#they might take me forever (even just this one took me a million years dfjkhfdfd)

[cry-stars]

Komaeda and Dementia: Part 1 of 5: Introduction and Overview of FTD

Hi everyone!

I’m an aspiring Komaedologist with an interest in dementia. I often see people doubting Komaeda’s stated diagnosis of frontotemporal dementia, since it presents differently in him than in the common portrayal of dementia in the media. While his portrayal may not be completely accurate, there is a lot of truth to it, and there are many symptoms visible in-game. I wanted to share a few posts about dementia symptoms that we do see canonically in Komaeda’s portrayals in SDR2 and DR:AE, and share some information regarding his specific diagnosis as opposed to Alzheimers, for example.

I work with people living with dementia as a recreation worker. This means that I see them living their daily lives, and know about difficulties they might have with recreational or day to day activities. There are a lot of observations that I might make that can’t be backed up scientifically yet, but do make sense in a practical way. Everyone with dementia is different, and since I work with seniors for the most part, some observations won’t transfer onto Komaeda. However, I’ll do my best to back up whatever I can with sources.

This post is just for fun and to give people ideas. It means a lot to me to see a fascinating and endearing character like Komaeda portrayed with dementia, since it is a sad and terminal disease, and I usually see it end badly in my job, so I hope to give people ideas on how to portray it, or just to notice things in a different way they might not have before!

My main sources for this post and the following ones include “Dementia Diaries,” which is a really cool project where people with dementia talk about their experiences, National Institute on Aging, Alzheimer’s Association, Alzheimer’s Society, and my own work experience. I plan on doing more posts about specific symptoms that we see in Komaeda later, but I would be happy to hear from other people who have dementia knowledge, or to answer any questions that I can.

For the most part, I'm only going to be talking about SDR2 and a little bit of DR:AE. I haven't finished watching the anime yet and have not read any of the manga. If anyone has ideas from any of those sources, I would love to hear about them!

Overview of FTD: Which Variant does Komaeda Have?

There are two major forms of frontotemporal dementia. The first, which Komaeda likely has, is the behavioural variant (BvFTD), which is also the most likely for young people to develop. This variant of FTD mainly affects behaviour, empathy, judgement, and planning.

Komaeda is less likely to have the other variant of FTD, primary progressive aphasia. This form of FTD mainly affects language skills, including speech and comprehension.

Komaeda doesn’t seem to have very much trouble with understanding the concrete content of what people say to him, but he does occasionally seem to have trouble fully comprehending hidden meanings behind statements (for example, taking statements literally rather than as sarcastic). To me though, this is less connected to him not being able to understand the words or content of statements, and more not picking up on the emotions hidden in the statements (which I’ll address more in the behavior post). He does seem to have some trouble with word-finding in the Japanese version of the game, but again, it doesn't inhibit his ability to express himself given enough time to speak.

Another thing to note about FTD is that, in its early stages, it mainly affects behaviour and language processing, as stated above, rather than memory. In later stages, memory does start to be affected as well, but it’s different from Alzheimers (probably the most well-known form of dementia) in that memory loss isn’t the main symptom.

FTD’s prognosis is about 6-8 years. Komaeda states in his fifth free time event that his life expectancy is between half a year and one year. However, he is also referring to his lymphoma diagnosis, meaning he expected to die from a combination of both illnesses within that time frame. In SDR2, Komaeda is probably in the early to middle stages of FTD, since he was diagnosed right before entering Hope’s Peak, and was a Remnant of Despair for some time without treatment, so while we can see evidence of memory issues (which I will address in another post), it’s something he’s able to cope with and isn’t a debilitating symptom yet.

One more observation: while dementia as a whole is usually seen in elderly people, Komaeda’s specific frontotemporal dementia diagnosis has an earlier age of onset, usually between ages 40-65, and is rarely seen in elderly people. Even though being diagnosed in high school seems unlikely, it is not impossible. According to Alzheimer Society Canada, early-onset or young-onset dementia (between ages 18 and 65) accounts for 2-8% of all dementia cases.

Thank you for reading! I plan on making five posts total. The other post topics will be Outward Behaviour, Judgement/Thought Processes, Other Symptoms, and Writing Ideas.