mild dementia, people lack the motivation to start the task, or the insight to know that it is time to get started, or the ability to plan, or the judgment to choose what is needed.

These complex behaviours often reflect more problems with planning, sequencing, insight and judgment, which are known as executive function . Such functions are importantly dependent on the frontal lobes. We know that because people who have localized damage to their frontal lobes (say from a car accident, bullet, tumor or blood vessel problem) characteristically have these types of problems. Frontal lobe impairment was classically seen as a late sign of Alzheimer's disease , but thinking about this has changed in two ways. Now that there is better testing of the frontal lobes, we see that there is involvement early. Also, brain imaging studies suggest that early on, the brain is able to compensate for damage in the frontal lobes, but the ability to compensate becomes less as the disease progresses. This is an important insight, because it suggests that strategies to treat Alzheimer's disease need not just focus on countering the disease process, but can also enhance the repair process.

This issue is explored in considerable detail in the chapter on 'executive function' by Sarah Voss and Roger Bullock, in the book Trial Designs and Outcomes in Dementia Therapeutic Research, published in London in 2005 by Taylor & Francis, 2005, and edited Kenneth Rockwood and Serge Gauthier. The assessment of function in anti-dementia drug trials is discussed in detail in another chapter in that book, by Serge Gauthier.

See Also:
Symptom Library > Memory & Language > Memory of Recent Events
Symptom Library > Personality Changes > Interest/Initiative (lack of)
Symptom Library > Everyday Activities > Operating Gadgets/Appliances
Symptom Library > Physical Changes > Sensory Input
Symptom Library > Thinking & Judgment > Judgment
Symptom Library > Thinking & Judgment > Attention/Concentration (lack of)
About Dementia > Alzheimer's Disease > Memory
About Dementia > Alzheimer's Disease > Agnosia
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Last updated January 15, 2019
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