With age comes a myriad of physical and mental health limitations that at any cost have to be borne by every single one of us. A lot of seniors around the world in fact deal with serious physical and mental health conditions that practically hinder their life in many ways. And cognitive impairment is one of the most common forms of mental ill-health.
In Canada, almost 564, 000 people are currently suffering from Dementia.
Mild Cognitive Impairment or MCI is very common among the older adult population and it basically refers to an unusually rapid decline in the ability to think, learn or remember.
Serious forms of cognitive impairment such as Dementia, may occur gradually or suddenly and may be temporary or permanent. Depending on the causes, it may develop rapidly or slowly. Needless to say, it requires utmost care and attention.
According to Dr. Mary Lawson of Halo Health Care, there could be many causes for the condition, but to ensure proper care and help, it is important to assess the exact causes.
Here are 10 possible common causes of cognitive impairment:
Metabolic insufficiencies – These include specific mineral deficiencies such as calcium, glucose or blood sodium. It can also include organ malfunctions like kidney or liver malfunctions.
Hormonal issues – Imbalances in the production of hormones like estrogen or other sex hormones.
Psychiatric issues – Since psychiatric issues like anxiety and depression are also concerned with the brain and mental health, they can also cause problems related to memory or concentration.
Substance abuse and withdrawal – As is the case with any health condition overuse and misuse of certain harmful substances like alcohol, prescription and non-prescription drugs and even medical marijuana can cause cognitive impairment.
Delirium – Delirium is a mental condition that can be induced by any other types of serious illnesses. This commonly occurs in adults who may be hospitalized for other issues.
Side effects from medicines – Medications taken for various purposes can have adverse side effects on brain functions. This is mostly caused by overuse of sedatives or tranquilizers as well as anticholinergic medications.
Vitamin deficiencies – Deficiencies of Vitamin B12, Folate as well as other B vitamins are likely to cause affect normal brain functioning.
Injuries affecting the brain – Head injuries have a very high chance of affecting the brain function leading to permanent or temporary cognitive impairment. Diseases of the small vessels in the cerebrum or strokes can also damage the neurons in the brain.
Infections – External infections like the urinary tract infection or pneumonia can lead to a case of delirium and in turn cognitive impairment. Sometimes infections can also be caused inside the brain.
Neurodegenerative disorders – Lastly, serious neurodegenerative disorders like Parkinson’s disease or Lewy-Body diseases can also lead to permanent cognitive issues.
10 things the doctor should evaluate
When a senior adult is brought for consultation because of cognitive issue symptoms, the doctor should ideally check for the following:
Changes in memory or retention and thinking abilities – The doctor should ask if the patient has been experiencing difficulties in thinking or remembering things. Documentation should also be done regarding the level of changes, including when the problem started and how rapidly the problem is progressing.
Difficulties in normal everyday activities – Daily normal activities like grocery shopping, cooking, driving or travelling are likely to get affected. The doctor or caregiver should ask about that as well.
Behavioural changes – These include changes in the mood and unusual behaviour such as having hallucinations, delusions, feelings of being demotivated, depression, anxiety and the like.
Review of medications – Along with checking for symptoms, the medications already being taken by the patient should also be reviewed to determine possible allergic reactions and side effects.
Possibility of substance abuse – The doctor should check for the possible overuse of substances like alcohol or drugs; both prescription and non-prescription. Suddenly stopping the use of the same should also be considered.
Further physical health issues – It is important to observe and check for further deterioration of health, especially in terms of neurodegenerative issues, like difficulties in walking, general co-ordination, speech etc.
Regular physical examination – This includes regular physical examinations to check the pulse, blood pressure etc. of the patient. Basic neurological examinations may also be conducted.
General orientation – This involves conducting cognitive tests to see whether the patient is aware of the day, date, month, his or her whereabouts etc.
Lab tests – This includes taking blood tests and brain imaging tests if needed to assess the functioning of organs like thyroid, kidney, liver etc.
Behavioural changes and memory issues from the point of view of caregivers – For many reasons, the patient themselves may not be the best person to assess their own mental health. Hence, it is important to gather such information about the patient from their caregivers and family members as well.
Image sources:
https://www.expicare.com/blog/avoid-medication-mix/
https://www.express.co.uk/life-style/life/827838/Energy-recycling-stairs-climbing-steps-elderly
https://www.nia.nih.gov/health/managing-older-patients-cognitive-impairment
