Atul Sunny Luthra
Homewood Health Centre
A.S.Luthra is presently an associate clinical professor at McMaster University, Hamilton, Ontario, in the faculty of health sciences, Department of Behavioural Neuroscience. He is also affiliated as a research scientist with the Research Institute for Aging, Schlegel, University of Waterloo, Ontario. He is currently working as medical coordinator in the Program for Older Adults at Homewood Health Centre, Guelph, Ontario. He is affiliated in the same capacity with the St. Peter's site of Hamilton Health Science, Hamilton, Ontario. His clinical and research focus is on developing safe pharmacological and affordable non-pharmacological treatment interventions for behaviors in moderate to advanced dementia.
Objectives: There is vast heterogeneity in use of terminology and classification of behaviors in dementia with no universally accepted classification system. Methods: Criteria proposed by Davis, Buckwalter and Burgio (1997) were identified as the basis for classification of behaviors in dementia. A review of the literature was done to identify the “Specification of the Theoretical Construct” (STC) to justify aggregation of similar behavioral symptoms into clinically meaningful categories. Results: STC identified for these behavioral categories are those based in theories on information processing (TIP). Two behavioral categories emanating from pathological changes in TIP are: Disorganized Behaviors (DOB), and Misidentification Behaviors (MiB). Discussion: DOB is the result of an alteration in the physiological status of the patient. This result in changes in arousal and attentiveness and this, in turn, leads to impairment of the sequential organization of information processing thereby giving way to fragmentation of the process at many different levels of the brain. MiB are the result of a specific breakdown in two specific steps of TIP; schema identification and pattern recognition. This result in the failure of the usual pairing of old and new information with an altered sense of relatedness between self and persons, places, objects and events.