Changes In Mental Health And Cognitive Functioning In ALS Patients

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ALS, otherwise known as Lou Gehrig’s disease, stands for Amyotrophic Lateral Sclerosis – a mental health condition affecting 1.5 in every 100,000 people. This progressive neurodegenerative disease impacts the nerve cells in the brain and spinal cord, causing mental and physical function impairment.

A person with ALS will become and feel increasingly weak in the later stages. Patients will experience progressive paralyzation until it becomes impossible to breathe or swallow, leading to their demise. As the motor neurons die, changes in muscle movement, as well as mental health and cognitive functions become apparent.

The families of those who have ALS truly knows what this horrific illness entails. It includes significant changes in the patient’s mental health and cognitive functioning.

Affects The Mind, Not Just The Body

Research from the University of Edinburgh in Scotland suggests ALS causes cognitive changes, including difficulties in higher-order executive functions. Problems with planning, organizing, paying attention, and social cognition are just a few of the mental woes.

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In a recent study, lead researcher Sharon Abrahams compared the thinking skills of people with ALS and those who don’t. In a discovery, 29% of ALS patients had problems with thinking skills, as seen on verbal ability tests. The verbal ability tests require participants to list as many things as they can that start with a particular letter. Overall, ALS patients scored lower on all of the thinking tests, except for one – visual-spatial ability.

Visible Changes In Cognitive Functions

The impairment and changes in thinking experienced by those with ALS are due to the manifestation of the disease. Other times, having too little oxygen or too much carbon dioxide brought about by breathing difficulties also becomes a factor. The behavioral changes seen when the cognitive functions are of functional impairment in ALS are the following:

  • The patient will start writing or saying words in the wrong order (jumbled thoughts), or without respect to proper grammar
  • The patient will feel the significant disconnect between the mind and the body. He or she will struggle with the thought or will to move, and being able to move the actual body part.
  • The patient will experience a hard time answering Yes or No questions. They become unreliable as they will often respond No” when they mean “Yes” and vice versa.
  • The patient will develop decreased attention to proper hygiene such as basic toileting, bathing, or grooming.
  • The patient will occasionally forget spelling or word meaning which will affect their social actions.
  • The patient will find it difficult thinking of words to use in a conversation. He or she will often speak and converse sentences that convey little or unclear meaning.
  • The patient will have a childlike and uncharacteristic behavior at times.
  • The patient will develop increased aggression, despite having an opposite attitude before acquiring ALS.
  • The patient will lack concern for his or her wellbeing and future, including others’ welfare
  • The patient will only be able to focus on a single thought, idea, or activity.
  • The patient will lose decision making or general judgment skills.
  • The patient will appear to have lost his or her “filter” when making remarks or merely expressing one’s opinions
  • The patient will not be able to completely follow instructions such as those given in physical therapy or occupational therapy exercises.
  • The patient will often forget swallowing precautions even when advised only recently.
  • The patient will face difficulties remembering what he or she wants or intends to do.
  • The patient will lose basic table manners.

Mental Health Of ALS Patients


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As with any other deadly disease, ALS dramatically affects the patient and his or her family members’ mental health. Aside from the changes in cognitive functions, the patient also battles emotion-related and psychological challenges such as depression. According to research, the clinical depression in ALS patients is not as severe as might be expected. The numbers are less compared to those suffering from another neurological disease, Multiple Sclerosis.

A high number of people with ALS possess a positive attitude toward life, even as the deadly disease progresses. Patients who feel depression will only feel so at the beginning of the illness and will lose it towards the end. However, one can never be too careful, as depression significantly can affect the patient and may influence ending one’s life.

How patients cope with ALS is of great importance. The impairments in their cognitive function are inevitable, but they can take comfort in the support, care, and love of family and friends. Ultimately, they hold the key to their mental health as well as their longevity.

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