Cognitive Impairment Guides & Articles

Kaia Koglin
Last updated:
Erin George, MFT
Medical Editor

What Is Cognitive Impairment?

Cognitive impairment occurs when a person’s brain isn’t able to function effectively. People with cognitive impairment may have trouble remembering, learning new things, or making decisions. The condition can negatively impact many areas of life, including school, work, relationships, driving, taking medications, and managing money.

The types of cognitive impairment include subjective cognitive decline (SCD), mild cognitive impairment (MCI), and short-term cognitive impairment. 1 Symptoms can range from mild to severe, and those with severe cognitive impairment can lose the ability to talk, write, understand others, and live independently.
Although cognitive impairment can affect people of all ages, advanced age is the greatest risk factor. Around two-thirds of Americans experience cognitive impairment at some stage in their life, and the average age of onset is 70. 2 In addition to impacting the person experiencing brain changes, cognitive impairment also affects the individual's families, friends, and caregivers.

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What Is Mild Cognitive Impairment?

Mild cognitive impairment, or MCI, is the formal name for the mildest symptoms of cognitive impairment. People experiencing MCI are likely to notice changes but are still able to complete everyday activities. Signs of MCI can include:

  • Regularly losing things
  • Forgetting events and appointments
  • Difficulty remembering words
  • Increasing mobility issues
  • Problems with the sense of smell

For most people, MCI is a step along the path to dementia. The American Academy of Neurology states that 14.9% of people aged 65 and over with MCI develop dementia within 2 years. 3 Although research is limited, it’s believed that these numbers continue to rise with time.

Although everyone ages in different ways, health care professionals consider some experiences part of “normal aging.” These include a gradual mental decline leading to forgetfulness and a slowing of the ability to process information. However, normal aging doesn’t decrease a person’s intelligence, long-term memory, or ability to perform daily activities. This is what differentiates cognitive impairment and MCI from normal aging.

What Causes Cognitive Impairment?

Cognitive impairment isn’t a particular disease. Various conditions cause cognitive impairment, including:

  • Dementia
  • Alzheimer’s disease
  • Developmental disability
  • Stroke
  • Traumatic brain injury (TBI)
  • Certain infections
  • Lack of oxygen to the brain

Alzheimer’s disease is the most common cause of cognitive impairment in the United States. 4

What Are the Symptoms of Cognitive Impairment?

The symptoms of cognitive impairment include:

  • Memory loss
  • Difficulty with short-term memory
  • Lapses of judgment
  • Inability to make decisions
  • Slowing of thought processes
  • Lack of recognition

These symptoms can look different for everyone. How noticeable the symptoms are can depend on the person, their coping mechanisms, and their level of independence. Signs to look for include:

  • Asking the same question or repeating the same story over again
  • Inability to recognize familiar people or places
  • Inability to discern what to do in an emergency
  • Changes in mood or behavior
  • Vision problems
  • Difficulty planning and carrying out tasks, such as following a recipe or keeping track of monthly bills

How Is Cognitive Impairment Diagnosed?

The first step in diagnosing cognitive impairment is taking a thorough medical history to determine what may be causing symptoms. A doctor also performs tests and assessments to rule out other issues, including blood tests and brain scans.

If no sign of another cause is evident, doctors perform cognitive impairment tests. These are short mental status assessments that test memory, planning, decision-making, the ability to understand information, language, and complicated thinking tasks. If cognitive impairment is found, the doctor looks for the underlying cause. These tests may be conducted by brain specialists, such as neurologists.

It’s important for people to make their doctors aware of symptoms that may be related to cognitive impairment. One study found that 40% of the time, physicians didn’t recognize cognitive impairment in their patients. 5 Mild cognitive impairment tests and screening for dementia can help detect some cases of cognitive impairment and allow for early treatment. 6

Best Treatment for Cognitive Impairment

The best treatment for cognitive impairment depends on the cause. It’s important to treat any underlying condition as the impairment may be reversible. Medications are available to slow Alzheimer’s disease and dementia and relieve cognitive impairment symptoms, but these don’t work for everyone. 7

Many people find it helpful to see a psychological professional. Anxiety and depression can worsen cognitive impairment. Treating these conditions often brings improvement to symptoms. Cognitive rehabilitation with a psychological professional may also ease problems.

It’s important for people with cognitive impairment to see a doctor every 6-12 months. This is especially true of people with MCI. A health care professional tracks changes and ensures the condition isn’t getting worse.

People can take steps to improve cognitive impairment or reduce its impact. These can include:

  • Regular physical exercise
  • Brain exercises, such as crossword puzzles and sudoku
  • Social support
  • Quitting smoking
  • Not drinking excessively
  • Maintaining good blood pressure and cholesterol levels
  • Reducing stress
  • Getting enough sleep

How to Cope With a Cognitive Impairment Diagnosis

A diagnosis of cognitive impairment can be challenging to cope with, as it can mean changes to the personality and a loss of independence. Finding ways to have some control over the situation can help. People can try gaining knowledge about cognitive impairment, making lifestyle changes, and reducing stress through sleep and relaxation.

It's helpful to find strategies to manage symptoms. For example, a person who has problems remembering appointments may invest in a good planner or add reminders to their phone. This can be helpful for those with MCI.

Support groups are a good way to process the news and get help from people with similar experiences.

How to Help Someone With Cognitive Impairment

It can be difficult watching a loved one cope with cognitive impairment. A proper diagnosis is the first step, so families should encourage the person to get medical help. It can be useful to accompany the person to doctor’s appointments. A person with cognitive impairment may have difficulty understanding or remembering the conversation and is often comforted knowing someone they trust is there for backup.

Other ways to help someone who has a cognitive impairment diagnosis include:

  • Making plans for future care, finances, and legal obligations
  • Adapting tasks to maximize independence
  • Prioritizing safety in the home
  • Finding opportunities for meaningful engagement
  • Re-evaluating needs regularly