What Is A Cognitive Disorder And How Is It Treated?
Cognitive disorders (CDs) are a category of mental health conditions that affect a person’s mental abilities, such as problem-solving, memory, learning, and perception. They may also be referred to as neurocognitive disorders. While gradual mental decline can be a normal part of aging, once it progresses to the point that you or your loved ones notice that something may be wrong, it could be a mild cognitive impairment (MCI). Read on to learn more about MCIs and what treatments may be available.
When does normal aging become mild cognitive impairment?
While some gradual cognitive deficits are a normal part of aging, these typically shouldn’t significantly impact your overall daily functioning. If you notice that you’re experiencing difficulty with recognition, long-term memory, or decreased intelligence, you may want to speak with your healthcare provider for a mental workup to evaluate your cognitive functioning and see if an MCI might be affecting you.
Some serious cognitive disorders that may result from an MCI that escalates include:
- Dementia, the term used to describe a decline in mental function that is significant enough to interfere with a person’s daily living and ability to care for themselves
- Amnesia, or amnestic syndrome, which refers to the loss of memories or the inability to retain new memories
- Delirium, which generally refers to a significant change in mental ability, symptoms of which often include confused thinking and a lack of awareness of surroundings
- Alzheimer’s disease, a progressive disease that involves the degeneration of the parts of the brain controlling thought, memory, and language, eventually interfering with the ability to complete even simple tasks
How are cognitive impairments diagnosed?
Before diagnosing an MCI, a healthcare professional will typically begin by conducting a thorough review of an individual’s medical history to help eliminate treatable causes for the cognitive impairment. You and possibly your close friends or family may be asked about changes in your ability to function during daily activities. Your healthcare provider may also order blood tests, brain scans, and various screenings to help evaluate your current level of cognitive functioning and any potential underlying causes.
In some cases, an MCI is caused by another treatable disease or condition such as low blood sugar, high blood pressure, dehydration, or other medical issues. Its effects can often be mitigated or reversed in these cases. If not, an MCI is generally considered an early indicator of more significant CDs. That’s why older adults are generally encouraged to see their doctor every 6–12 months for checkups and to track changes in memory/cognitive skills.
“Identifying pending cognitive impairment at an early stage has become an increasingly important challenge to physicians. Decades ago, it was satisfactory to distinguish dementia from typical cognitive aging, but in recent years, the desire to make a more fine-grained decision on incipient disease has become apparent”, say the authors of a paper about evaluating MCI subtypes.
Potential signs and symptoms of mild cognitive impairment
According to the Cleveland Clinic, some of the typical symptoms of a mild cognitive impairment can include the following. Note that while these can all be normal parts of aging, they may be a sign of an MCI when they begin to significantly interfere with daily functioning.
- Memory loss, which may include frequently misplacing items, repeating the same questions or stories, and forgetting names of close friends and family or important appointments, events, and conversations
- Complex decision-making, which can manifest as having difficulty with complex but routine tasks like taking medication, paying bills, or driving
- Language problems, such as difficulty finding the right word or trouble understanding verbal or written information
- Reasoning and judgment, meaning that it may become more challenging to make plans and decisions and execute sound judgment
- Attention, meaning you may notice that you need more time to focus and find yourself frequently distracted, sometimes in the middle of an activity
Can cognitive impairments be prevented?
The exact cause of cognitive disorders isn’t known. However, many healthcare professionals recommend that older adults aim to keep their minds limber along with their bodies in an effort to help prevent them from developing. This might include establishing a daily routine, learning a new skill, getting involved in activities that stimulate the mind and body, spending time with friends and family, reducing stress, sleeping and eating well, exercising, moderating alcohol use, and controlling high blood pressure, among other preventative measures.
Treatment for cognitive impairments
Some studies suggest that cognitive behavioral therapy (CBT) may be a feasible treatment for the anxiety often associated with dementia. Because psychotherapy helps stimulate the brain, it may also be another way to keep your mind active and help preserve memory. Otherwise, aside from the potential helpfulness of the preventative measures listed above, there are no approved medications or standard treatments for MCIs at this time.
