Cognitive functions of the brain: the structure of cognition. Cognitive impairment and dementia - what is it? What is cognitive dysfunction

Cognitive functions are understood as the most complex functions of the brain, through which the process of rational cognition of the world is carried out and targeted interaction with it is ensured. Cognitive functions include:

• thinking - a person’s ability to reflect objective reality in judgments, ideas, concepts;
• behavior - a certain established way of interaction with the environment;
• gnosis or perception of information - the ability to recognize information coming from the senses;
• memory - remembering and storing information;
• praxis - purposeful activity;
• attention - concentration of consciousness, selective focus on something that matters;
• speech - the ability for verbal communication, which includes understanding spoken speech, constructing one’s own speech utterance, reading and writing;
• intelligence - the ability to compare information, find commonalities and differences, make judgments and inferences. Intellectual abilities are provided by the integrated activity of the brain as a whole.

It is well known that the cognitive abilities of healthy adults are very different, since most cognitive functions have a conditioned reflex mechanism and develop after birth under the influence of the surrounding society. In the process of growing up and learning, cognitive functions continue to improve until they reach their peak, which is individual for each person.

Cognitive impairment

Cognitive impairment occurs when a disease causes a person's cognitive abilities to decrease compared to baseline. Mild (moderate) cognitive impairment may be an intermediate stage between the cognitive decline of normal aging and the more severe development of dementia. Mild cognitive impairment can be considered if a person:

• often forgets things
• forgets about important events (dates)
• loses his train of thought during a conversation
• feels more overwhelmed when making decisions, planning steps to complete a task, or interpreting instructions.
• becomes more impulsive, anxious, apathetic.

and these changes are observed by relatives or loved ones.

Causes of cognitive impairment

There are many causes of cognitive impairment:

• infections
• dehydration
• brain injury
• cerebrovascular diseases - cerebral atherosclerosis, stroke, hypertensive encephalopathy, etc.
• side effects of drugs (iatrogenic disorders).

Iatrogenic disorders

Often, cognitive impairment can be observed as a consequence of a side effect of drug therapy (30%) or when taking an inappropriately large dose of drugs.

The following have an adverse effect on the cognitive sphere:

• antidepressants
• neuroleptics
• sedatives
• lithium preparations
• bromides (medicines containing bromine and its compounds)
• benzodiazepine derivatives (diazepam, nitrazepam)
• barbiturates (barbituric acid derivatives that have a depressant effect on the central nervous system)
• opiates (narcotic alkaloids of opium)
• antiparkinsonian drugs (anticholinergics, dopamine agonists)
• antiepileptic drugs (carbamazepine, topiramate, lamotrigine, valproate, phenytoin)
• antitumor drugs (methotrexate, cisplatin, cytosine arabinoside, etc.)
• diuretics (narcotic alkaloids of opium)
• corticosteroids (adrenal hormones)
• digoxin (cardiotonic and antiarrhythmic drug, cardiac glycoside)
• amphotericin B (antifungal antibiotic)
• preparations containing bismuth, cosmetic creams containing bismuth

Radiation therapy for malignant tumors can also be an iatrogenic cause of cognitive impairment.

Both when prescribing such drugs and when monitoring patients with memory impairment of varying severity, it is necessary to take into account the medications they are taking. At the same time, older people often do not notice adverse reactions, or these reactions are interpreted by the patient and his environment as manifestations of normal aging. The latter is most relevant for drugs with anticholinergic properties, since they have the potential to worsen mnestic functions. Anticholinergics are used in neurological (for parkinsonism, dizziness, migraine), gastroenterological (for peptic ulcers, diarrhea), ophthalmological and urological practice. In addition to the anticholinergic drugs themselves, a number of drugs have anticholinergic properties, although they are used for other indications. Thus, atropine-like properties, in particular, are possessed by such different drugs as prednisolone, theophylline, digoxin, nifedipine, ranitidine, dipyridamole, codeine, captopril.

