Basic Cognitive Impairment Disorders

Discuss basic cognitive impairment disorders. Include the areas in which some people are more vulnerable than others. Also include signs and symptoms as well as causative factors.

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o Dementia. A chronic and progressive deterioration of brain function marked by impairment of memory (all cases involve amnesia), confusion and the ability to concentrate. In most cases, dementia is difficult to treat and becomes progressively worse over time. Patients initially may forget only recent memories, but as the disease progresses older memories may also be impaired. Patients may also fail to recognize familiar objects (agnosia), have trouble freely conversing (aphasia), fail to perform certain motor acts (apraxia) or have trouble performing complex behaviors (loss of executive functioning). Dementia typically develops gradually and is most often found in elderly people.

o Amnesia. Involves a significant loss of memory , although there is no associated loss of other cognitive functions as there is with dementia. Amnesia can be devastating to those with the condition. Patients may even forget events that took place only a few minutes earlier. Another type of amnesia called dissociative amnesia is a separate condition that occurs when a person loses memories related to a traumatic event (e.g., war or abuse).

o Cognitive disorders, not otherwise specified (NOS). Includes cognitive impairment that is thought to result from a general medical condition or substance use and does not fit into the other categories.


A wide variety of factors can lead to cognitive disorders. Delirium is usually the result of an underlying brain condition, especially a lack of oxygen to the brain (hypoxia). Conditions such as acute meningitis or encephalitis (infections of the brain) are also associated with delirium, as are general medical conditions, use of certain medications, intoxication with or withdrawal from drugs and/or alcohol, or exposure to toxins. Delirium usually reverses itself with successful treatment of the underlying medical disorder that triggered the condition.

Dementia is often the result of a condition that impairs the blood vessels or nerve structures in the brain. In some cases, these conditions are treatable, as is often the case with normal pressure hydrocephalus (brain disorder caused by blockage in the flow of cerebrospinal fluid), brain tumors and certain metabolic causes and infections. Research also indicates that people who consume regular quantities of omega-3 fatty acids (naturally found in fish and flaxseed) are much less likely to develop dementia than those who do not. More often, disorders that cause dementia are largely untreatable and irreversible.
The two major sources of dementia are Alzheimer's disease (a progressive, degenerative brain disease that accounts for more than half of all cases of dementia, according to the American Psychiatric Association [APA]) and vascular dementia (loss of brain function due to a series of small strokes). The two conditions often strike at the same time.

Many other conditions also can cause dementia, including:

o Head trauma.
o Infection with human immunodeficiency virus (HIV).
o Huntington's disease. A progressive disorder involving wasting (degeneration) of nerve cells in the brain.
o Creutzfeldt-Jakob disease. Also known as "mad cow disease," a neurodegenerative disease caused by a protein-like particle called a prion.
o Parkinson's disease. Disease associated with damage to a part of the brain involved with movement.
o Pick's disease. Disease similar to Alzheimer's that tends to affect only certain areas of the brain.
o Substance abuse.

Amnestic disorder (amnesia) can be caused by a general medical condition (such as a physical injury, chronic alcoholism or vitamin deficiency) or by use of certain substances, including medications such as sedatives, hypnotics and anxiolytics. ...