As mentioned previously, there may also be other medical causes for cognitive issues. If any are revealed through testing and evaluation, your healthcare provider should arrange for the appropriate treatment. For example, research shows that hypertension, smoking, and diabetes can contribute to cognitive decline, all of which may be responsive to certain treatments and/or lifestyle changes. Certain medications can also influence mental functions, so it can be helpful to speak to your doctor about your pharmaceutical regimen to determine if you may be experiencing any adverse reactions or side effects.
Tips for caring for someone with an MCI
It can be frightening when cognitive decline begins to affect a loved one. There are few tips to keep in mind for those who spend time with and/or provide care for someone who has been diagnosed with a mild cognitive impairment. First, you might endeavor to learn everything you can about their condition, how it works, and what you can expect. If it’s the type of MCI that could possibly escalate into a more serious cognitive condition, you may need to prepare for this.
Building a support network, reviewing legal documents, making safety adjustments to their home, and devising a care plan can all be important steps should their condition begin to progress. Encouraging them to pursue healthy habits like those listed previously in this article could potentially also help slow the progression of the impairment. Finally, seeking therapy for yourself as a way to preserve your own mental health may be helpful too. Details on different therapy formats are written below.
How therapy may help with cognitive disorders
Again, experiencing some level of gradual cognitive decline is a typical part of aging. However, certain practices and lifestyle changes may help mitigate these effects or potentially prevent them from worsening into an MCI or other condition. Therapy is one preventative measure to consider. Since high or chronic stress levels may contribute to cognitive decline, engaging in therapeutic treatment to reduce these can be helpful, for instance. Therapy can also be thought of as a way to engage the mind, which is another recommended preventative measure.
Virtual therapy platforms have become an increasingly popular choice for those who want to seek therapy, with many individuals citing convenience, affordability, and scheduling flexibility as its key advantages. It may also be a convenient choice for older adults who can no longer drive themselves to and from appointments, or who live in rural areas where they cannot get adequate mental health care. If you’re interested in trying online therapy, a platform like BetterHelp may be worth considering. With a service like this, you can fill out a brief questionnaire about your needs and preferences and get matched with a licensed therapist accordingly. You can then meet with them via phone, video call, and/or online chat.
A 2021 study measured the effectiveness of internet-based cognitive behavioral therapy (CBT) via Zoom technology for older adults with mild cognitive impairment. Though the study size was small, 67% of participants said the virtual therapy was both easy to use and effective. Participants also said the convenience of being at home was a “tremendous plus”, and that they enjoyed interacting with others experiencing similar issues in the group setting. Another study of online CBT for older adults (without cognitive impairment) showed a significant improvement in psychological distress, high participation levels and satisfaction, and sustained outcomes.
Takeaway
What does an impairment in the cognitive process of learning look like?
Differences in individual cognition can result in significant disparities in how cognitive disorders present. Many types of cognitive disorders can interfere with learning. Two of the most well-known, dyslexia and dyscalculia, refer to neurobiological disorders that interfere with a person’s ability to read or perform mathematical calculations.
Dyslexia and dyscalculia are sometimes used as catch-all terms to represent several different presentations of reading and mathematical impairments. The most commonly known form of dyslexia, in which letters appear jumbled or reversed, is not the only presentation of the condition. Both reading and math disorders usually result in slower skill acquisition and reduced ability. In some cases, children with either condition may fall significantly behind their peers in school.
How do you deal with someone with cognitive disorders?
There are many types of cognitive disorders, and symptoms can differ considerably from person to person. For example, communicating with someone who has a mild cognitive impairment - an early stage of dementia - often requires giving the person ample time to respond, while communicating with someone who has advanced dementia may be entirely nonverbal.
Cognitive disorders are any disorder that significantly impairs some part of a person’s cognition. They affect all ages and can have a myriad of effects. A person might struggle to remember things, understand abstract concepts, gain academic skills, or find social interaction challenging. While there is no one-size-fits-all approach to interacting with a person who has a cognitive disorder, the following general tips might be helpful:
- Learn as much as you can about how the person communicates.
- Be patient, giving them plenty of time to process what you say and form a response.
- Speak slowly and clearly, and make eye contact if the other person is comfortable.
- Treat the person with respect and dignity.
What is cognitive disorder NOS?
Cognitive disorder NOS is an outmoded diagnostic term for mild cognitive impairment (MCI). The NOS stands for “not otherwise specified,” the term was used in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) as a label for cognitive disorders that did not fit cleanly into other diagnostic categories.