However, iatrogenic events are more likely to involve acute episodes of confusion than dementia. Confirmation that this particular drug was the cause of the development of cognitive disorders is a decrease in their severity after discontinuation of this drug.

Any drug that affects general homeostasis (eg, diuretics) or neuronal function (eg, sedatives) should be considered as a possible cause of cognitive impairment.

Risk factors

The strongest risk factors for developing cognitive disorders are:

• age
• diabetes
• smoking
• high blood pressure
• elevated cholesterol levels
• depression
• sedentary lifestyle
• rare participation in mental activity.

Treatment of cognitive disorders

When cognitive functions are impaired, nootropic drugs are used in clinical practice that have a specific effect on the higher integrative functions of the brain, stimulating memory, improving mental activity, and increasing the brain’s resistance to damaging factors. These are derivatives of pyrrolidone, cyclic GABA (piracetam); agents affecting the GABA system (hopantenic acid); neuropeptides (Cerebrolysin); cholinergic drugs that enhance the synthesis of the mediator choline (choline alfoscerate); neuroprotectors (pentoxifylline, acetyl-L-carnitine); cerebral vasodilators (vinpocetine); antioxidants (Mexidol); ginkgo biloba extract (Tanakan, Memoplant); activators of neurogenesis, etc.

Impairment of cognitive functions (memory, speech, perception)

The central nervous system is responsible for the ability of the human brain to perceive, realize, study and process information coming from outside. Disruption of the activity of the higher nervous system causes cognitive brain disorder. In this case, a person’s personal individuality is lost. He becomes irritable. Behavioral characteristics change. Problems begin with the basic functions of awareness of the space around.

Cognitive deficit occurs due to a violation of a person’s intellectual characteristics. Gnostic, responsible for the perception of objects and phenomena and their awareness. Mnestic, responsible for reproducing information already processed by the brain. A decrease in these functions occurs in diseases of a neurodegenerative nature, diseases of the cardiovascular system, infectious diseases of the brain, or in the case of traumatic brain injury. The main mechanism of this process is the disconnected work of the cerebral cortex and subcortical structures.

People suffering from hypertension are at risk of developing this type of disorder. People who have suffered various types of heart attacks and are also predisposed to cognitive disorders.

There is a violation of the motor, or so-called, neurotransmitter system of the body. Dopaminergic neurons, which are responsible for motor activity and muscle contraction, die off. The activity of noradrenergic neurons is markedly reduced. In the body, the systems that transmit impulses – neurotransmitter connections – die off.

Our brain is divided into two hemispheres, one of which is responsible for logic and the other for creative aspects. If there is a disruption in the functioning of the left hemisphere, then the consequence will be a violation of logical thinking. Violations in the functions responsible for calculation, writing, reading. These are diseases such as apraxia, aphasia, agraphia, etc. There is a disorder in voluntary mental activity.

Violation of the right hemisphere of the brain is fraught with changes in visual-spatial perception. Lack of analysis of ongoing processes. Orientation in space. With such a violation, the ordered information about the organization of the body is disrupted. Emotionality of perception, the ability to fantasize and daydream are catastrophically reduced.

Damage to the frontal lobe can lead to loss of memory, will, planning, abstract thinking, and artistic expression.

The temporal region, if damaged, will deprive a person of hearing, smell, and vision. All sensory functions are at risk. At the same time, the use of previous experience based on memorization and emotional perception of the surrounding space will go beyond the norm.

Damaged parietal lobe of the brain can cause sensory or sensorimotor impairment of one half of the body, blindness in half of the visual field of both eyes, visual neglect of the opposite half of space, and disorientation in space. In some cases, it can cause the development of epileptic seizures.

The occipital lobe of the brain is responsible for visual perception. Lack of color separation, perception of color gamut, color shades, face recognition function.

