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Cognitive impairments or cognitive deficits are noted deteriorations in cognitive ability due to or associated with such factors as brain injury, physical illness, mental disorders, stress and aging. The effects may be temporary or long lasting. Such impairments include:


Cognitive dysfunction (or brain fog) is defined as unusually poor mental function, associated with confusion, forgetfulness and difficulty concentrating.[1][2] A number of medical or psychiatric conditions and treatments can cause such symptoms, including heavy metal poisoning (in particular mercury poisoning),[3] menopause,[2] fibromyalgia, mood disorders, ADHD and sleep disorders (including disrupted sleep).[2] The term brain fog is not commonly used to describe people with dementia or other conditions that are known to cause confusion and memory problems,[How to reference and link to summary or text] but it can be used as a synonym for sleep inertia or grogginess upon being awakened from deep sleep.

Case StudiesEdit

There is evidence to indicate that parallel age trends have been similar over a vast amount of time, as with Schaie’s Seattle Longitudinal Study, which contained fifty years worth of data as well as seventy years in Weshsler tests. Studies such as these have proven the different patterns in age trends have two specific patterns in cognition, a constant decrease in measures of processing abilities such as reasoning, and stability followed by a steady decline for knowledge previously acquired. [4]

A twelve year study published in 2012 researched the effects of lifestyle activities on cognitive deficit in the hopes that a long study such as this could, to some degree, help older adults to ward off cognitive decline. The study looked at verbal speed, episodic memory, and semantic memory to be influenced by physical, social, and cognitive activities. The results of the study concluded that maintenance of cognitive functions with normal ageing can be maintained by keeping an active lifestyle. The results also seemed to conclude that the correlation between lifestyle activities and cognition is not a simple one, as not all cognitive abilities were related to changes in the daily activities. Therefore, further research of longitudinal design observing the matches between activities and cognitive abilities in cognitively impaired adults could be critical. [5]

Longitudinal studies using brain imaging have been done in an attempt to note early signs of cognitive decline on healthy individuals before changes noticed clinically occur. In this way the study attempted to find more biomarkers for early onset of degenerative diseases. The results from the study concluded that there are indeed patterns of brain abnormality that can be associated with brain decline. [6]

In a cross-sectional study, researchers investigated patients with mood disorders in comparison with a control group to see if there was a difference on the effect of ageing between the groups. These patients were tested with the Central Nervous System Vital Signs, a neurocognitive battery test. The study examined subjects from ages 18 to 90, noticing a sharp decline in the patients with mood disorder compared to the normal group when subjects were ages 65 and up. These declines were observed in the cognitive areas of attention, executive function, processing speed, and memory. [5]


Other FindingsEdit

Although one would expect cognitive decline to have major affects 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, what cognitive tests observe as our maximum level of functioning. As the maximum cognitive ability we are able to achieve decreases, this may not actually affect our daily lives which only require the normal level. [7]


CausesEdit

There are a broad range of causes of cognitive impairment. Some of the most notable include:

Postoperative Cognitive DysfunctionEdit

Postoperative Cognitive Dysfunction (POCD) refers to cognitive problems (with memory, learning and the ability to concentrate) following surgery. There has been very limited research into POCD, but existing reports suggest that the incidence of POCD increases with age, it can last for long periods of time, with 2–3 months considered long-term.[How to reference and link to summary or text]

POCD has been studied through various institutions since the inception of the IPOCDS-I study centred in Eindhoven, Netherlands and Copenhagen, Denmark. This study found no causal relationship between hypoxia and low blood pressure and POCD. Age, duration of anaesthesia, introperative complications, and postoperative infections were found to be associated with POCD.[How to reference and link to summary or text]

POCD to be differentiated from postoperative delirium has a longer duration and no lability or fluctuations in impaired cognitive functioning. Some patients who demonstrated POCD at 10–14 days were found to have improved scores at 3 months, while others continued to demonstrate POCD at periods longer than 1 year. This suggests that in certain at risk patients, POCD may be a permanent alteration of cognitive functioning.[How to reference and link to summary or text]

Assessment of cognitive impairmentEdit

TreatmentsEdit

Treatment generally involves correcting any underlying medical conditions. For example, if the patient is found to be suffering a form of hypothyroidism, the mental declining effects associated with hypothyroidism can be corrected with thyroid hormone replacement therapy, although many times patients continue to endure confusion and a sense of dementia.[How to reference and link to summary or text] Additionally, occupational therapy may be helpful for some people. Neurofeedback can improve symptoms for some people.[8][9][10]


See alsoEdit

ReferencesEdit

  1. Treating Cognitive Dysfunction ("Brain Fog") in CFS & Fibromyalgia.
  2. 2.0 2.1 2.2 includeonly>Saether, Linda. “A journey of brain fogs and hot flashes”, CNN, 18 April 2008. Retrieved on 3 January 2009.
  3. Frackelton JP, Christensen, RL (1998). Mercury Poisoning and Its Potential Impact on Hormone Regulation and Aging: Preliminary Clinical Observations Using a New Therapeutic Approach. Journal of Advancement in Medicine 11 (1): 9–25.
  4. Gualtieri, C. Thomas, Johnson, Lynda G. (NaN undefined NaN). Age-related cognitive decline in patients with mood disorders. Progress in Neuro-Psychopharmacology and Biological Psychiatry 32 (4): 962–967.
  5. Clark, Vanessa H., Resnick, Susan M.; Doshi, Jimit; Beason-Held, Lori L.; Zhou, Yun; Ferrucci, Luigi; Wong, Dean F.; Kraut, Michael A.; Davatzikos, Christos (NaN undefined NaN). Longitudinal imaging pattern analysis (SPARE-CD index) detects early structural and functional changes before cognitive decline in healthy older adults. Neurobiology of Aging.
  6. Salthouse, Timothy (10 January 2012). Consequences of Age-Related Cognitive Declines. Annual Review of Psychology 63 (1): 201–226.
  7. Thatcher RW (January 2000). EEG operant conditioning (biofeedback) and traumatic brain injury. Clin Electroencephalogr 31 (1): 38–44.
  8. Thornton K (December 2000). Improvement/rehabilitation of memory functioning with neurotherapy/QEEG biofeedback. J Head Trauma Rehabil 15 (6): 1285–96.
  9. http://www.isnr.org/uploads/(1-1)4.pdf
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