Senile Recession: A Clinical Entity?

Abstract

At this point in medical history, one problem begins to loom up as a consequence of our conquering the infectious and contagious diseases and establishing better health standards. If during the next two or three decades researchers should succeed in mastering schizophrenia, the viruses, heart disease, cancer, and the major chronic degenerative diseases of the later years, senility may emerge as the major challenge to medical science. In a greatly prolonged life span, senility may, in time, become the chief psychopathologic feature of the human life cycle.One aspect of senility, namely recession, suggests many potentially profitable studies. Most useful for a general framework is Linden and Courtney's concept of the life cycle, especially the very last phases preceding dissolution and death (1). Medical and psychologic theories regarding recession need to be tied to the observation of rea1ity:Since we are still in the early stages of fact gathering, it may be necessary to assemble observations under a few headings, before drawing up working hypotheses.As a working definition, Linden's (2) will be employed:"In recession, the aged person appears to proceed through a series of retrogressive steps through level after level of the infantile development stages all the way back to psychological infantility. In a sense, these are the stages of childhood development up to early adolescence observed in reverse. The last stage of recession is thus the last stage of dementia before death, and corresponds in many ways to foetal and neonatal organization." THE STAGES OF RECESSIONThe following suggested stages of recession constitute a continuous process. Illustrative cases are presented for the purpose of emphasizing the characteristic aspects of each stage. The earlier stages represent psychophysical decline, a turning inward, with a broad ranging from the adult years back to puberty. There is a movement back and forth, involving adult crises, successes and failures. A claim by an older person that he is younger than he actually is, usually means that he has entered into the first stages of recession.Important phases of the process for society would appear to be puberty, and the four-year to eighteen-month stages. The return to the puberty stage probably helps to explain part of one tragic social problem today, that of the old man who sexually molests young children. These actions often take place as adult ego defenses and adaptations break down, and old sexual strivings are temporarily revived.The four-year to eighteen-month stage in a child represents dressing ability, and bowel and bladder control (3). A large part of institutional nursing time goes

The Sucking Behaviour of Two Patients in the Final Stage of Dementia of the Alzheimer Type

“…Wolf (1968) has stated that differences in the sucking modes could be due to a difference in the neurological damages. The natural course of DAT could be interpreted as being in agreement with the hypothesis of reversed development (Leeds 1960, Reisberg 1986. The sucking behaviour becomes progressively disorganized, much like a reflection of the sucking behaviour of infants, which becomes progressively better organized (Polft et al 1981).…”

“…As the process of the dissolution of the patients with DAT in many respects seems to proceed in a reverse order from the human being's development from a baby to a grownup (Leeds 1960;Reisberg 1986;Sandman et al accepted), a comparison with the infant sucking behaviour seems relevant. The infant sucking pattern has two distinctive modes; nutritive and non-nutritive sucking (Hack rf u/.…”

Overview of Methodologic Issues for Pharmacologic Trials in Mild, Moderate, and Severe Alzheimer's Disease

“…Subsequently, de Ajuriaguerra and associates and others have noted analogies between the losses in AD and normal human developmental reciprocals (de Ajuriaguerra el a]., 1964; de Ajuriaguerra & Tissot, 1968Tissot, , 1975Leeds, 1960). Cole and associates i n Canada build upon these ideas of developmental reciprocals in A D i n their construction of the Hierarchic Dementia Scale (Cole & Ilastoor, 1980Cole et al, 1981).…”

Interaction Between the Severely Demented Patient and His Caregiver during Feeding

“…Passive movements of the limbs will evoke resistence, "gegenhalten" (Paulson 1982). Later on the body becomes flexed and the patient might end up lying curled up like a foetus (Leeds 1960). Primitive reflexes might reappear (Basavaraju et al 1981).…”

“…Instead of being a tool for communication, lan-gua~e becomes an auxiliary to action (de Ajuriaguerra & Tissot 1975). In the late stage of dementia the patient appears apathic (Leeds 1960). He might also react to stimulation with primitive reflexes (Basavaraju et al 1981).…”