If the cerebellar zone of the brain is affected, the coordination of human movements is impaired. The gait becomes non-linear. If part of the cerebellum is damaged, then there is a disruption in muscle activity on the damaged side. Damage to the cerebellum is also accompanied by muscle fatigue. In the autonomic system, sweating and vascular innervation are disrupted.

Causes of cognitive disorders

Cognitive impairment may be temporary if it occurs as a result of mechanical trauma to the brain or intoxication of the body. This disorder is curable and the body will return to normal within a certain time. If the disorders are caused by vascular diseases, Alzheimer's disease or, then the problem will be progressive.

Almost the most common cause of cognitive diseases is disorders of vascular origin. It is defined as pseudo-neurasthenic syndrome. This is reflected in many diseases, such as aneurysms that grow from congenital or acquired in the process of life, defects in the walls of blood vessels. Spontaneous stratification of the tissue of blood vessels, cardiac, weakening of the circulatory system due to a stroke condition - all this can lead to progression in the disease. Another causative factor may be a decrease in blood flow through the vessels.

Also, the reason for the development of cognitive impairment can be a disease of internal organs, poisoning or abuse of alcoholic beverages. It is necessary to pay great attention to the normal functioning of all body systems. Constantly monitor blood sugar and cholesterol levels. Because changes in their quantitative composition can cause other disorders in the functioning of the body.

Every person has ever experienced the above consequences. cognitive impairment: forgetfulness, visual impairment, inability to analyze. But if these cases in your life are isolated, then this is one thing. What if you constantly exhibit such symptoms? If people around you begin to pay attention to this, you need to sound the alarm. Don’t delay - consult a neurologist. If the disease is present and left untreated, it will progress. This can cause a lot of unpleasant and problematic sensations, including the development of dementia.

Testing for cognitive impairment

If you are nevertheless diagnosed with this type of disorder, then it becomes necessary to determine the initial level of systemic indicators. The testimony of relatives and personal memories of the patient will be useful. Many factors must be taken into account. Did anyone in your family have similar deviations? Is the patient susceptible to depression? The presence of head injuries, use of medications, and consumption of alcoholic beverages are relevant.

In order to assess the general condition of the patient, depending on the severity of the disease, tests are carried out by a psychiatrist. They are based on the use of special clinical scales. The analysis takes into account the behavioral, functional and emotional states of the subject.

The MMSE (Mini-mental State Examination) scale is the most commonly used. It includes thirty questions aimed at determining the patient's level in the functions of speech, orientation, reading, etc. On this scale, the result is determined in points. From 21 to 25 points – there are unprincipled disorders in the cognitive system. If the score is low from 0 to 10, then the violations are global and must be treated immediately. The normal state of the system is in the range from 26 to 30 points. When using this scale, it is necessary to know the starting educational threshold of the subject.

In the Clinical Dementia Rating scale - CDR, the level of disease is determined by increasing points. If the subject has no memory impairment, behavioral characteristics at home and at work are unchanged, and he is able to take care of himself, then the score will be zero. A score of 1 indicates a mild impairment, 2 indicates a moderate level. Ball three is a severe form of the disease.

A disorder is indicated by low FAB scores if the patient scores less than 11 points. At the same time, the MMSE test gives a relatively high result. In Alzheimer's disease, MMSE decreases to 20-24 points, and FAB is at its maximum level. In severe dementia, scores on two scales are low.

If damage to subcortical structures and the frontal part of the brain is suspected, a clock drawing test is performed. You need to draw a dial with hands fixed at a certain time.

If it turns out that the disease is caused by heredity, a laboratory examination is prescribed. Testing is required to determine the type of heredity. Computed tomography and magnetic resonance imaging are also widely used to visualize the state of the brain. Ultrasound Doppler effect is used to check blood vessels. An EEG is also prescribed to determine the state of the brain.

The patient is examined for the presence of chronic diseases of the pulmonary region and cardiovascular system.

Alzheimer's disease is difficult to identify and treat. Its process is smooth. Without any obvious violations. It is almost impossible to determine this condition in the early stages. This disease mostly affects older people.

