Cognitive impairment is the medical state of reduced ability for the brain to perform tasks as it was intended. In practical terms, this means that cognitive impairment can range from difficulty with planning out motor moves requiring a lot of dexterity after a neck injury to deficits in memory, visual perception, or processing speed. There are many cognitive disorders and mental impairments, and they can take on many different forms.
In this article, we’ll give you a high-level overview of what is cognitive impairment, what impairments are linked to specific head for neck injuries, and what kind of mild cognitive impairments are a result of old age rather than injury.
We’ll also take a look at a few of the cognitive impairment tests and offer a few tell-tale signs which you could use to see whether you might be affected by cognitive impairment.
What Is Cognition?
Before we can get into deep detail about cognitive impairment, we should first define cognition so that we’re clear on the terms. Cognition comprises the acquisition, storage, manipulation, and internal processing of information to effect an internal change which can then affect an external result. In short, most of the actions we take as human beings require cognition, whether it’s remembering to cross off all the items on our grocery list or adding two plus two in our heads.
Scientists and members of the public break cognition down into a few core parts, with Oxford’s cognition definition including:
- Information acquisition
- Information transcription into long term memory
- Working memory
- Processing of the contents of working memory
- Comparing the results of processing of working memory materials with long term memory
- Modifying another piece of the cognitive chain or memory in light of the processing
- Planning to use the processed elements of the cognitive chain to effect an external change
Cognition has a lot of moving parts, and there’s an entire field of the science behind it: cognitive science. If it’s ever unclear whether a certain cognitive deficit is based on physical or on psychological factors, there’s a good chance that a cognitive scientist has examined the question in great detail.
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What Damages Cognition?
The brain is easy to damage, and with damage to the brain comes damage to cognition. Damage to cognition results in impaired memory, which we call amnestic cognitive impairment. There are other disabilities associated with impaired cognition, but the inability to maintain a firm flow of events bridging past to present to future is particularly harmful.
When we discuss cognitive impairment, we can trace its cause to one of three sources: physical damage, chemical damage, and damage caused by aging.
Aside from obvious extreme damage to the brain like TBI, less destructive brain injuries like concussions from playing sports can damage cognition, too. Given enough knocks to the head, football players develop what is called Mild Cognitive Impairment, which is abbreviated to MCI.
MCI results in slowed cognition, difficulty reading, difficulty with short term memory, anger, aggression, difficulty sleeping, and confusion between things like left and right. Depending on the exact locations of the brain which were abused the most in MCI, additional impairments may crop up.
If you’re an aggressive football or hockey player and you feel like you’re not at your mental peak, you probably have cognitive impairment as a result of repeated physical damage to your brain.
Just as common as physical damage causing cognitive impairment is chemical damage. The chemical damage that causes mild cognitive impairment could be the result of years of drug abuse, particularly drugs that are rough on the serotonergic and dopaminergic neuronal systems.
In general, everyone’s brain encounters some degree of chemical damage which causes mild cognitive impairment transiently at one point or another. Drinking alcohol is a short term experience in cognitive impairment, and it shows: drinking is associated with slower cognition, worse working memory, increased aggression, euphoria, and also lasting changes on the brain’s reward system which may result in differential preference of certain cognitive pathways to the detriment of the brain’s function.
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Everyone is familiar with the idea that those who are old aren’t as mentally quick or mentally powerful as they used to be. The reasons for these impairments are varied but may be caused by Alzheimer’s disease, which can be thought of as systemic build up of cognition-impairing plaques.
For most people, geriatric damage based cognitive impairment is the result of a long life, and there’s little to be done to mitigate the accumulated impacts of wear and tear on the brain. Living a life that’s full of intellectual challenges and problems to solve seems to be an effective way to mitigate or slow down some of the onsets of Alzheimer’s but all brains age, and all aging brains become impaired.
Testing For Cognitive Impairment
There is a battery of tests that doctors and scientists use to determine whether someone is experiencing cognitive impairment. Some of these tests are very simple, whereas other are more involved and may require brain imaging in addition to interviews.
In general, the test used for cognitive impairment will be specific to the suspected cause of impairment. This means that the test administered after a concussion will be much different from a frailty test administered to an older adult. If you suspect that you have a cognitive impairment, don’t be afraid if your doctor asks you a battery of questions culminating in imaging for your brain.
Interviewing patients allows doctors to hone in on the areas of specific impairment, and a subsequent brain scan allows for confirmation of the intuitions generated during the interviews. Though cognitive impairment can’t always be cured, there are many interventions that show at least some effectiveness, so don’t lose hope.
If you suspect that you are suffering from cognitive impairment, ask your friends and relatives. If they agree that you’ve been acting a bit strange recently, it may be time to head to your doctor for a full assessment and starting on a course of treatment.