Bouts of forgetfulness are normal, whether it’s leaving your charger at home or forgetting your boss’ birthday. Many of us also get into the occasional slump and struggle to sustain attention. However, when these difficulties become increasingly common and start to interfere with your productivity at work or the quality of your social life, it’s time to see if you are experiencing a cognitive deficit.
Cognitive function refers to a range of mental processes that involve the acquiring, storing, processing and retrieval of information. Those who suffer from cognitive deficit may struggle with various mental tasks such as memory, problem solving, attention or judgment. There are various types of cognitive impairment, and the terminology is often haphazardly used. For the sake of clarity, this article will separate cognitive impairment into 4 tiers: Cognitive Deficit Disorder, Mild Cognitive Impairment, Symptomatic Cognitive Impairment, and Sub-Clinical Cognitive Impairment. If you are under 50, the first two tiers are unlikely.
This resource is aimed at helping you navigate the levels of cognitive impairment, figure out if they are applicable to you, and provide guidelines to improve and prevent a cognitive deficit.
Tiers of Cognitive Impairment:
Clinical Deficit as a Disorder
The most severe form of cognitive impairment can be categorised as a disorder and is in most cases irreversible, although some treatments can help curb decline. There are a variety of causes for this condition.
Some people are born with cognitive deficits, which can range from an overall intellectual disability or specific cognitive abilities being impaired such as limitation in learning as is the case with dyslexia. You may, however, even as an adult, be undiagnosed. So, this is nevertheless an important point to note when understanding learning in adults.
Age-related disorders like dementia are usually highly noticeable to the sufferer as well as those around them. There will be a significant depletion in function that will have a profound impact on daily activities such as going shopping, commuting to work or remembering details about one’s own identity.
Other cognitive disorders are the result of neurophysiological changes from physical trauma, significant malnutrition or substance abuse. These are usually obvious and can be seen on brain scans. After substance abuse or physical trauma, it is usually a part of routine testing when visiting your doctor.
Mild Cognitive Impairment
If your memory, attention or performance at work is more subtly impaired, you may be suffering from Mild Cognitive Impairment (MCI). MCI can be seen as a halfway house between expected age-related cognitive decline and dementia. What differentiates MCI from dementia or Alzheimer’s is that daily activity is not affected and usually only one or two areas of cognitive function are affected. People with MCI are unlikely to have a significant case of identity confusion. There are numerous tests that can indicate cognitive impairment. MCI is not necessarily degenerative, in fact, 1 out of 5 people diagnosed with MCI actively improve their cognitive functioning and go back to ‘normal’ within 3 to 4 years of diagnosis. Therefore, it is important to visit your doctor to receive appropriate treatment.
MCI is age-related, however, not every person suffers from MCI as they age. Similarly, those with poor mental health, infections, vitamin or hormone deficiencies are more likely to get MCI and at an earlier age.
Symptomatic Cognitive Impairment
A variety of physical conditions such as diabetes and thyroid disease list cognitive decline (often colloquially referred to as “brain fog”) as a common symptom. Taking the appropriate medication and treatment for these conditions should reduce or eliminate this impairment altogether.
Poor mental health can also affect cognition. Mood disorders such as recurrent depressions, anxiety and bipolar disorder can affect various areas including paying and sustaining attention, memory, and recall of information, critical thinking, and even hand-eye coordination. Studies have shown that even in cases where individuals ‘beat’ depression or have a handle on their mental health, cognitive issues can persist in periods of remission from low mood or mental illness. It can take time for things to return to normal. In these cases, Cognitive Remediation Therapy or CRT is often recommended. CRT involves various ‘intervention’ strategies to improve the process of thinking to repair compromised cognition.
Those who suffer from sleep apnea (a condition where your breathing repeatedly stops and starts during sleep) can also struggle with focus and memory, which should improve with treatment.
Sub-Clinical Cognitive Impairment
If you are more forgetful than usual, fatigued, struggling to concentrate or less sharp than usual, but don’t have an underlying health issue, it might be time to prioritise holistic wellbeing. Health — both mental and physical is a spectrum, as is cognitive impairment. Cognitive function should improve concurrently in taking care of your physical and mental health. Due to its sub-clinical nature, there is no diagnosis for this. Rather, it may be time to make some lifestyle changes or take a serious vacation.
Treatment and Prevention
Although there are specific treatments and medications available for those struggling with cognitive deficit disorder or other mental and physical conditions, the following tips are advisable for everyone — those struggling with sub-clinical impairment as well as those with dementia.
Exercise
Exercise has a positive impact on cognition in both the long- and short-term. The instant effect of exercise is significant — and it doesn’t require an intense session of cardio. Findings from the University of California show how connectivity between areas of the brain responsible for memory formation and storage increased after just 10 minutes of light exercise — slow walking, tai chi or yoga.
Numerous studies have also shown the long-term physiological changes to the brain from those who exercise regularly. The parts of the brain that control memory and thinking — the medial temporal cortex and the prefrontal cortex — are greater in volume in those who exercise than in those who do not. One 2013 study has even shown how a molecule called irisin, which is produced from endurance exercises has neuroprotective effects and therefore can prevent cognitive degeneration.
Social Connections
Social isolation is harmful to our wellbeing and can trigger psychological and cognitive decline. Psychologist John Cacioppo’s findings have shown how loneliness has a number of detrimental symptoms such as increased cortisol, elevated blood pressure can even alter gene expression in our immune cells. Keeping up social contact in the long-run is a vital component of wellbeing.
Sleep
We are all aware of a bad night’s sleep or two can affect our ability to stay focused. However, the long-term impact of insufficient sleep can result in a physiological change in your brain. Studies have shown how poor sleep quality can result in a reduction of grey matter in the brain’s frontal lobe, which is responsible for executive function and working memory. So, if you are looking for long-term success, sleep should be a close friend.
Diet
The impact of a poor diet is well-versed. However, it’s always important to re-emphasise the importance of a balanced and varied diet, especially as those with high blood pressure and elevated cholesterol are at higher risk of cognitive impairment.
Stress Reduction
Chronic stress triggers long-term cognitive decline. Persistent stress causes more stem cells to be turned into a cell which inhibits connections to the prefrontal cortex. This new cell simultaneously strengthens connections that promote anxiety and depression. Scheduling in wind-down time and cutting down your workload from time to time can, therefore, keep you intellectually sharp for decades to come.
Environment
For those who have difficulty in paying attention, reducing external distractions can make it easier. Those with cognitive impairment may benefit more from working remotely where they can have better control over the auditory and visual environment. They may also benefit from breaking down tasks into smaller parts to prevent being overwhelmed. Ordinary tactics to increase focus, like non-verbal music, caffeine, and fresh air can, of course, come in handy too.
Moving Forward…
It is important to not mistake cognitive decline with a lack of motivation. Colleagues, friends or family members may have sincere difficulty performing tasks once easy to them. If you believe yourself or someone close to you is struggling with this it is important that you have a health check-in. And, If your cognitive health is tip-top, there’s no harm in working to keep it that way.
