Why can't patients with psychosis of dementia learn reality?

Patients with psychosis of dementia are unable to learn or grasp reality primarily due to severe cognitive damage associated with the progression of the dementia. Dementia, which affects memory, thinking, and reasoning skills, leads to significant impairments that alter an individual’s perception of reality. As cognitive function deteriorates, individuals may struggle to form new memories or accurately perceive their environment, making it increasingly difficult for them to understand or accept reality as it is.

While other factors like interest, choice, or medication might influence a person's engagement with reality, the fundamental issue in patients with dementia is their compromised cognitive abilities. This cognitive damage is a direct result of the neurodegenerative processes inherent to dementia, which impacts their overall ability to process information and respond to external stimuli accurately. Thus, the major barrier to learning reality lies in the severe cognitive impairment rather than a lack of interest or choice.