 Dementias are a family of neurodegenerative disorders, culminating in Alzheimer's disorder. It is the brain shutting down, incrementally, gradually, sometimes imperceptibly, but always inexorably. There is no way to stop it, no one knows why it starts, there are various hypotheses, but there's no cure, and no way to stop this train from reaching its final destination. The process is terrifying to behold, and even more terrifying to experience. To understand dementia, I would recommend that you watch two movies, one The Father with Anthony Hopkins and the other one, Still Alice. Put these two movies together and you get a perfect picture of the process and how it unfolds in that sanctum of our identity, of our essence, in the whole, the shrine of who we are, the brain. Imagine a smartphone, iPhone 20, the greatest smartphone ever. It includes your photo library, all your memories are there, videos, books, you name it, and then one day it breaks, it becomes a brick, you can't access it, there's no way to break into it, to penetrate it, to revive it, to resuscitate it, nothing works. No technology lab, no hacker, it's gun and done, it's as good as trash. Or imagine waking up from your sleep in terror confronting a hideous monster, but you're actually not awake, this is a nightmare within a nightmare, within a nightmare, you believe yourself to be awake but you're actually still asleep, and you can't stop this nightmare from happening, it weighs on your chest and it threatens to suffocate you. These two similes or metaphors are dementia, this is how dementia is felt. I'm going to read to you a brief description from Psych Central, an article titled The Aging Narcissist Adding Dementia to the Mix. What seemed natural and habitual now becomes foreign and difficult, memory becomes scattered and unreliable, familiar people become strangers or even enemies that are out to get you. Narcissists typically struggle to remember even recent events, accidentally send too much money to an electrical company or get lost easily in new locations, this applies to all dementia patients. Mass work tasks become too difficult, memory deficiencies become significant as even common tasks such as cooking, dressing or grooming require some sort of assistance. No longer able to care for themselves and having embarrassing problems such as eating or bowel control, delusional thinking, watching something on TV, believing they're actually doing it, this all leads to anger, outbursts and these are common as are paranoid delusions. Little to no communication, psychomotor skills or walking, they all deteriorate, everything requires assistance and the narcissist is a shell of what they once wear, no longer able to recognize themselves or others, all the narcissistic symptoms have disappeared along with their personality. I'm going to delve a bit deeper of course in this video and back it up with literature but this is a very painful and hurtful topic. I'm 62 years old, I'm experiencing cognitive decline, I don't think it amounts to dementia but I may be in denial, I'm not quite sure. I am, there's nothing that terrifies me more than this and I mean nothing, I've done it all, I've been everywhere, I've experienced everything, I believe and nothing terrifies me more than this. The deficit in cognitive functioning is probably owing to a life-long stress and anxiety, hormones flood the blood and affect every tissue in the human body, the brain not accepted. The narcissist and to a very large extent the psychopath and the borderline are in the throes of perpetual stress and anxiety, anticipation of the worst, catastrophizing. They can't cope with this so they have these defenses that we are all by now familiar with but the stress and the anxiety masked as they are still exact a horrible price. Dimensions are exactly like modification because they involve public shaming and public humiliation in front of significant others, that's exactly the definition of narcissistic modification. So you can imagine what dementia does to the narcissist's mind, pushes him over the edge beyond the border, he becomes utterly decompensated, dysregulated, he falls apart in disintegrates internally long before the dementia reaches its apex in the brain the narcissist's mind gives up. Now when I say he, it's a she and she it's a he, clear, half of all narcissists are women. The narcissist typically, the first reaction is to conceal, to hide, to prevaricate, to confabulate, to bridge over the memory gaps, to pretend that mishaps and mistakes and accidents were all intentional, part of a mega plan, the narcissist's mega plan, this mastermind at work and of course this resembles gaslighting a lot, the narcissist's nearest and dearest, his family members, friends and so on, they believe he's gaslighting them, he's not gaslighting, he is simply desperately trying to hide his condition from them, and to do so he needs to reframe and falsify reality first and foremost to himself. Self-deception long precedes other deception in narcissism generally and especially in conditions of dementia. Dementia challenges the narcissist's bulwark, the narcissist's foundation, the narcissist's pivot and axis, his grandiosity, the cognitive distortion that falsifies reality in a way that supports an inflated fantastic self-image and self-deception. Dementia challenges always, for example, failing to remember things doesn't sit well with omniscience, knowing all knowing, knowing all, yeah, being godlike, being perfect doesn't sit well with needing assistance in the toilets, so dementia penetrates these defenses, invades the narcissist's firewall and his ability, intrudes upon his ability to maintain the delusion, the facade, the shared fantasies with everyone, he can't do this anymore because even he can't deny and repress what's happening to him. He is no longer omnipotent, he