Module 7: Cognition Flashcards
Define cognition
Mental action or process of acquiring knowledge and understanding through thought, experience, and the sense
- Usually, refer to all processes involved in human thought
- Related to reception of sensory input, its processing, its storage, its retrieval, and its use
What are the 6 domains of cognitive function?
- Perceptual motor function
- Language
- Learning and memory
- Social cognition
- Complex attention
- Executive function
Perceptual Motor Function (1/6 Domain)
Interpretation of the environment and is dependent on the acuity of sensory input
- difficulty in using familiar technology, tools, or kitchen appliances
- getting lost in familiar environment
Perceptual Motor - Example of Deficits
- trouble with previous familiar activities, trouble navigating familiar environments, trouble with spatial tasks
Language (1/6 Domain)
Expressive language - Auditory association areas; posterior superior temporoparietal supramarginal gyrus
Receptive language - Lateral inferior posterior frontal lobes
Language - Example of Deficits
- using general phases (“that thing on your foot”) rather than the name of an object (“shoe”), trouble with names of family members, grammatical errors
- difficulty finding the correct words
- using general pronouns instead of names
- mispronunciation of words problems with understanding written or verbal communication
Learning and Memory (1/6 Domain)
- forgetting to buy items or buying the same item multiple times
- repetition in conversations
- difficulty in recalling recent events
- relying on lists of tasks to complete
- forgetting to pay bills
Learning and Memory - Example of Deficits
- repeats self in conversation, can’t keep a shopping list, requires frequent reminders
Social Cognition (1/6 Domain)
- apathy, increase inappropriate behaviours, loss of empathy and impaired judgment
Social Cognition - Example of Deficits
Behaviour out of acceptable social range, insensitivity to social standards, makes decisions without regard to safety
Executive function (1/6 Domain)
The higher thinking processes allow for flexibility, adaptability, and goal-directedness
- higher-order, complex cognitive processes, including thinking, planning, and problem-solving
- determines the contents of consciousness, supervises voluntary activity, and is future-oriented
- involves frontal lobes
- regulates primitive impulses through many connections within the cerebrum
Executive Function - Example of Impaired
- Preparing a meal
- difficulty in completely previously familiar multi-step tasks, such as preparing a meal- no longer wanting to participate in activities
- difficulty in completing or tasks because easy distractibility
- social outing become more taxing and less enjoyable
Complex Attention (1/6 Domain)
- Normal, routine tasks take longer.
- Difficulty completing tasks when multiple stimuli present
- Difficulty in maintaining information while completing task
Complex Attention- Example Deficits
- Difficulty with multiple stimuli, easily distracted, unable to perform mental calculations
- Walking down a flight of stairs with a laundry basket
Memory
- Retention and recall of past experiences and learning. Series of different subsystems, each of which has a unique localization in the brain
- Related is visuospatial cognition, which is the capacity to comprehend, retain, and use visual representations and their spacial relationships
Declarative semantic memory (subsystems)
Refers to the ability to consciously learn and recall information. Provides for long-term storage of large amounts of info
- Memory of knowledge, words and facts
- Temporoparrietal Assocation Cortices
Declarative episodic memory (subsystems)
Information related to specific events
- Hippocampus, medial thalamus
Immediate memory “attention span” (subsystems)
- allows memory of very small amounts of information, such as a series of 6 or 7 digits, for a very short time
- ie. 6-7 digits
- Primary auditory or visual cortex
Working memory (subsystems)
- allows a small amount of info (approx 4 chunks or meaningful units) to be maintained and manipulated over a short amoutn of time
- allows you to plan and initiate activity
- part of executive functioning
- lateral frontal cortex
Procedural memory (subsystems)
- Retention and retrieval of motor skills
- Requires extensive training and provides for long-term storage of a moderate amount of info
- basal ganglia, assocation neocortices
Scope of cognitive impairment
- intact or impaired
- ranges from cognitive impairment to basic cognitive functioning (infant) to higher order cognitive functioning
- range of disturbances
- location of the dmg indicates what will be impaired
Intact Cognitive Function
Individual demonstrates normal cognitive behaviours for age and culture
Impaired Cognitive Function
Indicates measurable differences in normal cognitive processes
Basic Cognitive Functioning
- perception
- pattern recognition
- attention (what you start with as an infant)
Perception
- the process of organization and interpreting sensory information using all 4 senses, enabling us to recognize meaningful objects and events
- ie. Use all 4 senses to know when it is safe to cross the street
Pattern recognition
- the classification of a simulus into a category
- brain is recognizing and using patterns to predict what could happen next
- allows for logic to be applied to common activities
Attention
- consciousness
- fully conscious person is aware of their surrounds and reacts to simuli in their environment
Higher order Cognitive Functioning
- Learning
- Comprehension
- Insight
- Problem-solving
- Reasoning
- Decision making
- Creativity
- Metacognition
(What you develop as you age)
6 Cognitive Impairment
- delirium
- neurocognitive disorders (dementia)
- cognitive impairment (not dementia)
- focal cognitive disorders
- intellectual disability
- learning disability
What are the 4 main units of the human brain?