Treatment of cognitive impairment

Treating dementia involves finding and eliminating the cause of the disorder. Many drugs are used: donepezil, galantamine, rivastigmine, memantine, nicergoline. The treatment regimen is selected for each case individually.

For treatment to be effective, the patient must, in addition to taking medications, follow a diet. Consume more vitamin B. Low-cholesterol foods are recommended: vegetables, fruits, low-fat dairy products, seafood. Avoid drinking alcohol and smoking.

Consultation with a neurologist on the topic of cognitive impairment

Active activity is good for the brain. We need to make it work. Count in your head, solve crosswords, draw, etc.

People suffering from absent-mindedness are at risk for cognitive diseases. They experience improper functioning of short-term memory and the speed of processing incoming information. There is a violation of spatial perception and the visual apparatus.

Some people wonder what “evoked cognitive potentials” are. These potentials are a kind of indicator of work in the brain. The essence of the method is to determine the processes occurring in the brain when reacting to a stimulus and the processes of remembering and reproducing the irritating aspect. The method is used in electroencephalography.

If you have identified any factors of brain dysfunction, do not self-medicate. Contact your doctor and he will give professional recommendations to eliminate the causes of your anxiety. After all, the problem may be larger than you imagine.

Cognitive disorders of brain function are specific deviations that lead to personality disorder because they interfere with a person’s cognitive activity. They occur in adults and children. How does cognitive dysfunction occur, for what reasons and how to recognize it? Let's try to figure it out.

What are cognitive impairments, their types and mechanism of development

What are cognitive impairments? These are deviations in the normal functioning of the brain. They occur for various reasons in adults and can also appear in children. The human brain is a complex mechanism that regulates all physiological and mental processes in the body. Cognitive or cognitive functions include:

Any violation of them can provoke a change in personality and turn a rational person into an animal that is guided only by instincts. How do such disorders develop? First of all, this is due to a disruption in the connection between the cerebral cortex and subcortical structures. Depending on the location of the damage, the following disorders are distinguished:

Depending on the degree of damage, the following cognitive disorders are distinguished:

Brain activity is a very complex mechanism. Any violation of it contributes to the emergence of deviations that significantly affect human behavior.

Causes of development, main symptoms

Why do cognitive impairments occur in children and adults? Depending on their nature of origin, they are distinguished:

• functional (temporary);
• organic (associated with the occurrence of an irreversible pathological process).

Functional disorders are predominantly temporary. They are often associated with the following phenomena:

Such abnormalities in brain activity can occur at any age. For example, cognitive impairment in children can be triggered by an unfavorable environment at home or at school, the death or illness of friends, close relatives, and other emotional shocks. They are temporary and go away on their own when the irritating factors disappear.

Organic disorders are associated with pathological processes in the brain. There are several reasons for this condition:

How to identify signs of cognitive impairment in the early stages in order to begin appropriate treatment in time? You should pay attention to the following symptoms:

• deterioration of memory and ability to memorize;
• decreased attention;
• fatigue from the simplest mental (intellectual) activity.

If such disorders are present (especially in children), it is necessary to undergo an examination so as not to start the disease and begin treatment on time.

In more severe cases (at a moderate stage), the following symptoms are observed:

In the very last stage, which is called dementia, the following unpleasant symptoms are added to the above:

• personality disorder;
• inability to perform basic self-care functions (for example, inability to go to the toilet, wash, eat);
• change in character;
• mental deviations (a person forgets who he is, does not recognize people around him).

The earlier cognitive impairment is identified, the better it can be treated with medications and psychological techniques. Dementia is progressive and cannot be cured.

