My apologies for any non-ideal language I’m using here. I don’t know much about the topic.
Are there types of mental deterioration associated with age which “come and go,” in the sense that one day the person might seem perfectly sharp and on his game, and another day the same person might seem to be showing signs that their brain isn’t working quite right? Then back to perfectly sharp on another day, and so on?
Or is it generally more of a steady decline?
In the case of my father (who has Alzheimers, which is fairly advanced these days), in the beginning, it was pretty come and go. The overall progression was probably more of a steady decline, with fairly broad plateaus (at the beginning anyway, the decline is getting a lot steeper here lately). Talking with my mother about it, for at least a while it was difficult to tell whether my dad was experiencing some form of mental deterioration or if he just (for example) really hadn’t been paying any damn attention when she told him about some bit of local gossip he had no recollection of when it came up again later. It is probably most fair to say that while the progression was fairly steady, the outward manifestation was very, very come and go.
The thing I noticed about his decline was that in the case of mental deterioration, there is a lot that the sufferer can do to mask the outward manifestations, and many, many, many people suffering mental deterioration do everything they can to do precisely that. Not only that, but diseases that erode the mental functioning of their sufferers are terrifying in a way it’s almost impossible to understand if you’re not a sufferer, I think. That terror often makes people either hide their symptoms or double down on their efforts to try to be themselves. It’s hard to tell if the “come and go” is an abatement of symptoms or the result of improving or increased coping mechanisms. For at least a while, a person experiencing mental deterioration can do things that at least appear to help. They’re not actually improving the clinical prognosis, mind you, but they can mask the issue - or develop work-arounds that appear from the outside to be “them being normal”.
Unlike other diseases, there are issues with measurement of deterioration. With (for example) diabetes, one can monitor the blood sugar and generally get a reasonable approximation of the clinical scenario. Or, to use a different example, if your blood pressure is high, it’s high. If you’re dealing with an illness whose primary symptoms involve sub-critical alterations of mental functioning, that is a whole lot harder to measure in any objective fashion.
I don’t know if this is helpful or not.
My father had vascular dementia, and how lucid he was depended on how much blood was getting to his brain at any particular time. Sometimes he’d be almost like his old self, and then other times he had no idea what was going on.
As the overall condition worsened, the lucid moments became less and less.