Learning processes in dementia

In its broadest sense, learning is a form of adaptation which continues throughout life; a process through which individuals are able to provide adequate responses. Dementia, however, generates a process of unlearning as well as an alteration of the capability to acquire new knowledge. Among the classical theories of learning, genetic psychology seems to be the one that is best suited to provide an understanding of how demented patients use their altered intellectual tools in an effort to master the reality of a world that escapes them. From this perspective, the observations of these patients permit a distinction of five classes of spontaneous activities. Moreover, this theory is helpful in understanding the patient's movements in space, no longer represented internally as a global entity. In occupational therapy workshops, the analysis of the tasks proposed to patients reveal two types of learning, one in which the repetition of the elementary actions is the only causal link with the construction of the object, the other in which a causal sequence of several stages of activity is necessary to reach this goal. Furthermore, within the framework of this theory, it is possible to identify the support necessary to carry out the objectives, in spite of the memory deficits. The social interaction between two patients jointly solving the same task seems to favour learning. Thus, learning remains possible, inasmuch as the channels still open are detected and the ways to use them are defined.