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Dementia is a disorder which manifests as a set of related symptoms, which usually surfaces when the brain is damaged by injury or disease. The symptoms involve progressive impairments in memory, thinking, and behavior, which negatively affects a person's ability to function and carry out everyday activities. Aside from memory impairment and a disruption in thought patterns, the most common symptoms include emotional problems, difficulties with language, and decreased motivation. The symptoms may be described as occurring in a continuum over several stages. Consciousness is not affected. Dementia ultimately has a significant effect on the individual, caregivers, and on social relationships in general. A diagnosis of dementia requires the observation of a change from a person's usual mental functioning, and a greater cognitive decline than what is caused by normal aging. Several diseases and injuries to the brain, such as a stroke, can give rise to dementia. However, the most common cause is Alzheimer's disease, a neurodegenerative disorder.
Cognition refers to "the mental action or process of acquiring knowledge and understanding through thought, experience, and the senses". It encompasses all aspects of intellectual functions and processes such as: perception, attention, thought, intelligence, the formation of knowledge, memory and working memory, judgment and evaluation, reasoning and computation, problem solving and decision making, comprehension and production of language. Imagination is also a cognitive process, it is considered as such because it involves thinking about possibilities. Cognitive processes use existing knowledge and discover new knowledge.
Delirium is an organically caused decline from a previous baseline of mental function that develops over a short period of time, typically hours to days. Delirium is a syndrome encompassing disturbances in attention, consciousness, and cognition. It may also involve other neurological deficits, such as psychomotor disturbances, impaired sleep-wake cycle, emotional disturbances, and perceptual disturbances, although these features are not required for diagnosis.
Dementia with Lewy bodies (DLB) is a type of dementia characterized by changes in sleep, behavior, cognition, movement, and regulation of automatic bodily functions. Memory loss is not always an early symptom. The disease worsens over time and is usually diagnosed when cognitive impairment interferes with normal daily functioning. Together with Parkinson's disease dementia, DLB is one of the two Lewy body dementias. It is a common form of dementia, but the prevalence is not known accurately and many diagnoses are missed. The disease was first described by Kenji Kosaka in 1976.
Vascular dementia (VaD) is dementia caused by problems in the supply of blood to the brain, typically a series of minor strokes, leading to worsening cognitive abilities, the decline occurring piecemeal. The term refers to a syndrome consisting of a complex interaction of cerebrovascular disease and risk factors that lead to changes in brain structures due to strokes and lesions, resulting in changes in cognition. The temporal relationship between a stroke and cognitive deficits is needed to make the diagnosis.
Neuropsychological tests are specifically designed tasks that are used to measure a psychological function known to be linked to a particular brain structure or pathway. Tests are used for research into brain function and in a clinical setting for the diagnosis of deficits. They usually involve the systematic administration of clearly defined procedures in a formal environment. Neuropsychological tests are typically administered to a single person working with an examiner in a quiet office environment, free from distractions. As such, it can be argued that neuropsychological tests at times offer an estimate of a person's peak level of cognitive performance. Neuropsychological tests are a core component of the process of conducting neuropsychological assessment, along with personal, interpersonal and contextual factors.
Cognitive disorders (CDs), also known as neurocognitive disorders (NCDs), are a category of mental health disorders that primarily affect cognitive abilities including learning, memory, perception, and problem solving. Neurocognitive disorders include delirium, mild neurocognitive disorders, and major neurocognitive disorder. They are defined by deficits in cognitive ability that are acquired, typically represent decline, and may have an underlying brain pathology. The DSM-5 defines six key domains of cognitive function: executive function, learning and memory, perceptual-motor function, language, complex attention, and social cognition.
The Mini–Mental State Examination (MMSE) or Folstein test is a 30-point questionnaire that is used extensively in clinical and research settings to measure cognitive impairment. It is commonly used in medicine and allied health to screen for dementia. It is also used to estimate the severity and progression of cognitive impairment and to follow the course of cognitive changes in an individual over time; thus making it an effective way to document an individual's response to treatment. The MMSE's purpose has been not, on its own, to provide a diagnosis for any particular nosological entity.