Diagnosis, treatment and prevention methods

How to determine if a person has cognitive impairment? To do this, the patient must undergo a special examination, which includes the following procedures:

Only after identifying the cause of the deviations is the necessary treatment prescribed. It is based on the use of medications. So persistent brain damage in dementia is treated with the following medications:

1. Donepezil.
2. Galantamine.
3. Rivastigmine.
4. Memantine.
5. Nicergoline.

They are prescribed only by a doctor. He also determines the dosage and duration of therapy. For minor impairments of cognitive functions, medications are used that help improve blood circulation, as well as neuroprotectors. These are the following drugs:

In addition to medications, a special anti-cholesterol diet is prescribed to improve blood flow and oxygen supply to the brain. It consists of avoiding fatty meats, dairy products and eating fresh vegetables and fruits, and seafood. It is also important to take B vitamins and exclude alcoholic beverages and coffee from your diet.

Once cognitive impairment occurs, it is rarely possible to cure it completely. You can only pause the process.

To do this you need to change your way of life. Therefore, to stop negative phenomena in the brain, you should adhere to the following rules:

If you adhere to the right lifestyle, then brain abnormalities will not occur very soon. This is important for maintaining a person’s well-being and intellectual activity.

Cognitive impairment can appear at any age for one reason or another. They can cause a person and his loved ones a lot of trouble, as they lead to personality disorder and slow degradation. If such deviations are detected, it is important to consult a doctor for help as soon as possible in order to prevent complications.

How unpleasant it is to notice in yourself or loved ones a deterioration in the ability to remember information, the appearance of rapid fatigue, and a decrease in intelligence. Such disorders in the functioning of the brain are called “cognitive disorders” in medicine. However, one should not despair. Adequate therapy is of great importance for people with this disease. Modern medicine is able to provide proper treatment and achieve stable remission.

What is cognitive impairment

Cognitive functions are perception, intelligence, the ability to get acquainted with new information and remember it, attention, speech, orientation in space and time, motor skills. Over time, a person begins to experience disturbances in everyday behavior due to disruptions in cognitive functions. Isolated cases of forgetfulness are not a reason to worry, but if a person begins to regularly forget events, names or names of objects, then this may indicate disturbances in brain activity, then the patient needs the help of a neurologist.

Symptoms

If the impairment of cognitive functions is associated with the left hemisphere of the brain, then one can observe such external symptoms as the patient’s inability to write, count, read, difficulties with logic and analysis begin, and mathematical abilities disappear. The right hemisphere affected by the disease will produce spatial disturbances, for example, a person ceases to navigate in space, the ability to dream, compose, fantasize, empathize, and engage in drawing and other creative activities disappears.

The activity of the frontal lobes of the brain is associated with the perception of smells and sounds, with the emotional coloring of the surrounding world, it is responsible for experience and memorization. If the disease affects the parietal lobes of the brain, then the patient loses the ability to purposefully perform actions, he does not distinguish between right and left, and cannot write or read. The occipital lobes are responsible for the ability to see color pictures, analyze, recognize faces and objects. Changes in the cerebellum are characterized by inappropriate behavior and speech impairment.

Mild cognitive impairment

It can be considered the initial stage in a chain of disruptions in higher brain activity, which for the most part relate to the patient’s memory. Mild types of disorders can be provoked not only by age-related changes. Often the cause is encephalitis or head trauma. What is a cognitive disorder and how does it manifest itself externally? These include severe fatigue during mental activity, the inability to remember new information, confusion, difficulty concentrating, and problems in performing purposeful actions.

It is often difficult for a patient to understand someone else’s speech or choose words to convey thoughts. An interesting fact is that this is a reversible process. With strong mental stress, the symptoms progress, and after a good rest they disappear. However, there is a need to visit a neurologist and therapist, who will conduct the necessary instrumental studies and prescribe tests.

Mild cognitive impairment

When the functioning of several processes deteriorates beyond the normal range of the patient's age, but does not reach the level of dementia, we can speak of a moderate impairment. According to medical statistics, such symptoms can occur in 20% of people over 60 years of age. However, most of these patients develop dementia within the next five years. In 30% of people, the disease progresses slowly, but if a disorder of several cognitive functions occurs in a short period of time, then urgent consultation with a specialist is necessary.