- Cerebrum
- Diencephalon
- Brain stem
- Cerebellum
What happens in the Cerebellum?
- Most cognitive task occurs here, divided into 2 hemispheres (right and left)
- Each hemisphere has four lobe (frontal lobe, parietal lobe, temporal lobe, and occipital lobe)
Cerebral cortex function
- carrying out the ability to reason, function intellectually, express personality, and purposefully interact with the external environment
- neurons and neurotransmitters deliver information through complex networks
Limbic system function
- helps supports cognitive processing, is a structure that overlaps the cerebrum and diencephalon
- regulation of emotion; memory; appetite; autonomic, neuroendocrine; olfaction
Cerebrum function
Area of the brain responsible for all voluntary activities of the body
Diencephalon function
Memory processing and emotional response, relay and control centre
What is the idea Automatic and Continuous in the Brain?
- Always receiving internal and external data signals
- These signals are integrated and interpreted, triggers a sensory or motor response
Brain function
Reponsible for multiple processes, including those that involve purposeful thought and response and those that are automated and occur without purposeful thought
Brain stem function
- Controls automatic behaviours necessary for survival (breathing, heart rate, and BP)
- Connects brain to spinal cord
What do thoughts require?
The ability to take in data signals and actively think about (integrate) and act on the information
Hippocampus Function (Limbic System)
Plays a significant role in commiting information to long-term memory
What does optimal brain function depend on?
The continuous perfusion of oxygenated and nutrient-rich blood
What happens to the brain when hypoxia happens?
Decrease in O2 and glucose supply, as well as electrolyte and acid-base imbalances, significantly, impaired cognitive function
Signs of Impaired Cognition
- Lethargic: sleepiness, needs significant stimulus to respond, fluctuating atteniton span
- confused: unsure of person, place, or time
- amnesia: poor short-term and/or long-term memory
- body odor: soiled/mismatching clothing, wearing clothing inappropriate for season
- gait: slow movements while walking, dragging feet, shuffling, uncoordinated
- eyes: avoiding/indirect eye contact, fleeting, cannot keep eyes open during convo
Symptoms of Impaired Cognition
- cannot stay awake/poor sleep
- being confused to time, place, person
- frustration, denial and/or anger at self for changes
- inability to complete ADLs/IADLs
- decreased quality of life (ie. Social isolation)
- safety concerns: getting lost, hurting self, hurting others, etc.
What happens to the older adult brain through aging?
- size and weight of the brain and number of neurons decrease
- reduction in and atrophy of neurons results in less efficient neurotransmission and a slowing of neural responses
- decrease in synapse connection and leads to decrease coordination
- cerebral blood flow and metabolism are reduced, impacting mental functions
- changes to the peripheral nervous system may affect visual acuity, hearing, and balance
- committing new information to memory is less efficient in older adults, but the majority of memory functioning remains intact
What is not a normal part of aging in cognition?
- Cognitive impairment is not normal aging
- intellectual loss is not normal
Risk factors for impaired cognition
- work; ie. Head injury
- environment; ie. Pesticides
- congenital/genetics: substances, cerebral palsy, Huntington’s disease
- personal: substance abuse, high-risk activities
- diseases: stroke, diabetes, cerebrovascular
Older adult age-related changes in cognition
- overall ability to pay attention
- language skills
- developed communcation skills
- comprehension level
- visual perception
Examples of individual risks that affect (conditions) memory
- over the counter or prescription medications
- excessive use of alcohol- underlying medical condition
- psychological causes (ie. Depression, stress)
- higher lvls of cortisol are released and have an adverse effect on the hippocampus (harder to retrieve old memories or make new ones)
Cognitive Impairment “CIND” (NOT dementia)
- Mild cognitive impairment, demonstrate a greater reduction of congitive function than expected for an individual’s age and education, but it does not interfere with functional ability
- higher risk of progressing to dementia
- ranges of disturbances: memory, orientation, attention and concentration
