Neurocognitive Disorder (Mild cognitive impairment): Definition, Affected Functions and Causes

The Impaired Neurocognitive, also known as cognitive impairment or mild cognitive impairment, refers to the first signs of loss of functions related to perception, attention, memory, thinking, language and learning as a cognitive process.

Neurocognitive impairment is the slight impairment that occurs at the level of the different brain areas and that affects the processes of cognition, without these damages influencing the ability of the person to carry out their activities of daily life. It should be noted that neurocognitive impairment is linked to the normal cognitive changes that are initially observed in the aging of an individual. According to the DSM-V, neurocognitive impairment is classified as a minor neurocognitive disorder.

Functions affected by neurocognitive impairment:

• Perception: When it is affected, it does not allow the individual to organize and understand the environment that surrounds him through the stimuli that are received with the senses (sight, hearing, taste, smell and touch). It also interferes with proprioception, which is what informs about body position, allowing the person to know what position they occupy in space. Likewise, interoception can be compromised, which is what allows us to know how the body’s organs are and indicates to the individual when they are hungry or thirsty.
• Attention: This function is fundamental because it is the one used in most of the tasks that are carried out, controlling and regulating the rest of the functions of cognition, so when it is affected, the individual has difficulty concentrating on a stimulus or an activity, making it difficult for you to process information deeper into consciousness.
• Memory: It is a basic process for learning because it allows you to encode, store and retrieve information. When this function is affected, the individual is diminished in his ability to temporarily keep information on telephone numbers, names, among others. You can also lose memories or knowledge.
• The thought: When a person is compromised this function loses the integration of all the information received and it is difficult for him to establish the relationship between the data that constitute it. Therefore, changes in reasoning, synthesis and problem solving are observed, that is, executive functions are affected.
• Language:  This function is linked to thought, they are developed in a parallel way so that being affects one the other is involved. A person with damage from this process is observed with difficulty expressing thoughts and feelings through words, for which he communicates or organizes information about himself and the world in a poor way.
• Learning:  A person with neurocognitive impairment may see their ability to learn diminished. That is, it is difficult for them to incorporate new information to the previous knowledge acquired through socialization and school. The repertoire of learning of a person is represented from behaviors or habits to the academic intentionally achieved.

Causes of neurocognitive impairment

Physiological changes

They are caused by natural changes in the body, which produce cognitive degeneration, among which are the loss of neurons without their regeneration, loss of white matter, visual or hearing loss that interferes with the ability to recognize or hear correctly.

Psychological changes

Each person has their own psychological dynamics, psychic defense mechanisms that allow them to increase or decrease situations of stress or pressure, which can cause neuron wear to be greater, increasing the risk of impaired memory. The attitude to situations associated with negative thoughts about old age led the individual to fall into a state of demotivation and the lack of effort to improve their cognitive functions.

Social changes

Leading a life isolated from people and immersing oneself in routine or mechanical tasks affects cognitive abilities. The lack of reading, study and discussion of ideas with others also leads to a high risk of neurocognitive impairment.

Assessment of neurocognitive impairment

It must be recognized that advances in brain imaging and other diagnostic techniques that allow the location, extent, and anatomical effects of brain damage to be seen have been of great help to specialists. However, damage is not always fully identified until psychological tests designed for the diagnosis or detection of neuropsychological problems are used that allow the evaluation of sensation, speed and motor power, perception and perceptual-motor integration, language, attention, ability to abstraction, orientation and memory.

Here are some tests that allow evaluating the deficit of some neurocognitive functions:

• Attention: WAIS-III Digit Retention Subtest, WMS-III Spatial Retention.
• Executive Functions (Abstraction Skill) WAIS-III Similarity Subtest, WISCONSIN Card Sorting.
• Language: Boston Severe Aphasia Assessment, Boston Aphasia Diagnostic Exam, WAIS-III Vocabulary Subtest.
• Learning and memory: Benton’s Visual Retention Test, King’s Auditory Verbal Learning Test, Wide Range assessment of memory and learning.
• Visuospatial Skills: WAIS-III cube design, Complex Figure Test and Recognition.
• Global Intellectual Functioning: Wechsler Intelligence Scale for Adults III.

Neuropsychological tests are an important tool because they allow us to determine if a person has mild neurocognitive impairment or is a dementia in progress. It also provides a basis for professional treatment or intervention. Read more about Dementia

Frequent questions:

How to improve neurocognitive impairment?

To improve and sometimes reverse neurocognitive deterioration, it is recommended to make changes in eating habits, that is, to incorporate foods that improve vascular function into the diet. Perform physical exercise and cognitive training through digital or traditional mental games with the purpose that structural and functional changes exist in the brain, reaching brain plasticity or neuroplasticity.

Does the risk of cognitive impairment increase at an older age?

There is a higher percentage of risk. However, many older adults reach the end of their lives with their intellectual faculties preserved. Prevention is the best action to take, improving your lifestyle contributes to good neurological health.

 Can a person with neurocognitive impairment develop dementia?

Mild neurocognitive impairment is a middle state between the cognitive disorders typical of old age and dementia. In some cases there are people who, due to significant alterations in cognitive functions, reach a state of dementia.

What are the symptoms of neurocognitive impairment?

• Ask repeated questions like: What time is it?
• Not remembering the day, month or year, this is temporary disorientation
• Difficulty expressing ideas or words, forgetting words.
• Getting disoriented in a familiar environment, forgetting addresses you frequent.