Severe form

The prevalence of dementia is observed in elderly patients, and it is usually provoked by Alzheimer's disease. AD is a brain disease associated with the death of acetylcholinergic neurons. Its first signs are loss of memory, constant forgetfulness of life events. At the next stage of progression of pathological changes, disorientation in space begins, the person loses the ability to express his thoughts, speaks nonsense, becomes helpless in everyday life and may need help from loved ones.

Often, severe impairment of cognitive functions is provoked by cerebrovascular insufficiency, then memory for life events may remain good, but intelligence suffers. Patients stop distinguishing and seeing similarities between concepts, their thinking slows down, and difficulty concentrating appears. In addition, the person experiences an increase in muscle tone and a change in gait. If such signs occur, a neuropsychological examination is prescribed.

Causes

Violations are divided into two types: functional and organic. Functional disorders are provoked by emotional overstrain, stress, and overload. They are typical for any age and when the causes are eliminated, as a rule, they go away on their own. However, there are times when the doctor decides to use drug therapy.

Organic disorders are provoked by changes in the brain under the influence of a disease. As a rule, they are observed in old age and are stable in nature. Modern medicine offers productive ways to solve this problem, allowing you to get good results. The following reasons for violations can be named:

• Insufficient blood supply to brain cells. This includes diseases such as cardiovascular pathology, stroke, hypertension. A person must monitor his blood pressure, maintain optimal sugar and cholesterol levels.
• Age-related brain atrophy or progressive Alzheimer's disease. In this case, the symptoms of the disease increase gradually over many years. Adequate treatment will help improve the patient’s condition and stabilize symptoms for a long time.
• Metabolic problems.
• Alcoholism and poisoning.
• Cardiovascular failure.

In children

The practice of childhood neuralgia shows that cognitive deficits appear as a result of diseases affecting the nervous system of a small patient. This could be, for example, a birth injury or intrauterine infection, or congenital metabolic disorders in the child’s nervous system. There is a problem with quick and correct diagnosis, but the sooner specialists identify the disease and begin adequate therapy, the better the result will be.

Cognitive disorders in old and senile age

In older patients, the brain experiences a lot of changes, and its mass decreases significantly. This process begins early, at the age of 30-40, and by the age of 80 the degree of neuron loss can be up to 50% of the total mass. Surviving neurons do not remain the same; they undergo functional changes. On the external plane, this can also manifest itself in the form of impaired cognitive functions.

Cognitive dysfunction in older people is expressed in excessive irritability, touchiness, limited thinking, and poor memory. Their mood often changes, qualities such as pessimism, fear, anxiety, dissatisfaction with other people appear, and social and everyday disadaptation is possible. Without treatment, catastrophic cognitive impairment will result.

Classification

The modern classification of cognitive disorders is based on the degree of their severity and is divided into mild, moderate and severe forms. In mild disorders, processes such as the ability to quickly process incoming information and switching from one type of activity to another are affected. In moderate disorders, memory impairment predominates, which over time can develop into Alzheimer's disease. Severe disorders include disorientation in time, speech suffers, the ability to reproduce words is impaired, and the psyche suffers.

Diagnosis of cognitive impairment

It is based on the subjective complaints of the patient himself, on the assessment of his condition by loved ones and the determination of his neurological status. In addition, the doctor conducts neuropsychological testing and prescribes tests such as computed tomography and magnetic resonance imaging. To diagnose the presence of depression in a patient (it often causes the development of cognitive disorders), the Hamilton scale is used.

Treatment

Cognitive personality disorder is treated with three types of neurometabolic drugs: classical drugs (Piracetam, Pyritinol, Cerebrolysin), drugs for the treatment of Alzheimer's disease (Halina alfoscerate, Memantine, Ipidacrine), combined drugs (Omaron, Cinnarizine). A large selection of neurometabolic drugs for the regulation of cognitive processes makes it possible to individualize the treatment of patients with impaired cognitive functions.

