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cognitive impairment

Alternative Names
cognitive disorder, cognitive disability

A cognitive impairment means there is a change in how a person thinks, reacts to emotions, or behaves.

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 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.

What are the signs and symptoms of the condition?
A cognitive impairment interferes with the body's normal function. The change may be minor and have little or no impact on a person's daily functioning. In other cases, the impairment may be obvious. A cognitive impairment can range from mild memory problems to exaggerated emotional reactions. It can also entail the complete inability to think independently.

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: 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.

What can be done to prevent the condition?
Cognitive impairment can occur at any age. It is possible to reduce the risk of acquiring certain cognitive impairments. Pregnant women should receive antenatal care to help prevent problems in the developing baby. Sports safety guidelines for children and for adults can help prevent head injuries. Wearing safety helmets while cycling, motorcycle riding and engaging in risky sports can help prevent head trauma. A person should use care when diving, especially avoid diving into shallow water. The correct use of medication can also prevent cognitive impairments. Preventing substance abuse is important, as well.

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 and the diagnosis is confirmed with a chromosome analysis.

The diagnosis of cognitive impairments from other causes may involve cognitive testing to identify the type and severity of the person's deficits. Other tests, such as a cranial CT scan or cranial MRI, may be ordered if head injury or stroke is suspected.

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.

What are the risks to others?
There are no risks to others, as a cognitive impairment is not contagious.

What are the treatments for the condition?
After a cognitive impairment has occurred, there may be ways to improve the problems. If the cause is known, it can sometimes be eliminated. This will often allow problems stemming from the mental impairment to resolve without treatment. If the cause is unknown, or the problems do not resolve with treatment, cognitive testing may be necessary. This process is designed to diagnose the condition and develop a plan for treatment.

A doctor who specialises in cognitive problems is called a phychiatrist. Other professionals may also be involved in treatment. These include psychologists, rehabilitation nurses, physiotherapists, 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, counselling may help. Controlling the person's surroundings can also help prevent outbursts. Behaviour problems may also be helped with cognitive behavioural therapy. Teaching a person how to behave in different situations is useful, as well. If behaviour problems are severe, the person may require supervision.

What are the side effects of the treatments?
There are no side effects to these rehabilitation therapies.

What happens after treatment for the condition?
An individual with mild or well controlled problems 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.

How is the condition monitored?
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 doctors should share instructions with family members and caregivers on how to help or supervise.

Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Potential conflict of interest information for reviewers available on request

This website and article is not a substitute for independent professional advice. Nothing contained in this website is intended to be used as medical advice and it is not intended to be used to diagnose, treat, cure or prevent any disease, nor should it be used for therapeutic purposes or as a substitute for your own health professional's advice.  All Health and any associated parties do not accept any liability for any injury, loss or damage incurred by use of or reliance on the information.


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