is no longer omniscient, he is far from perfect, dementia is the ultimate in imperfection, he is not so brilliant as he believed himself to have been, he is nothing and nobody deteriorating into the abyss and the void of his own absence and the darkness of the black hole and the void that he has been all his life. Normal healthy people, when they experience dementia, they have a fallback option, their true self, who they've always been, this kernel, this nucleus actually never disappears, but not so with the narcissist, the minute the dementia abscondes with the narcissist's envelope with his delusion, nothing is left behind, that is the shocking thing for family members and friends and colleagues and so on, the narcissist simply vanishes, hoof evaporates, smoke and mirrors, it's all been a carnival act, this becomes utterly clear, unambiguous and unequivocal in the wake of dementia in its aftermath, the narcissist first tries to conceal and to hide and to pretend and to fake and to claim that everything is planned and mastered and controlled by him, it's part of a master plan and then when this doesn't work anymore, as it never does, the narcissist begins to withdraw, he begins to avoid triggers and reminders of his own frailty, vulnerability, dependency, lack of autonomy, declining agency, disappearing cognitive function, he develops a series of unsustainable strategies, isolating himself, the clinical term is constriction, constricting his life, limiting it, narrowing it until he's on the point of vanishing altogether, he avoids people, he avoids places, he avoids situations, he avoids reminders, he avoids certain words, he avoids certain novels, he avoids certain movies, he shuns certain music and gradually nothing is left, withdrawal and avoidance give place to depression and grief, narcissism as I've been saying a long time is a prolonged grief disorder, the child traumatized and abused child begins to grieve itself having committed essentially mental suicide, having sacrificed the true self to the new monarch, to the new god of the false self, the child grieves its own demise and so the child adult turned narcissist is in the throes of grief anyhow, depression is a constant companion of narcissistic personality disorder in various forms and for various reasons, I have a video here about the three depressions of the narcissist but this becomes much more pronounced, much more debilitating, much more all-consuming and all-pervasive in dementia, the narcissist goes through catatonic depression, he never, he never gets gets up, he never washes himself, he never, he refuses to eat, he refuses to watch television, he refuses to talk to people, he grieves, he mourns, he he's withers, he withers and shrivels and it's very painful, even to people who hate the narcissist, even to people who have been wronged by the narcissist, the angry the narcissist, it's still very painful to watch this gradual disintegration, decomposition, decay, decadence and decline, there's a loss of independence involved in dementia, there's a need for assisted care even in the early stages, this way dementia challenges everything the narcissist has ever been, what is a narcissist if not a narrative, it's a story, it's a piece of fiction, it's a movie script, it's a theatre play, it's not a human being, there's nobody there, it's a non-entity, it's an absence masquerading as a play, it's it's nothingness in the bad sense of the world, it's vacuum and so take away the omnipotence and you expose the vulnerability, the underbelly of the narcissist, his non-existence, how can a non-existent person or non-entity, how can this thing, whatever it is, affect others, influence them, be admired and adulated by them, the narcissist charade is exposed, revealed, dementia is like an investigative journalist, it exposes the narcissist's stratogens, storylines, fiction and BS and the narcissist cannot stand it because there's nothing else except this and frustration breeds aggression, agitation, impatience, alloplastic defenses, the narcissist begins to blame other people which leaves him very fast to paranoid ideation and rage in a desperate attempt to make sense of everything that's happening to him, the narcissist says others are to blame, he's always been saying this throughout his life, alloplastic defenses, others are to blame, he's being perhaps poisoned or maybe people are putting him under stress on purpose or maybe the whole thing is engineered in order to get rid of him and put him in a senior's home, senior's home or something, there's paranoid ideation, there's a conspiracy, malign intent, he develops referential ideation, everyone is talking about him, everyone is mocking him behind his back and that creates huge bouts of rage, the likes of which by the way have never occurred before, the narcissistic rage in dementia is the most explosive form of rage there is, the narcissist becomes defiant and conchumacious as a last hurray, hurrah, a last attempt to demonstrate his superiority, his omnipotence, he hortily and arrogantly rejects for example his medical doctors, berates and demeans them and devalues them, he refuses medical treatment as a way to demonstrate his omniscience, he knows everything better than his own doctors, he becomes conchumacious, he rejects authority and expertise, at this stage the role of secondary supply is crucial, secondary supply to remind you is the recounting of glories past, the reminiscences, the remembering of the narcissist past successes and so this is what a faithful spouse does with the narcissist, she records everything, remembers it, records it and then in times of deficient supply or when the narcissist is experiencing collapse or modification or extreme injury, the loyal faithful loving caring spouse tells him do you remember how great you are, do you remember this accomplishment, this