The 7 A’s of dementia

There are 7 symptoms of dementia, known as the 7 A’s of dementia as they all start with the letter A, which are common symptoms of dementia, although not everyone will experience all the 7 symptoms.

The 7 A’s  of dementia are:

  1. Anosognosia (no knowledge of illness)
  2. Aphasia (loss of language)
  3. Agnosia (loss of recognition)
  4. Apraxia (loss of purposeful movement)
  5. Amnesia (loss of memory)
  6. Altered perception (loss of visual perception)
  7. Apathy (loss of initiation)

Below is a more in depth look at the 7 A’s of dementia.

What is anosognosia?

Anosognosia is the medical term given to someone with a mental illness who is unaware of their condition.  Anosognosia is caused by damage/changes to the brain’s frontal lobe which is responsible for our self image.

Mum was in complete denial about her illness and initially I thought that it was because she was embarrassed about her diagnosis. Mum often used to ask “explain to me why you think I have dementia” and I now believe that she was genuinely unaware that she was ill. 

I wish that I had known about anosognosia in the earlier stages of Mum’s illness as I would have approached her questions differently, if I had realised that she had a genuine lack of insight.

What is aphasia?

Aphasia is the term used to describe someone who has difficulty with language and speech, including problems with reading, listening, speaking and writing. Aphasia is caused by damage to the left side of the brain responsible for language.

There are 4 broad categories of aphasia:

  • Expressive aphasia (non-fluent) is where someone has difficulty communicating their thoughts and ideas.
  • Receptive aphasia (fluent) is where someone has difficulty understanding things.
  • Anomic (aka amnesia) aphasia is where someone has difficulty finding the right names for people, objects or places.
  • Global aphasia is the most severe form of aphasia where someone loses almost all language function including the ability to speak, understand speech, read or write.

For more information visit the Communication & Aphasia page.

What is agnosia?

Agnosia is the term given when someone is unable to process sensory information, leading to an inability to recognise objects, people, smells, shapes, or sounds even though, for example, there is no damage to a person’s hearing or sight.

There are 3 categories of agnosia:

  • Auditory agnosia is the inability to recognise or differentiate between sounds. There are two types of auditory agnosia:
    • Semantic associative is caused by damage to the left hemisphere in the brain.
    • Discriminative agnosia is caused by damage to the right hemisphere in the brain.
  • Tactile agnosia which is the inability to recognise or identify objects by touch alone is caused by lesions to the parietal lobe.
  • Visual agnosia which is the inability to recognise objects. Visual agnosia is caused by damage to the left occipital lobe and temporal lobes.

There are many types of each category of agnosia for example:

  • A type of auditory agnosia is phonagnosia which is the inability to recognise familiar voices.
  •  A type of tactile agnosia is autotopagnosia which is the inability to orient to parts of the body
  • A type of visual agnosia is prosopagnosia (also known as face blindness) which is the inability to recognise a familiar face.

What is apraxia?

Apraxia is the inability to carry skilled movement, such as perform known tasks, even though the instruction has been understood and the person has the physical ability to do so. Apaxia is caused by damage to cerebral hemispheres of the brain (especially the parietal lobe).

There are several kinds of apraxia including:

  • Buccofacial or orofacial apraxia – the inability to carry out facial movements on command such as licking lips, whistling, coughing, or winking.
  • Limb-kinetic apraxia – the inability to make fine, precise movements with an arm or leg.
  • Ideomotor apraxia – the inability to make the proper movement in response to a verbal command.
  • Ideational apraxia – the inability to make multiple, sequential movements, such as dressing, eating, and bathing.
  • Verbal apraxia  – difficulty coordinating mouth and speech movements.
  • Constructional apraxia – the inability to copy, draw, or construct simple figures.
  • Oculomotor apraxia – difficulty moving the eyes on command. 

What is amnesia?

Amnesia is a condition that results in memory loss or the inability to form new memories, and memory loss is a common symptom in some types of dementia.

Types of amnesia include:

  • Anterograde amnesia – the inability to form new memories.
  • Retrograde amnesia – where someone will lose existing, previously made memories.
  • Transient global amnesia (TGA) – where someone experiences fluctuating confusion or agitation over the course of several hours. They may experience memory loss in the hours before the attack, and will probably have no lasting memory of the experience.

For more information visit the Memory Loss page.

What is altered perception?

Altered perception is the inability to interpret sensory information. For example someone with dementia may suffer from problems with depth perception where they are unable to correctly judge the distance of an object to themselves which can result in bumps and falls.

Mum had a particular problem with steps as she was unable gauge how far down the step or wide the tread was and she would nearly always stumble.

What is apathy?

The definition of apathy is a lack of interest, enthusiasm or concern. There are many reasons why someone with dementia will suffer from apathy including problems in the brain’s motivation pathways or a decreased function (for example an inability to initiate conversation or perform certain tasks).

Mum appeared to suffer from apathy in the earlier stages of her illness and she stopped doing the household chores or any of the things that she had previously enjoyed. We now know that it wasn’t that she didn’t want to but rather that as a result of her illness she was simply unable to perform even the most basic day to day tasks.

The 7 A's of dementia

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