1.2 Describe the types of memory impairment commonly experienced by individuals with dementia

This guide will help you answer 1.2 Describe the types of memory impairment commonly experienced by individuals with dementia.

Memory impairment is one of the most common and defining symptoms of dementia. It can significantly affect a person’s daily life, relationships, and independence. Different types of dementia impact memory in different ways, and the severity of memory impairment often depends on the stage of the condition. Understanding these types of memory issues can help you support individuals with dementia more effectively.

In this guide, we cover the types of memory impairment commonly experienced by individuals with dementia.

Short-Term Memory Impairment

Short-term memory, also known as working memory, refers to the ability to store and use information for a short period of time, generally from a few seconds to a few minutes. This type of memory is one of the first to be affected in many forms of dementia, especially Alzheimer’s disease.

Individuals may experience:

• Forgetting recent conversations.
• Repeatedly asking the same questions, even if they were answered moments ago.
• Misplacing items, such as keys or glasses.
• Forgetting what they were in the middle of doing, such as leaving a kettle boiling or an oven switched on.

These lapses in short-term memory can cause frustration for the individual and their loved ones. It often leads to a loss of confidence as people become more aware of their difficulties.

Long-Term Memory Impairment

Long-term memory includes memories stored over days, months, or years. This can involve personal memories, such as childhood experiences, and general knowledge. In the early stages of dementia, long-term memory is often preserved, while short-term memory is affected. However, as dementia progresses, long-term memory can also deteriorate.

Individuals with long-term memory impairment may experience:

• Forgetting past life events, such as wedding days, holidays, or the birth of a child.
• Losing knowledge of facts and information, like the names of famous people or historical events.
• Struggling to remember familiar people or places, including family members or their own home.
• Blurred distinctions between old and new memories (e.g., thinking events from decades ago happened recently).

Long-term memory loss could lead to feelings of disconnection from the world around them.

Episodic Memory Impairment

Episodic memory relates to remembering specific events or experiences from an individual’s life, such as a birthday party, a visit to the doctor, or a significant achievement. It includes details like when and where something happened. People living with dementia, particularly Alzheimer’s disease, often struggle with episodic memory.

Signs of episodic memory impairment include:

• Forgetting recent outings or events, such as attending a family dinner.
• Difficulty connecting events with the correct time or place, e.g., believing an event happened years ago when it was recent.
• Losing awareness of their personal history or forgetting important life milestones.

These memory lapses can have a strong impact on a person’s sense of identity.

Semantic Memory Impairment

Semantic memory refers to the knowledge of facts, concepts, and meanings. It involves general knowledge rather than personal experiences. For example, recognising objects, understanding words, or knowing what “spring” or “electricity” means are all linked to semantic memory.

Dementia, especially frontotemporal dementia (FTD), can interfere with semantic memory. This might look like:

• Forgetting the meaning of common words or phrases.
• Difficulty naming familiar objects (“What’s this?” when holding a spoon).
• Misunderstanding jokes, metaphors, or idioms.
• Struggling to retain general knowledge about the world, such as recognising countries or understanding seasons.

Semantic memory loss can sometimes appear similar to language-based communication difficulties, which adds further challenges.

Procedural Memory Impairment

Procedural memory involves remembering how to perform tasks or routines, such as tying shoelaces, riding a bike, or brushing teeth. It is a type of implicit memory, meaning it is learned through practice rather than conscious effort. Procedural memory is often retained longer in dementia than other types of memory.

However, in the later stages of the condition, individuals may begin to lose these abilities. For example:

• Forgetting how to make tea or use common appliances.
• Struggling with basic tasks like dressing or using cutlery.
• Losing fluency in skills they once mastered, such as playing an instrument or knitting.

This type of impairment can make individuals more dependent on carers for physical support with day-to-day activities.

Recognition Memory Impairment

Recognition memory relates to the ability to identify previously encountered people, places, or objects. This commonly becomes impaired in dementia, particularly in conditions such as Alzheimer’s disease and Lewy body dementia.

Examples of recognition memory problems include:

• Not recognising close family members or long-term friends.
• Walking into familiar places, such as home, and finding them unfamiliar.
• Forgetting the purpose of familiar objects, like a toothbrush or a microwave.

Recognition issues can lead to confusion, fear, or distress, especially in social situations or when familiar environments begin to feel alien.

Prospective Memory Impairment

Prospective memory refers to remembering to carry out planned actions in the future, such as attending an appointment or taking daily medication. This type of memory often deteriorates early on in dementia.

For example:

• Forgetting to take prescribed tablets or other treatments as scheduled.
• Missing appointments or planned social activities.
• Failing to complete household chores or tasks they intended to do.

Prospective memory loss often results in the need for reminders, prompts, or external aids like calendars or alarms.

Emotional Memory Impairment

Emotional memory involves retaining feelings or emotions related to specific experiences. Even without recalling the details of an event, the emotional response to it can linger. In dementia, this can become disrupted.

For instance:

• An individual may forget why they feel sad, anxious, or angry, but still experience the negative emotion strongly.
• Memories tied to joyful or comforting experiences may begin to fade, impacting emotional well-being.

This type of memory loss can create emotional confusion and make it harder to regulate feelings.

Temporal Memory Impairment

Temporal memory allows individuals to place events in the correct order or timeframe. When this is impaired, a person may struggle to understand the sequence of events or distinguish between the past and present.

For example:

• Thinking that someone who passed away years ago is still alive.
• Believing they are living in a different time period (e.g., thinking they are still a child).
• Forgetting which day, month, or year it is.

Confusion about time can lead to difficulties in distinguishing reality from memories. It may also cause disorientation about daily routines.

Spatial Memory Impairment

Spatial memory enables people to remember locations and navigate their surroundings. Dementia often reduces spatial memory, especially in conditions like Alzheimer’s disease.

Common signs include:

• Getting lost in familiar places, such as walking home from the local shop.
• Being unable to remember where objects are stored, e.g., items kept in cupboards or drawers.
• Difficulty with tasks that involve remembering spatial layouts, such as puzzle-solving or rearranging rooms.

Spatial memory impairment increases the risk of wandering and enhances the need for supervision to keep individuals safe.

Supporting Individuals with Memory Impairment

Memory impairment varies widely among individuals with dementia. Some may experience more profound difficulties with certain types of memory than others. Recognising which specific areas are affected allows care workers to adapt their approach to meet the person’s needs more effectively.

Practical methods of support include:

• Using visual reminders (e.g., labels, photographs, or written instructions).
• Establishing consistent routines to reduce reliance on memory.
• Offering supportive prompts or cues during conversations or activities.

Each type of memory impairment affects a person’s autonomy and confidence in different ways. By identifying and addressing these challenges, care workers play a vital role in improving the lives of people living with dementia.