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If you've ever known someone with dementia, you're probably aware that they often "lose their filter" and come out with weird statements. A new study found that dementia can alter someone's sense of humor well before diagnosis.

"Hahahaha, so she'll be visiting her husband soon then," a woman I take care of told me — loudly — during the funeral of a nursing home neighbor, to which I was accompanying her because she is in a wheelchair. "I hope they won't fight like they used to!", she exclaimed, followed by more hysterical laughter. It was inappropriate; everyone could hear what she said. 

As a caregiver, this was hardly the first time I witnessed strange, embarrassing, and at the same time also slightly funny statements made by older people. The fact that senior citizens can, as some say, "lose their filters" and say whatever comes into their heads is well known. The lady in question used to be exactly that — a lady, prim and proper. A few months after she thought her neighbor's funeral was funny, she was diagnosed with dementia. 

Are the humorous statements made by older people in any way significant? In fact, according to a study conducted by researchers from the University College London, patients with frontotemporal dementia were shown to have developed an increasingly odd sense of humor as their symptoms worsened

In hindsight, their caregivers noted that an alteration in dementia patients' senses of humor was among the first signs of their disease. 

The lead author, Dr Camilla Clark, and her colleagues selected 48 patients with different types of dementia from their University College London dementia clinic. Their caregivers — a cohabiting spouse in many cases, children, other relatives or friends in others — were asked to complete questionnaires relating to the sense of humor the dementia patients displayed, and how it had altered over the last 15 years. 

Amazingly, nearly all who answered the questionnaire reported that their loved-ones with dementia had undergone changes in their sense of humor in the nine years prior to the diagnosis. Darker, more warped kinds of humor were more appreciated by people with dementia. In particular, the study found that "Patients with [behavioral variant frontotemporal dementia] were significantly more likely to express humor in situations not generally considered humorous". They tended to find tragic situations exactly like the funeral I mentioned above funny, in other words. 

Dr Clark mentioned that we're talking about "marked changes — completely inappropriate humor well beyond the realms of even distasteful humor. For example, one man laughed when his wife badly scalded herself."

Why does this happen? Frontotemporal dementia, which is among the least common kinds of dementia, affects the part of the brain that processes behavior and personality. As the disease sets in, patients can become increasingly impulsive, lose their inhibitions, and become unable to cope with interpersonal situations in socially acceptable manners. 

An altered sense of humor was displayed well before diagnosis, usually triggered by more easily recognizable symptoms, in both patients with Alzheimer's Disease and frontotemporal lobar degenerations. While the study's authors recognize limitations in the form of a small sample and the fact that the information was gathered on the basis of self-reporting, the findings may help medical professionals recognize dementia earlier in the future by paying attention to changes in older people's sense of humor.

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