The sense of humor in people with dementia may change over the course of the disease.

A recent study in the United Kingdom asked the primary caregivers of people with different subtypes of dementia — frontotemporal, semantic, progressive non-fluent aphasia (speech disorder), and Alzheimer's disease — to rate how much the participants liked and were exposed to different types of humor. The caregivers also had to indicate their humor preferences and exposure 15 years earlier, before they received a dementia diagnosis. Another group of healthy older adults served as the control group, and they answered the same survey themselves.

Studies in Changing Senses of Humor

The authors of the study distinguished between three common categories of comedy with examples: slapstick such as Mr. Bean; satire such as Yes, Minister; and absurdist Monty Python. They also employed several neuropsychological tests to evaluate each participant's performance in tasks that tap into particular cognitive skills.

Patients with all the subtypes of dementia liked slapstick humor more than they had 15 years earlier while showing less appreciation for satire and absurdist humor compared to healthy participants of the same age. This study did not find any correlations between changes in humor preference and disease severity or cognitive ability.

Other studies have shown that changes in sense of humor relate to aging in general without dementia. For example, older adults have been found to prefer nonsense humor that is surprising but does not make sense (such as a cartoon of a teacher wearing a gorilla suit), as opposed to humor that involves surprise and makes sense (a cartoon of a teacher hiding under a desk after giving out final grades).

Some studies have also found correlations between age-related changes in the ability to understand and appreciate different types of humor and performance on cognitive tasks such as mental flexibility and verbal fluency.

Still others have also found that certain brain regions are especially implicated in processing humor. Those using functional magnetic resonance imaging have shown that the brain's frontal and temporal lobes seem to be activated differently when people process humorous material versus neutral material. This is consistent with the dysfunction that occurs in frontal and temporal regions in both aging and dementia. Changes in sense of humor, especially in the ability to understand or appreciate certain types of humor, in dementia patients could indicate underlying changes in brain function, not just indirect changes in mood and personality.

How Humor Helps

Older people may be especially likely to use humor as a coping mechanism. Some institutions are incorporating comedy into therapeutic interventions for patients who have dementia. Being sensitive to dementia-related changes in humor may help caregivers understand and support people with dementia by selecting cognitively appropriate humor content to help alleviate stress and improve quality of life.