The fifth edition of the DSM (DSM-V) removed “not otherwise specified” as a diagnostic category and replaced the “cognitive disorders” category with “neurocognitive disorders” (NCDs). MCIs (which are not a diagnostic term) are now termed “mild NCDs,” whereas more severe conditions are considered “major NCDs.”
What are some of the signs that an individual might be developing cognitive issues?
Some degree of cognitive decline is normal as a person ages, but if the decline reaches a point where it interferes with daily living, it may represent a loss of cognitive function greater than what is normal. Dementia, most notably Alzheimer’s disease, represents the most severe cognitive impairments due to age. In between normal decline and dementia is mild cognitive impairment, which can often be thought of as early-stage dementia.
The difference between dementia and mild cognitive impairment is how severely the cognitive issues affect the person’s life. Some common signs of cognitive decline are below; if the decline is sudden or severe, it may represent a cognitive impairment:
- Increased forgetfulness, difficulty keeping appointments, and difficulty managing time.
- Repeating questions or comments at a higher rate.
- Increased difficulty finding common words or communicating their thoughts.
- Decreased alertness and increased distractibility.
- Increased difficulty completing tasks with multiple steps.
- Increased impulsiveness or recklessness.
How does cognitive impairment affect everyday life?
Cognitive impairments affect people differently depending on their presentation and severity. Some impairments may be relatively minor and have little impact on a person’s everyday life, while others may be so severe that the person requires around-the-clock care.
For example, a 70-year-old with a mild cognitive impairment - also called pre-clinical dementia - may need to start writing notes or reminders to remember things, but they can still function independently. In contrast, a 32-year-old who has experienced a severe traumatic brain injury may struggle to use language or complete basic tasks and may require significant assistance to complete daily routines.
Is cognitive impairment the same as learning disability?
Cognitive impairments and learning disabilities are both cognitive deficits, but those and other terms are commonly confused. “Cognitive impairment” is often used to refer to an intellectual disability, a condition associated with impaired general intelligence.
“Learning disability” usually refers to a condition that affects specific neurocognitive systems, although “intellectual disability” is sometimes included as a type of learning disorder. For example, dysgraphia - a type of specific learning disability that affects handwriting - only affects the parts of the brain that are associated with writing.
Learning disabilities also tend to be developmental, meaning they can improve over time, especially with intervention. Not all cognitive impairments are developmental. Dementia, for example, is an ongoing progressive decline that cannot be reversed, but it may be possible to slow the progression.
Can someone with mild cognitive impairment live alone?
Someone with a mild cognitive impairment can likely live alone. One of the key distinguishing features between mild and major cognitive impairments is the degree to which a person’s independence is affected. By definition, mild cognitive impairments do not interfere with the capacity for independence in everyday activities. If a person cannot live independently, they likely meet the criteria for a major neurocognitive disorder rather than a mild cognitive impairment.
Is cognitive impairment permanent?
The source of cognitive impairment determines whether it is permanent. Those with impairments due to genetic disorders, like Fragile X syndrome, are permanent and lifelong. In contrast, impairments due to brain damage, often from a traumatic brain injury or illness like meningitis, can improve considerably as the person heals.
The evidence is unclear regarding whether age-related cognitive impairment is permanent. It is normal for everyone to experience a cognitive decline as they age, but if the decline is faster than average, it might be diagnosed as a mild cognitive impairment. If the decline is especially quick or severe enough to interfere with daily functioning, it may be a sign of dementia. Dementia is typically irreversible, although it may be possible to slow its progress. In contrast, there is some evidence to suggest that the symptoms of mild cognitive impairment can be improved.
Is cognitive impairment a normal change that comes with aging?
Some degree of cognitive decline is a normal part of aging. Most people experience more challenges with memory, abstract thought, and language usage as they age. Normal levels of age-related decline are typical and not associated with a diagnosable condition. However, if the decline becomes noticeable to others or severe enough to interfere with a person’s life, the cognitive impairment may represent a disorder.
Cognitive decline that occurs faster than average but does not interfere with independence is often referred to as mild cognitive impairment or a mild neurocognitive disorder. Mild impairments are often the early stages of dementia, and intervening early may help slow the decline. If cognitive impairment is severe enough to interfere with a person’s ability to complete everyday tasks, dementia or some other pathology is likely the cause.
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