Cognitive Impairment

Cognitive Impairment

Alternate Names

  • cognitive disorder
  • cognitive disability

Definition

A cognitive impairment means that a person is not able to think, remember, and process information in a manner or at a rate that falls within the normal limits for the person's age and level of education or training.

What is going on in the body?

A person can be born with a cognitive impairment. In this case, it is usually termed mental retardation. It may result from a birth injury, such as a lack of oxygen. It may also result from a defect as the baby was formed. A cognitive impairment also may occur later in life, following an injury or as part of a disease.

Risks

What are the causes and risks of the condition?

A cognitive impairment may be present when a child is born, which is known as mental retardation. It may also be the result of:
  • abuse of prescription medicines, chemicals, street drugs, or alcohol
  • a disease, such as Alzheimer disease
  • a side effect of some medicines
  • a trauma such as head injury
Frail, elderly people who are removed from a familiar setting often develop cognitive problems. This may occur when they go to a hospital because of illness or when they are moved to a nursing home. Depending on the cause, cognitive impairments may be temporary or permanent.

Prevention

What can be done to prevent the condition?

Cognitive impairment can occur at any age and cannot always be prevented. However, the following measures may be helpful:
  • avoiding illegal drugs
  • drinking alcohol in moderation or not at all
  • following sports safety guidelines for children, adolescents, and adults
  • obtaining prenatal care during pregnancy
  • using medicines only as directed

Diagnosed

How is the condition diagnosed?

In some cases, mental retardation can be diagnosed at birth. An infant with Down syndrome, for example, is often identified by characteristic features. The diagnosis is confirmed with a chromosome analysis.
Other tests used to diagnose cognitive impairments or their causes include:
  • cognitive testing, which provides information about the individual's memory and thinking skills
  • cranial CT scan
  • cranial MRI
  • spinal tap

Long Term Effects

What are the long-term effects of the condition?

A person with cognitive impairment can often live a nearly normal life. He or she can learn ways to deal with disability and take part in many activities. He or she may become so good at this that others may not notice the impairment. Even if the impairment is severe, rehabilitation therapy can help many people learn to function independently.

Other Risks

What are the risks to others?

Cognitive impairments are not contagious and pose no risk to others.

Treatments

What are the treatments for the condition?

After a cognitive impairment has occurred, there may be ways to improve the problem. If the cause is known, it can sometimes be eliminated. In this case, the symptoms may improve without further treatment. Professionals involved in the treatment of cognitive problems may include psychiatrists, psychologists, rehabilitation nurses, physical therapists, occupational therapists, and speech therapists.
Therapy may help improve thinking skills, such as memory, concentration, and problem-solving. Aids such as alarms or earplugs can also be used. If the person has trouble controlling emotions, psychotherapy may help. Controlling the person's surroundings can also help prevent outbursts. Behavior problems may also be helped with cognitive behavioral therapy. Teaching a person how to behave in different situations is useful, as well. If behavior problems are severe, the person may require supervision.

Side Effects

What are the side effects of the treatments?

There are no side effects to these rehabilitation therapies.

After Treatment

What happens after treatment for the condition?

An individual with mild or well-controlled impairments may be able to live alone. He or she may be able to drive, work, and make independent decisions. A part-time helper may be needed for tasks such as money management.
A person who needs regular help usually lives with family members or in residential care. Another option for some people is a group home. This provides the person with help in a shared setting. The individual is still able to retain much of his or her independence. In severe cases, living in a supervised, structured setting, such as a nursing home, may be needed.
A person with cognitive impairment should be treated as normally as possible. If the person requires some help or supervision, it is important for others to know exactly what kind of help is needed. In many cases, the affected person can ask for help. If this is not possible, the healthcare professionals should share instructions with family members and caregivers on how to help or supervise.

Monitor

How is the condition monitored?

An individual with a continuing cognitive impairment needs to make regular visits to his or her healthcare professional, to whom any new or worsening symptoms should be reported.

Sources

Gatens, C&Hebert, A. (1996). Cognition and behavioral patterns. In S. Hoeman (Ed.), Rehabilitation nursing: process and application. St. Louis: Mosby.

Preston, K. (2000, March). Neuropsychologic function. Seminar session presented at Professional Rehabilitaiton Nursing Course, Association of Rehabilitation Nurses, Chicago.

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