06 Dec Mind Matters: Examining Cognitive Impairment and Dementia
Cognitive impairment is decline in memory and thinking abilities. It involves problems with memory, judgment, or language.
If you’re suffering from memory problems, you might think about these questions such as, do you keep forgetting names? Do you forget addresses you had no problem remembering before?
Are you having a hard time remembering things where you kept them? If these are some issues you’re going through, you can visit a neuropsychiatrist in Patna, Dr. Vivek Pratap Singh.
Cognitive Impairment vs Dementia
Cognitive impairment can be defined as an early stage of brain function decline. While dementia is severe cognitive impairment affecting memory function, thinking, behavior, and multi-tasking abilities.
Mild cognitive impairment consists of
- Inability to remember messages, lists and minor things
- Trouble finding the right word to say
- Difficulty doing a task but can manage
- Can manage alone with basic needs
Dementia consists of
- Inability to remember events and places
- Major difficulty finding the right word
- Cannot handle tasks alone
- Dependent on someone else
Dementia spans a group of diseases as a symptom. Diseases like Alzheimer’s disease are the most common reason for dementia.
It is a severe form of disorder with other symptoms such as confusion, memory problems, mood changes and communication difficulties.
Dementia symptoms get worse over time and eventually the individual needs assistance for basic tasks.
Mild cognitive impairment does not manifest as severely as dementia. It is a mild impairment in thinking and behavior. It can be causes by underlying conditions such as
- Depression, and stress
- Vitamin deficiency
- Infections
- Thyroid disorders
- Autoimmune conditions
The average age for mild cognitive impairment ranges from 65 years. As one grows older, the brain function declines.
Signs and Symptoms
There is disruption in brain function, and as age increases people become more forgetful and lucid.
The cognitive decline symptoms can be attributed to underlying medical comditions. Sometimes, individual may experience more than normal memory deficits like
- Forgetting things frequently
- Cannot remember social events or appointments
- Trouble remembering the train of thought
- Difficulty remembering the address
- Inability to make judgement
Along with these symptoms, people might even have
- Depression
- Anxiety
- Lack of motivation
- No kmterest
Most cases, mild cognitive impairment can lead to depressive episodes and anxiety. The people get worried and irritated when they cannot remember numbers and small details.
How fast does mild cognitive impairment progresses?
The mild cognitive impairement might remain stable for years, but eventually it can progress to developing Alzheimer’s disease. It takes around two to five years on average to progress to dementia. These changes can involve
- Lumps of beta-amyloid protein called plaques, and tau-protein tangles.
- Other microscopic protein clumps called lewy bodies, associated with Parkinson’s disease.
These people suffer from visuospatial and language deficits, and executive dysfunction. Other neuropsycjiatric symptoms such as
- Behavior disturbance
- Mood disorders
- Psychosis
- Altered alertness or awareness
- Tremor
- Parkinson features
- Seizure-like activities
The cognitive impairment examples can be the disorders like prion diseases is one of the most common disorders that rapidly progress to dementia.
It reaches the level of dementia within one to two years. Other disorders like lewy body dementia, frontotemporal dementia, dementia die to causes shch as infectious, toxic metabolites, or psychiatric illness.
The cognitive decline normally starts from older age such as when one reaches over 60. However, nowadays a lot of individuals have been identified who have started showing cognitive decline in quite a young age.
The cognitive decline in 20s can manifest as subtle signs like
Struggling to stay on top of things affecting the brain’s processing speed, attention, planning, judgement, and organisation. The brain’s corticolimbic system regulates stress and anxiety which is responsible for this decline.
It gets difficult to find the roght words and even simple things like a kitchen appliance, and eventually one has to describe it. Over time, this can gradually progress to failing to keep up with the conversations that leads to anxiety.
A sudden decreased interest in activities that you loved and enjoyed is a common symptom of dementia. The things that were easy to accomplish, and now you’re finding it overwhelming to achieve.
Usually, individuals react to this by detaching themselves which results in condition getting worst.