Prevention

What should you do to avoid cognitive impairment? From a young age you need to take care of your health. To prevent this problem, doctors recommend engaging in active sports every day, training your memory, and communicating more. A huge role is played by giving up bad habits, sufficient intake of vitamins, and proper nutrition. For example, a Mediterranean diet can help reduce the risk of developing disorders. Recently, herbal remedies from ginkgo biloba have been used for prevention.

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Attention! The information presented in the article is for informational purposes only. The materials in the article do not encourage self-treatment. Only a qualified doctor can make a diagnosis and make recommendations for treatment based on the individual characteristics of a particular patient.

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Among the symptoms indicating the presence of neurological disorders, the most common are cognitive disorders, which arise as a result of pathological changes in the structure and functioning of the brain.

This problem mainly occurs in older people. The high incidence of cognitive disorders in this category of patients is explained by age-related changes in the body, which negatively affect the functioning of the central nervous system.

Cognitive impairment refers to mental capacity and other intellectual functions. Such changes are identified by comparing current indicators with the individual norm.

Cognitive brain functions - what is it?

Cognitive (cognitive) functions are the most complex processes occurring in the brain. They provide a rational perception of the surrounding reality, an understanding of the events occurring around a person. Through the cognitive abilities of the brain, people find connections between themselves and what they encounter in everyday life.

Cognitive activity consists of the following functions:

Problems with memory and intelligence occur when any part of the brain is damaged. Violations of other cognitive functions occur when certain parts of the central nervous system are damaged (parietal, frontal, temporal and other lobes).

Three stages of cognitive impairment

Such violations are usually classified according to the severity of the consequences. Cognitive disorders may be of the following nature:

1. At lungs violations, minor changes are observed that fall within the established norms for a specific age group. Such disorders do not create problems for a person in everyday life. At the same time, people themselves or those around them may notice such changes.
2. For moderate disorders are characterized by changes in cognitive functions that go beyond existing norms. However, such violations do not affect the person’s condition and do not cause maladjustment in his everyday life. Moderate disorders usually manifest themselves as problems in performing complex intellectual tasks.
3. The most dangerous type of cognitive personality disorder is , or dementia. This condition is accompanied by significant changes in memory and other brain functions. Such disorders are pronounced and have a direct impact on a person’s daily life.

Complex of provoking factors

There are more than 10 different factors that can lead to cognitive disorders of brain function. The most common reason for the development of such disorders is considered. This pathology is accompanied by the gradual death of brain neurons, as a result of which its individual functions are suppressed.

The first and most striking sign of Alzheimer's disease is memory loss. At the same time, motor activity and other cognitive functions remain within normal limits for a long time.

In addition to Alzheimer's disease, a decrease in a person's intellectual capabilities is observed in the following neurodegenerative pathologies:

• corticobasal degeneration;
• and others.

Quite often, cognitive disorders can appear with. These include:

Clinical picture

The intensity of the clinical picture is determined by the severity of the lesion and the location of the pathological process in the brain. In most cases, several types of cognitive disorders of varying severity and intensity are observed.

Neurological diseases manifest themselves in the form of the following phenomena:

• problems with the perception of third-party information;

With dementia, patients lose the ability to critically assess their own condition, and therefore, when interviewed, they do not complain about the above symptoms.

The first sign indicating a cognitive deficit is memory loss. This symptom occurs even with mild forms of brain dysfunction. At the initial stages, the patient loses the ability to remember information that was received relatively recently. As the pathological process develops, he forgets events that happened in the distant past. In severe cases, the patient is unable to say his own name and identify himself.

Symptoms of disorders with moderate brain damage often go unnoticed. Such disorders are sluggish in nature and do not transform into dementia. The presence of moderate disorders can be determined by the following symptoms:

• difficulties in performing simple counting operations;
• problems repeating recently learned information;
• disruption of orientation in a new area;
• difficulty finding words during a conversation.

