Cognitive impairment

Cognitive deficit

Psychiatry

Cause[edit]

Cognitive impairments may be caused by many different factors including environmental factors or injuries to the brain (e.g. traumatic brain injury), neurological illnesses, or mental disorders.[2] While more common in elderly people, not all people who are elderly have cognitive impairments.[2] Some known causes of cognitive impairments that are more common in younger people are: chromosomal abnormalities or genetic syndromes, exposure to teratogens or birth-defect causing agents while in utero (e.g. prenatal exposure to drugs), undernourishment, poisonings, autism, and child abuse.[2] Stroke, dementia, mental health disorders such as depression or schizophrenia, drug, substance, or alcohol abuse, brain tumours, nutritional deficiencies or malnutrition, brain injuries, hormonal disorders, and other chronic disorders may result in cognitive impairment with aging. Cognitive impairment may also be caused by a pathology in the brain. Examples include Alzheimer's disease, Parkinson's disease, dementia caused by HIV, Lewy Body dementia, Huntington disease.[2]


Short term cognitive impairments can be caused by pharmaceutical agents or drugs such as tranquilizers or sedatives.[2]

Screening[edit]

Screening for cognitive impairment in those over the age of 65 without symptoms is of unclear benefit versus harm as of 2020.[6] In a large population-based cohort study included 579,710 66-year-old adults who were followed for a total of 3,870,293 person-years (average 6.68 ± 1.33 years per person), subjective cognitive decline was significantly associated with an increased risk of subsequent dementia.[7]


In addition to a series of cognitive tests, general practitioner physicians often also rely on clinical judgement for diagnosing cognitive impairments.[8] Clinical judgement is ideal when paired with additional tests to that permit the medical professional to confirm the diagnosis or confirm the absence of a diagnosis.[8] Clinical judgement in these cases may also help inform the choice in additional tests.[8]

Treatment[edit]

Deciding on an appropriate treatment for people with cognitive decline takes clinical judgement based on the diagnosis (the specific cognitive problem), the person's symptoms, other patient factors included expectations and the person's own ideas, and previous approaches to helping the person.[8]

Other findings[edit]

Although one would expect cognitive decline to have major effects on job performance, it seems that there is little to no correlation of health with job performance. With the exception of cognitive-dependent jobs such as air-traffic controller, professional athlete, or other elite jobs, age does not seem to impact one's job performance. This obviously conflicts with cognitive tests given, so the matter has been researched further. One possible reason for this conclusion is the rare need for a person to perform at their maximum. There is a difference between typical functioning, that is – the normal level of functioning for daily life, and maximal functioning, that is – what cognitive tests observe as our maximum level of functioning. As the maximum cognitive ability that we are able to achieve decreases, it may not actually affect our daily lives, which only require the normal level.[9]


Some studies have indicated that childhood hunger might have a protective effect on cognitive decline. One possible explanation is that the onset of age-related changes in the body can be delayed by calorie restriction. Another possible explanation is the selective survival effect, as the study participants who had a childhood with hunger tend to be the healthiest of their era.[10]

Prognosis[edit]

When a person's level of cognition declines, it is often harder to live in an independent setting and some people have trouble taking care of themselves and the burden on the people caring for them can increase. Some people require supportive healthcare and in some cases institutionalization.[5]

Research[edit]

The role of light therapy for treating people with cognitive impairment or dementia is not fully understood.[11][12][13][14]

PASS Theory of Intelligence

Fluid and crystallized intelligence

Dementia

Das, J.P.; Naglieri, J.A.; Kirby, J.R. (1994). Assessment of Cognitive Processes. Needham Heights, MA: Allyn & Bacon.  0-205-14164-1.

ISBN

Das, J.P. (2002). A better look at intelligence. Current Directions in Psychology, 11, 28–32.

Goldstein, Gerald; Beers, Susan, eds (2004). Comprehensive Handbook of Psychological Assessment: Volume I: Intellectual and Neurological Assessment. Hoboken, NJ: John Wiley & Sons.

Kaufman, Alan S. (2000). "Chapter 20: Tests of Intelligence". In (ed.). Handbook of Intelligence. Cambridge: Cambridge University Press. pp. 445–476. ISBN 978-0-521-59648-0.

Sternberg, Robert J.

Naglieri, Jack A.; Otero, Tulio M. (2012). "Chapter 15: The Cognitive Assessment System: From Theory to Practice". In Flanagan, Dawn P.; Harrison, Patti L. (eds.). Contemporary Intellectual Assessment: Theories, tests, and issues (Third ed.). New York: . pp. 376–399. ISBN 978-1-60918-995-2. ERIC ED530599.

Guilford Press

Sattler, Jerome M. (2008). Assessment of Children: Cognitive Foundations. La Mesa (CA): Jerome M. Sattler, Publisher.

Urbina, Susana (2004). . John Wiley & Sons. ISBN 978-0-471-41978-5.

Essentials of Psychological Testing

Urbina, Susana (2011). "Chapter 2: Tests of Intelligence". In ; Kaufman, Scott Barry (eds.). The Cambridge Handbook of Intelligence. Cambridge: Cambridge University Press. pp. 20–38. ISBN 978-0-521-73911-5.

Sternberg, Robert J.