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Cognitive Loss

Knowing is not something that most of us routinely think about. We just are and we just know. We don't wonder how we know where we are or when we are living, we just do. As age takes its toll, many people cease to be able to take knowing for granted. Orientation, memory and focus all become a little hazier. Upper level mental processes may even become impossible to perform. Causes for loss of cognition are difficult to diagnose. Treatments are sometimes effective, but are at other times useless or only marginally effective. There are three main categories of cognitive loss to be aware of when old age approaches.

Delirium

Delirium is a frustrating problem that causes the person suffering to lose some awareness of the world around him. Orientation is the most likely piece of knowledge to lose. Locations, seasons and people all start to seem unfamiliar. Other brain functions may also suffer. Hallucinations, memory loss and language difficulties may accompany the loss of awareness. Delirium can be a very brief illness or it can lead to Dementia or Amnestic Disorder.

Causes of Delirium

Delirium may be caused by medical illnesses such as strokes, tumors or head trauma. It may also be caused by substance abuse. Suddenly stopping the use of a powerful drug, rather than slowly dropping doses, may cause delirium.

Dementia

Dementia is a more severe disorder than Delirium. The person will always have severe memory loss. It may start with only bits of memory lost, but eventually, the person will have no memories at all. It is also common for those who are suffering from Dementia to lose language abilities. Both spoken and written language may become incoherent or at least without meaning. Dementia can also affect the coordination of sensory and motor activity. Higher level thinking will also be affected by Dementia. Problem solving skills and the ability to exercise judgment will fade. Agitation is common in patients with Dementia. There are all kinds of factors that may contribute to the feelings of aggression, but it is understandable that loss of control would make a person feel irritable.

Causes of Dementia

Dementia most often results from impairing diseases. Alzheimer's disease, Parkinson's disease and Huntington's disease can lead to Dementia. AIDS frequently causes Dementia in those who carry the disease. Dementia may also be caused by other medical conditions. Strokes, for example, can severely affect brain functioning. Some medical problems that can cause Dementia can be treated and the symptoms can therefore be reversed. Vitamin deficiencies, blows to the head and hormonal imbalances will not necessarily lead to irreversible Dementia. Alcohol abuse will not necessarily lead to Dementia either, but it is one of the leading causes.

Amnestic Disorder

Amnestic Disorder is not as encompassing as Dementia. It is a disorder that solely affects memory. All other cognitive functions remain intact. Orientation is also free from the blurriness of Delirium. Sometimes only a block of memory disappears. Other patients, starting at the onset of the disease, are unable to write any new memories and so continually have an increasing block of time with no associated memories.

Causes of Amnestic Disorder

There are very few factors that only affect memory functions in the brain. Head injuries, Thiamin Deficiencies and sedatives can all cause memory loss.

Frances, Allen MD and First, Michael B. MD. Your Mental Health: A Layman's Guide to

the Psychiatrist's Bible. New York: Scribner, 1998.