Personality changes can be a subtle indication of cognitive decline. They will start withdrawing and won’t participate in social activities and conversations.
The cognitive impairment may be further diminished because of functional disabilities like
- Agnosia – inability to find objects in spite of intact memory function.
- Apraxia – inability to perform motor functions that were previously learnt
- Aphasia – inability to use language
Moderate dementia individuals are unable to recall new information and cannot learn new information.
They don’t remember some of the events that happened and might confuse it with the past. These individuals go through personality changes becoming self-centered and inflexible.
They even have changes jn their behavior leading to wandering around, hostile, getting irritated suddenly, and even physically aggressive.
End-stage dementia incolves individuals needing complete assistance with walking, feeding, or activities of daily living.
They are at risk of severe disorders such as pneumonia (due to aspiration) and pressure ulcers because of bed-ridden individuals.
Diagnosis
To confirm mild cognitive impairement, the neurophysicians might conduct some history taking to know their behavior and personality changes.
They even order some laboratory tests and neuroimaging to see if there are major changes such as atrophy, or hyperteophy in brain matters.
At times, there are presence of some proteins and diagnostic bodies in CT or MRI scans.
If the cognitive impairement is not severe enough to interfere with daily functions, it can be diagnosed as mild. However, when the person’s memory, and intellectual ability is limited there might be some degree of confusion.
To confirm the impairment, it should involve either two or more than two aspects from the following:
- Inability to acquire and remember the new information
- Inability to handle complicated tasks and poor judgment
- Inability to remember words or form language
- Personality with behavior changes
- Inability to recognize faces or objects
The mini-mental status is the approved screening test for people with dementia. The best cognitive impairment test is screening for memory like looking at 3 objects and then recalling it after 5 minutes.
Lab tests are used for diagnosis such as
- CBC
- Kidney and liver function tests
- Biomarkers for alzheimer’s disease
These tests can confirm the diagnosis of dementia and cognitive impairment. CT or MRI can detect the brain changes and can provide us with differentials.
How to help someone with cognitive impairment?
Mild cognitive impairement treatment depends upon the causes and care.
The approved medication for Alzheimer’s is aducanumab in some cases of Alzheimer’s because of it’s removal of amyloid plaques. However, it has not shown any improvement at slowing the cognitive decline.
Lecaneman is another one of the medication under trial, that has shown promising results. Cholinesterase inhibitors like donepezil, rivastigmine, and galantamine have been effective in improving cognitive function.
Sometimes, taking certain medications can have some side effects like benzodiazepines, anticholinergics leadjng to sode effects like anxiety, seizures or sleep disturbances.
Other reversible causes of mild cognitive impairment can be treated to prevent severe memory like
High blood pressure causes issues with the blood vessels in the brain and might lead to memory loss.
Depression can cause the memory to become foggy and forgetful. This is a very common symptom for MCI and treating depression might improve the symptoms.
Along with this the treatment shoucld include
- Ensuring the safety of the individual
- Eradicating medications with severe side effects
- Providing with caregivers
- End-of-life care arrangements
The individual’s safety is the foremost priority and responsibility. The family and close relatives can care for them, or provide them with 24/7 caregiver who can assist them with daily needs and tasks. The safety measures includes
- Preventing falls and accidents
- Managing aggressive behavior
Checking for how the person is around the house, and outside can help with knowing what measures to take.
If you feel the person is at risk of harming themself, then hiding the knives, unplugging the stove, hiding the car keys, removing things that can be hsed as weapons. These are some of the measures that can be adapted to help.
Mild cognitive impairement is a serious condition affecting the older age group causing memory problems. This can progress to dementia when not teated adequately.
Dementia manifests with worsening cognititive symptoms that can eventually lead to oatient being bed-ridden, inability to do anything without assistance.
Diagnosing it in early stages can somehwat prevent its progression to serious symptoms.
If you think your close relative is showing signs of dementia, get the neuropsychiatric illness treatment in Patna, Dr. Vivek Pratap Singh.
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