Cognitive disorder is a broad term referring to the impairment of one or all of a person’s thinking or cognitive skills.
Cognitive disorders used to be referred to as “organic mental disorders”, a term indicating the biological basis of the disorder. However, the term “organic” was removed because it suggested that disorders outside this category fall outside of a biological basis.
Causes of Cognitive Disorders
Cognitive disorders can be caused by one of many issues including:
- Head injuries
- Genetic factors
- Exposure to neurotoxins
The kind of cognitive disorder a person develops will depend on what part of their brain is affected. For example, if a tumor grows in the speech centers of the brain, it will result in communication issues. A genetic issue impacting the hippocampus will affect a person’s ability to remember.
Are Cognitive Disorders Reversible?
Cognitive disorders can be set into two categories: reversible and irreversible disorders.
Some reversible disorders can be treated and allow those diagnosed with them to make a partial or full recovery. For example, delirium, pseudodementia, and medical conditions affecting cognitive impairment can typically be treated once properly identified.
Irreversible disorders include Alzheimer’s disease and dementia. Symptoms of these can be managed through therapies, including medication, but a person who has dementia will not be able to return to a previous level of functioning.
Kinds of Cognitive Disorders
There are several disorders that fall into the cognitive category, which we’ll outline below.
Dementia is a broad term referring to any syndrome characterized by more than one cognitive deficit. A person with dementia may suffer from impaired memory, language skills, orientation, judgment, or executive functioning.
Dementia is most often the result of Alzheimer’s Disease, Vascular Disease (including strokes and mini-strokes), or Lewy Body disease.
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Alzheimer’s Disease is not a natural part of the aging process; it is a devastating degenerative cognitive disorder that eventually robs most patients of their ability to remember, speak, or care for themselves.
While many people find they become more forgetful as they get older, forgetting specific dates or fine details, Alzheimer’s Disease takes issues like forgetfulness and takes them far further. Indeed, it is important to be able to characterize the differences between the normal aging process and Alzheimer’s.
Despite the increased focus on the causes of Alzheimer’s, a single cause of the disease has yet to be found.
Between 20 and 30% of all dementia cases are those of vascular dementia.
Vascular Dementia is characterized by impaired blood flow to and in the brain. In some cases, this can occur when blood vessels in the brain become blocked and are unable to pass blood. In some cases, transient ischemic attacks (TIAs) or infarcts, which are most commonly referred to as small strokes, can cause Vascular Dementia.
A single, devastating stroke can also cause dementia; though, not all major strokes will lead to post-stroke dementia.
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Lewy Body Dementia
Alzheimer’s Disease and Vascular Dementia are the two best-known types of dementia. However, there is a third major type known as Lewy Body Dementia.
The prevalence of Lewy Body Dementia is difficult to grasp because Lewy bodies, which characterize this cognitive disorder, are also heavily associated with other diseases. Thus, it can be difficult to determine whether the dementia is directly associated with Lewy bodies and whether it is distinguishable from other conditions.
Lewy bodies are deposits of proteins (alpha-synuclein) that have been misfolded inside of neurons, which are found in the brain in addition to the spinal cord. The formation of Lewy bodies in the brain can create symptoms similar to Parkinson’s disease in addition to creating problems in memory, thinking, learning, and perception.
Lewy bodies are also found in the brains of those diagnosed with Parkinson’s Disease, and they can also sometimes be found in Alzheimer’s patients.
Pseudodementia is a reversible cognitive disorder in which a person with depression has a cognitive impairment masking itself as dementia.
Sometimes, depression has cognitive symptoms that go beyond a loss of interest in life, social withdrawal, and sleep and appetite issues. It can also create symptoms like difficulties concentrating, thinking clearly, and making decisions, all of which may be mistaken for signs of mild cognitive impairment or dementia.
Distinguishing between dementia and pseudodementia is often done using the Geriatric Depression Scale. The results are compared with a person’s medical history and an assessment of their cognitive functioning to determine whether another type of dementia may be setting in or whether it is pseudodementia.
Delirium describes a sudden and dramatic change in a person’s ability to focus their attention. The change is so great that those affected may find themselves confused as to where they are or what day it is.
Delirium is a reversible cognitive disorder caused by a condition that may either alter the level of neurotransmitters in the brain or may disrupt the brain’s metabolism. It can be caused by general medical conditions like meningitis, endocrine disorders, hypothermia, heat stroke or urinary tract infections.
Medical Conditions Causing Cognitive Disorders
Several medical conditions can cause cognitive disorders; though, many of these are reversible.
Thyroid issues, malnutrition, dehydration, infections, and the side effects of some medications can all result in cognitive impairment.
Reversing the cognitive impairment involves a full diagnostic workup to determine the cause of the impairment, and finding the precise cause may require exploring several potential explanations before finding the correct diagnosis.
Traumatic Brain Injury (TBI)
Traumatic Brain Injuries (TBI) occur when the brain experiences an injury after physical trauma.
Car accidents, physical beatings, sports injuries and combat injuries are common causes of TBIs.
There are two types of TBIs: closed head injuries and open head injuries. Closed injuries occur when the brain is injured while inside of the skull, such as if the brain bounces against the side of the skull on impact with another object or as the result of a shock wave.
Open head injuries occur when an object manages to move through the scalp and the skull. It reaches the brain and destroys the brain tissue around the injured area.
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