A mild form of cognitive impairment is indicated by:

• memory loss;
• problems with concentration;
• high fatigue when performing mental work.

Cognitive impairment must be differentiated from other forms of neurological disorders. In particular, to make a correct diagnosis, it is necessary to establish the presence or absence of pathological changes in a person’s behavior and emotional state.

Brain dysfunction in children

Children experience cognitive dysfunction due to a deficiency of certain vitamins.

Modern research has proven the relationship between cognitive impairment and a lack of beneficial microelements in the body. Vitamin deficiency negatively affects the ability to remember new information, concentrate, the intensity of the thought process and other types of brain activity.

Pathologies caused by a lack of microelements occur in approximately 20% of children and adolescents. In most cases, problems related to speech and language functions are observed.

In addition to vitamin deficiency, neurological diseases in children occur for the following reasons:

In the latter case we are talking about:

• birth injuries;
• infection of the fetus during gestation.

In this regard, one of the main challenges facing modern medicine is the development of methods for early diagnosis of cognitive disorders in children.

Diagnostic criteria

Diagnosis of malfunctions in brain functions is carried out if the patient or his immediate relatives consult a doctor with complaints of memory loss and deterioration of mental abilities.

A study of a person's current state is carried out using a brief mental status assessment scale. In this case, it is important during diagnosis to exclude the presence of emotional disorders (depression), which lead to temporary memory impairment. In addition to screening scales, the patient’s mental status is assessed through dynamic monitoring of him and his behavior. Repeated examination is scheduled approximately 3-6 months after the first one.

To assess the degree of dementia, the patient is asked to draw a clock

To quickly analyze the patient’s mental state, the so-called Montreal Cognitive Impairment Rating Scale is used today. It allows you to test many brain functions in about 10 minutes: memory, speech, thinking, counting ability and more.

The assessment is carried out by testing the patient. He is given tasks and a certain time to complete them. At the end of the tests, the doctor calculates the final results. A healthy person must score more than 26 points.

The MMSE scale is used in stroke to detect cognitive impairment

How to improve the patient's condition?

When selecting a treatment regimen for a patient, it is important to first establish the cause of the development of cognitive disorder. Therefore, after assessing the mental status, a comprehensive examination of the patient is carried out.

Treatment tactics for disorders are determined based on the severity of the disease and the cause of the brain dysfunction. In the treatment of mild to moderate dementia caused by Alzheimer's disease or vascular pathologies, acetylcholinesterase inhibitors or. However, the effectiveness of these drugs has not yet been proven. They are prescribed mainly to prevent further progression of the pathological process and the development of dementia.

In case of diagnosing vascular pathologies that provoke a failure of brain activity, the following are used:

• phosphodiesterase inhibitors promote vasodilation, which leads to normalization of blood circulation;
• α2-adrenergic receptor blockers suppress the actions of the sympathetic nervous system, which lead to the narrowing of blood vessels.

To restore the neurometabolic process, it is used. The drug increases the plasticity of brain neurons, which has a positive effect on cognitive functions.

In addition to these medications, in the presence of neurological disorders, various therapeutic tactics are used to correct the patient’s behavior. It takes a lot of time to complete this task, since such treatment involves a consistent transformation of the human psyche.

Tactics for managing a patient with impaired cognitive functions:

Prevention and prognosis

A general prognosis for cognitive disorders cannot be made. In each case, the consequences are individual. But provided that you seek help from a specialist in a timely manner and follow all medical instructions, it is possible to stop the development of the pathological process.

It is important to note that there are two types of cognitive impairment: reversible and irreversible. The first form can be corrected, but the second cannot.

Prevention includes measures aimed at reducing and increasing a person’s mental and physical activity. To avoid the occurrence of such disorders, it is recommended to regularly perform intellectual tasks from a young age.

In addition, in order to prevent dementia, vascular pathologies and liver diseases should be treated promptly, and the deficiency of B vitamins should be regularly compensated.