An explanation for sporting memories can be found in the “bookcase analogy”, featured in the ‘Dementia Friends’ initiative

One amazing phenomenon is that it’s possible to stimulate memories in people living with dementia by the presentation of football memorabilia, as described by Rachel Doeg here.

The transformation is quite remarkable: “reeling off expert knowledge and sharing collective memories that bring laughter and camaraderie to the group,and a boost to their self-esteem.”

“Bill’s story” is another brilliant example from “Sporting Memories“:

 

“Sporting memories” was established to explore the stimulation of living well in people with dementia, through conversations and reminiscence.

The Dementia Friends programme supports people who want better to understand all the implications of the condition. Last week saw celebrities and people living with dementia teaming up with the Dementia Friends Campaign to encourage even more of us to sign up. It is hoped that one million will be recruited by 2015.

One of the ‘talking points’ in ‘Dementia Friends’ might “the bookshelf analogy of Alzheimer’s Disease”.

This video taken from the “Dementia Partnerships” website shows Natalie Rodriguez, Dementia Friends Champion, using this analogy to describe how dementia may affect a person.

This simple explanation, orginally devised by Dr Gemma Jones, can be helpful for Dementia Friends Champions to explain dementia to others. A full description of it is given here.

 

 

The usual explanation of the early features of Alzheimer’s disease using the ‘bookcase analogy’

In this analogy, the brain has a number of ‘bookcases’ which store a number of memories, such as memory for events about the world, memory for sensory associations, or emotional memory, to name but a few.

Let’s now focus on the memory for events about the world bookcase.

The top shelves contain more recent memories, and, as you go down the bookshelf, more old memories are stored.

Bookcase

 

When you jog this memory shelf, the books on the top may wiggle a bit, causing minor forgetfulness about recent events, such as where you put your keys.

As you jog it a bit more, the books on the top shelf may fall off altogether, making it impossible to learn new stuff and retain stuff for a short period of time.

The bottom shelves of the short memory bookcase remain unperturbed.

The jogging of this memory for events about the world bookcase is equivalent to what happens in early Alzheimer’s disease, when something goes wrong in the top shelves only.

The top shelves correspond to the hippocampus part of the brain – it’s near the ear, and so called  as it looks like a sea-horse. That’s where disease tends to happen first in Alzheimer’s disease.

So you can see what happens overall. In the early stages of Alzheimer’s disease, a common cause of dementia, problems in short-term memory for events about the world can be profound, while long-term memories around the world are relatively infact.

As they correspond to different bookcases altogether, sensory and emotional memory are left relatively intact.

 

How the ‘bookcase analogy’ can be used to explain the phenomenon of “sporting memories”

 

I haven’t mentioned another bookcase altogether. This is a memory of events about yourself – so-called “autobiographical memory” – and this is held in a part of the brain by the eye (the ventromedial subgenual cortex).

There’s a very good review from a major scientific journal, called “The role of the ventromedial prefrontal cortex in memory consolidation” by Ingrid L.C. Nieuwenhuisa and Atsuko Takashima published recently in 2011.

Autobiographical memories, such as sporting matches, are first formed in the hipppocampus, and they then get dispatched to a totally different part of the brain, the ventromedial/subgenual cortex as these memories become “consolidated”.

memory shifts

In other words, books can come from the events around the world bookcase, but while this is wobbling the autobiographical bookshelf is unscathed.

The crazy thing though is that the intact ventromedial prefrontal cortex is also connected with the intact amygdala in early Alzheimer’s disease, which means the autobiographical bookcase can arouse emotional memories in that bookshelf.

circuitry

 

Sporting memories and “dementia friendly communities”

It is also a nominee under the category “National Initiative” in the Alzheimer’s Society first Dementia Friendly Awards, sponsored by Lloyds Banking Group and supported by The Telegraph, the winners of which will be announced on May 20. The awards recognise communities, organisations and individuals that have helped to make their area more dementia-friendly.

 

 The awards shortlist is at alzheimers.org.uk/dementiafriendlyawards

If no two people are the same, how can we build ‘dementia friendly communities’?

Even identical twins act differently.

This is because they are shaped by the environment in unique ways, even if they have exactly genetic sequence as the blueprint which designed them.

It therefore cannot be any surprise that no two individuals in society are in the same, as you can easily witness with the range of opinions on your timeline on Twitter.

A person with a dementia might be very different to another person with a dementia.

There are a hundred different causes of dementia, tending to affect people in different age groups in distinct ways at different rates? Let’s pick one type of dementia, the most common cause, Alzheimer’s disease.

A 83 year-old with Alzheimer’s disease might have a number of different problems, for example memory – or even with problems in planning, aspects of language, or behaviour.

And of course it’s pretty likely that 83 year-old might be living with another different condition too, such as heart disease.

Your perception of that 83 year-old might vary from your next-door neighbour, according to, perhaps, your own personal experiences of dementia, good, bad or neither.

So, in raising awareness over the uniqueness of individuals through “Dementia Friends” or “Dementia Champions”, there’s an inherent contradiction.

How do we build ‘dementia friendly communities’, given one’s desire to embrace diversity?

I have for some time explained elsewhere why I think the term is a misnomer. I don’t see the point of “asthma friendly communities” or “chronic demyelinating polyneuropathy communities”, worthy though they are.

I think when you pick off any of the ‘protected characteristics’ in the Equality Act, such as ‘disability’, ‘sexual orientation’ or ‘age’, you have to be careful about not inadvertently  homogenising groups of people, worthy though the cause of ensuring that they do not suffer any unfair detriment is.

It could be that people in the early stages of Alzheimer’s disease, due to how the condition tends to affect the brain, could have particularly problems with spatial memory or navigation. Therefore, it would be desirable perhaps to have places with clear landmarks such that such individuals can navigate themselves around.

But take this situation to an extreme. Would society feel comfortable with people with dementia having their own cafés?

The story of Rosa Parks is well known.

After working all day, Parks boarded the Cleveland Avenue bus around 6 p.m., Thursday, December 1, 1955, in downtown Montgomery. She paid her fare and sat in an empty seat in the first row of back seats reserved for blacks in the “coloured” section.

The bus driver moved the “coloured” section sign behind Parks and demanded that four black people give up their seats in the middle section so that the white passengers could sit.

Rosa did not move.

A legitimate learning objective of ‘dementia awareness’ sessions is to think about what a person with dementia might or might not be able to do.

But if we then meet this learning objective, that people with dementia are all unique, we should steer away from stereotypes that people with dementia act ‘a certain way’.

This, I personally believe, is a big failing of this ‘dementia friendly communities awareness video’.

How Can We Include People With Dementia in Our Community? from NEIL Programme on Vimeo.