Clouding of consciousness occurs when a person is slightly less wakeful or aware than normal. They are not as aware of time or their surroundings and find it difficult to pay attention. People describe this subjective sensation as their mind being "foggy".
Cognitive deficit is an inclusive term to describe any characteristic that acts as a barrier to the cognition process.
Mild cognitive impairment (MCI) is a neurocognitive disorder which involves cognitive impairments beyond those expected based on an individual's age and education but which are not significant enough to interfere with instrumental activities of daily living. MCI may occur as a transitional stage between normal aging and dementia, especially Alzheimer's disease. It includes both memory and non-memory impairments. The cause of the disorder remains unclear, as well as both its prevention and treatment, with some 50 percent of people diagnosed with it going on to develop Alzheimer's disease within five years. The diagnosis can also serve as an early indicator for other types of dementia, although MCI may remain stable or even remit.
The MCI Screen is a brief neuropsychological test checking for mild cognitive impairment (MCI).
Psychological therapies for dementia are starting to gain some momentum. Improved clinical assessment in early stages of Alzheimer's disease and other forms of dementia, increased cognitive stimulation of the elderly, and the prescription of drugs to slow cognitive decline have resulted in increased detection in the early stages. Although the opinions of the medical community are still apprehensive to support cognitive therapies in dementia patients, recent international studies have started to create optimism.
Elizabeth Kerr Warrington FRS is a British neuropsychologist specialised in the study of dementia. She holds a PhD in Psychology visual processing and is now an emeritus professor of clinical neuropsychology at the University College London. She formerly worked as the Head of the Department of Neuropsychology at the National Hospital for Neurology and Neurosurgery where she is also a member of the Dementia Research Centre. She was made a Fellow of the Royal Society in 1986.
Alzheimer's disease (AD) is a neurodegenerative disease that usually starts slowly and progressively worsens. It is the cause of 60–70% of cases of dementia. The most common early symptom is difficulty in remembering recent events. As the disease advances, symptoms can include problems with language, disorientation, mood swings, loss of motivation, self-neglect, and behavioral issues. As a person's condition declines, they often withdraw from family and society. Gradually, bodily functions are lost, ultimately leading to death. Although the speed of progression can vary, the typical life expectancy following diagnosis is three to nine years.
The General Practitioner Assessment of Cognition (GPCOG) is a brief screening test for cognitive impairment introduced by Brodaty et al. in 2002. It was specifically developed for the use in the primary care setting.
The Montreal Cognitive Assessment (MoCA) is a widely used screening assessment for detecting cognitive impairment. It was created in 1996 by Ziad Nasreddine in Montreal, Quebec. It was validated in the setting of mild cognitive impairment, and has subsequently been adopted in numerous other settings clinically. This test consists of 30 points and takes part in 10 minutes from the individual. The Montreal test is performed in seven steps, which may change in some countries dependent on education and culture. The basics of this test include short-term memory, executable performance, attention, focus and more.
Although there are many physiological and psychological gender differences in humans, memory, in general, is fairly stable across the sexes. By studying the specific instances in which males and females demonstrate differences in memory, we are able to further understand the brain structures and functions associated with memory.
The Addenbrooke's Cognitive Examination (ACE) and its subsequent versions are neuropsychological tests used to identify cognitive impairment in conditions such as dementia.
Sex differences in cognition are widely studied in the current scientific literature. Biological and genetic differences in combination with environment and culture have resulted in the cognitive differences among men and women. Among biological factors, hormones such as testosterone and estrogen may play some role mediating these differences. Among differences of diverse mental and cognitive abilities, the largest or most well known are those relating to spatial abilities, social cognition and verbal skills and abilities.
References
- ↑ EL, Teng; Al., Et (2018-12-06). "The Cognitive Abilities Screening Instrument (CASI): a practical test for cross-cultural epidemiological studies of dementia". International Psychogeriatrics. 6 (1): 45–58, discussion 62. doi:10.1017/S1041610294001602. PMID 8054493. S2CID 25322040.
- ↑ KN, Lin; Al., Et (2018-12-06). "[Cognitive Abilities Screening Instrument, Chinese Version 2.0 (CASI C-2.0): administration and clinical application]". Acta Neurologica Taiwanica. 21 (4): 180–9. PMID 23329550.
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