victory, this triumph etc etc, she is like an external hard disk, a battery and she recharges the narcissist with secondary narcissistic supply, secondary narcissistic supply becomes the only form of supply in dementia, the narcissist can no longer garner or secure narcissistic supply from the outside, he is pitiable, the only emotions he provokes in other people are pity or derision or contempt or disgust, that hardly constitutes narcissistic supply, he cannot even make other people be afraid of him, fear him, so he needs secondary supply, he needs his nearest and dearest and loved ones, whatever that means, his insignificant others, his intimate partners, he needs them to keep telling him how great he is because of how great he has been, narcissistic, then he needs them to release the memories of past erstwhile narcissistic supply in lieu of and substitute to real fresh narcissistic supply, and the narcissist develops at this late stage of dementia, he develops selective memory, his narcissists often remember clearly events, circumstances, even days related to the island of stability, you remember the concept of the island of stability, the narcissist has one area of life to which he is dedicated, so he is dedicated to his marriage and all the rest is an ocean of chaos, his marriage is an island of stability and can last 40-50 years, but all the rest in his life is chaos, he goes to prison, he goes bankrupt, you know he changes jobs and so on, or vice versa, his career is the island of stability and he ascends, the corporate ladder becomes chief executive officer after 45 years, but in the meantime he divorces and remarries 19 times, so there's always an island of stability, dementia brings out the island of stability, the narcissist focuses on the island of stability and it helps him to elicit, to dredge up, to bring up to the surface memories of time past, now to some literature, Bastida and others, article title disorder of the personality, a possible factor of risk for dementia, you can find all the references in the literature, the authors say definitely the patients with medical record of borderline or narcissistic personality disorder present more alterations in brain structures such that presenting these types of personality disorders could increase the risk of developing dementia in the future, the article is from 2019, another article Poletti, Bonuccielli and others forgive the names, the article is titled from narcissistic personality disorder to frontotemporal dementia, a case report and I'll read to you from the article, premorbid personality characteristics could have a pathoplastic effect on behavioral symptoms and personality changes related to neurodegenerative diseases, patients with personality disorders in particular of the dramatic cluster B may present functional frontal limb bink, frontal limb bink abnormalities, can these neurobiological vulnerabilities linked to a premorbid personality disorder predispose or represent a risk factor to subsequently develop a neurodegenerative disorder, ask the authors are subjects with personality disorders more at risk to develop a dementia than mentally healthy subjects, this topic is discussed presenting the clinical case of a patient who suffered of a suffered or a probable narcissistic personality disorder subsequently develop a clinically diagnosed frontotemporal dementia, interesting case study, another article, Austin journal of clinical neurology 2015 titled narcissism vulnerability as risk factor for Alzheimer's disease a prospective study authored by Daniel Serrani from Argentina of all places and he says and I'm going to read extended segments from this article, it's a great review of literature and I thought it's very I found it a very insightful article, in this study a clear association was disclosed between elders with high scores in pathological narcissism and greater risk for Alzheimer's disease for vulnerable narcissism etc etc findings were somewhat comparable when enter entered the loan or in conjunction with other npi subscales, results remain significant even after depression was inserted in the model and the same could be said regarding cognitive function, the predictive value of narcissistic grandiosity was not apparent when all subscales were entered simultaneously suggesting that narcissistic vulnerability is an independent risk factor, some authors further distinguish between grandiosity and vulnerability in narcissism, the first associated with overt expressions of grandiose fantasies, arrogance and self entitlement, the latter vulnerability with themes of fragility depletion and feelings of inadequacy, although patients may exhibit both aspects of narcissistic personality others could probably express only one of those facets much of the time, that's my dominant dominant time for example narcissistic vulnerability being more at risk, okay so they go on and on in the in the article and their conclusion is our findings suggest that elevated scores in narcissistic vulnerability traits may be an important factor for dementia and I really recommend to read this article it's available online full text and I think it throws very interesting light on the connections between various types of narcissism, other factors including lifestyle factors and dementia, it was published in 2015 so it's relatively recent, that's it the narcissist in decline the aging narcissist the disappearing narcissist dementia eats him up the way he has done to other people throughout his life finally the narcissists have come across a worthy adversary and none of his strategies and none of his this one none of his defenses can work function dementia is going to have the upper hand on the narcissist and realizing this many narcissists give up on themselves and give up on life and give up on others and yet even this is not enough