why does alzheimer’s increase the likelihood of aggression/anger in older people?
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There are a lot of different reasons, but I’ll go through a few of the more common ones I see in my practice (I deal a lot with Organic brain diseases, of which Alzheimer’s is one).
Everything is new. Everybody is new. They know you, they know your name, but you don’t know them. This weird person shows up every day and makes you take pills. You don’t know why, but they keep telling you that you have to take them. You need to do something. But you don’t remember what it is. But you need to do something, but you don’t remember what it is. You NEED to do something, but you don’t remember that you need to do something…. Memory issues often lead to mild to moderate anger and significant depression. Sometimes people will lash out because they just aren’t sure what is going on.
Another reason is damage to a part of the brain called the prefrontal cortex. This is at the very front of the the brain and is what makes humans human, in essence. All of our higher social functioning, reasoning, emotional regulation etc… happen here (and in areas around it),. This is also a very common place for damage. A good example of the changes when there is damage here is a case study of a guy named Phineas Gage. [The article is worth a read](https://en.wikipedia.org/wiki/Phineas_Gage?wprov=sfla1)
Another very common reason is people ending up in “survival mode” 24/7. The brain is good at keeping us alive, so it prioritizes all of our most important functions like breathing and heart beat. This “primitive brain” focuses on us making quick decisions to keep us from dying, so this is where our Fight or Flight response comes from. Imagine being in a dark alley with a person trying to attack you. Your brain focuses all of its power into staying alive. Organic brain diseases (like Alzheimer’s) usually start in the non-primitive brain, and as these other parts shut down, the brain is now in permanent Fight or Flight mode. Everybody is a stranger, strangers are dangerous so I need to protect myself. This is where a great deal of raw aggression comes from.
Organic brain diseases are incredibly varied, so there are dozens more reasons, but for the sake of ELI5 I’ve narrowed them down and generalized.
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