Cognitive Disorders (A complete guide)

In this brief guide, we will look at some prevalent cognitive disorders, types of cognitive disorders, cognitive disorders in the DSM 5, and Cognitive Disorders treatment.

Cognitive Disorders

Cognitive disorders are a class of disorders that include symptoms related to brain functioning, that means processes such as memory, thinking or planning may be affected in a cognitive disorder, and examples include Alzheimer’s or Huntington’s.

Prolonged substance use can also cause cognitive disorders, as it can alter brain structure and chemistry considerably, which can often lead to problems in the cortex.

Another instance where cognitive disorder can happen is cases where there is some trauma to the skull or some kind of internal hemorrhage, and there have been many instances where the person has hurt their head too hard which lead to either personality or cognitive changes in their day-to-day life.

The most famous case of this cause was Phineas Gage, who suffered an accident at work, and he suffered an enormous change in personality and other aspects of cognition, like increased risk taking and lack of clear planning abilities, which indicated that the brain is responsible for much more than just keeping the body and systems running.

Cognitive disorders are included under mental health disorders, and they usually hamper or stunt learning, memory, perception, and problem-solving, and include problems like amnesia, dementia, and delirium. 

There are 4 major categories of cognitive disorders which are:

  • Delirium, which refers to a change in consciousness and is typified by its acute development,  and people suffering from this may have reduced awareness of their environment
  • Dementia, which is a progressive deterioration of brain function and where the impairment of memory is most common, along with confusion and inability to concentrate
  • Amnesia which refers to a significant loss of the memory, without any loss of other cognitive functions like in dementia.

Based on the information above, Cognitive disorders may be defined as any type of disorder that significantly impairs the cognitive function of an individual in a way that causes normal functioning in society impossible without treatment. 

Types of Cognitive Disorders

While there are many types of cognitive disorders, broadly speaking there are three main types of cognitive disorders which encompass other types usually, and there may be other domains of specific limitations of functionality like Aphasia that may be included as standalone problems.

The three main types of disorders:

  • Amnesia
  • Delirium
  • Dementia

Let us explore each type in more detail.

Amnesia

Amnesia is characterized by impairment of memory in any way without an involvement of other cognitive functions, but it may sometimes involve loss of memory related processes that may seem cognitive, like procedural memory.

Amnesia may be caused by anything, and there may be two main types depending on whether the person is unable to form new memories or remember very old ones, and these are Retrograde Amnesia or Anterograde amnesia.

Retrograde amnesia is when the person is not able to remember details of their past, it can be either recent past or remote past, and their current memory processes may still be intact.

This type of amnesia is more common with injuries or trauma to the skull, and the kind of amnesia that is usually seen in movies where someone can’t remember who they are after a car accident is Retrograde amnesia.

Anterograde amnesia is when the person loses their ability to make new memories and is either unable to recall things they just heard a while back, causing confusion, or they might be unaware that it is happening, which may lead to something called Confabulation.

Anterograde amnesia is seen in a very interesting phenomenon called Korsakoff’s Syndrome, which may often occur in individuals who have a Thiamine deficiency or people who abuse alcohol for very long, which causes problems in the brain structure and the ability to make new memories.

Delirium

Delirium is an acute state that may occur as a result of various other conditions, sometimes it may happen in degenerative disorders like Alzheimer’s and other times it may happen as a result of substance abuse or use of psychoactive drugs.

Delirium is characterized primarily by a change in consciousness which may cause the person to be confused and disoriented, so much so that they may not be able to tell where they are or what time, date, or day it is.

A patient who is in a delirious state may be impossible to communicate with, depending on how bad their condition is, and their speech and thinking might be especially hampered.

Delirium usually clears up about as quickly as it comes about, and there are very few instances of delirium going on for too long.

Dementia

Dementia is one of the most devastating types of cognitive disorders, as they are progressive and in most cases untreatable.

A type of dementia everyone is familiar with is Alzheimer’s, which is a condition that affects many people over the ages of 55-60.

In this condition the person may initially suffer from memory impairment that progresses over time and may be accompanied by problems in the motor category, as well as clouding of judgment and thinking.

Mood changes may also often accompany dementia, and the person may become more irritable and experience fluctuating mood states as time goes on, and while therapy may sometimes help, in most cases these changes tend to be somewhat deteriorating and permanent,

List of Cognitive Disorders in Childhood

Given below is a list of cognitive disorders in childhood:

  • Attention-deficit hyperactivity disorder (ADHD)
  • Autism
  • Intellectual disability (intellectual developmental disorder).
  • Specific Learning Disability 
  • Speech impairment 

Cognitive Disorder Symptoms

Given below are some of the common cognitive disorder symptoms:

  • Confusion
  • Poor motor coordination
  • Loss of short-term or long-term memory
  • Identity confusion
  • Impaired judgment
  • Inability to comprehend instructions
  • Loss of fine motor movement
  • Repetitive motions of the hand
  • Stereotyped movements or motions
  • Inability to speak
  • Inability to comprehend speech
  • Inability to do complex mental functions like arithmetic
  • Fluctuating mood states
  • Social Withdrawal

Cognitive Disorders (DSM-5)

The cognitive disorder chapter in DSM 5 used to be known as Delirium and other Mild and Major Neurocognitive disorders, but it is now called just Neurocognitive disorders, and includes the following:

  • Delirium
  • Mild or Major Neurocognitive Disorder due to: 
    • Alzheimer’s Disease
    • Lewy’s Bodies
    • Huntington’s Disease
    • Vascular problems
    • Prion Disease
    • Brain Trauma
    • Medication or Substance Abuse


The criteria for some of the most prominent cognitive disorders in the DSM 5 are given below:

Delirium

“A. A disturbance in attention (i.e., reduced ability to direct, focus, sustain, and shift attention)and awareness (reduced orientation to the environment).

B. The disturbance develops over a short period of time (usually hours to a few days), represents change from baseline attention and awareness, and tends to fluctuate in severity during the course of a day.

C. An additional disturbance in cognition (e.g., memory deficit, disorientation, language, visuospatial ability, or perception).

D. The disturbances in Criteria A and C are not better explained by another preexisting, established, or evolving neurocognitive disorder and do not occur in the context of a severely reduced level of arousal, such as coma.

E. There is evidence from the history, physical examination, or laboratory findings that the disturbance is a direct physiological consequence of another medical condition, substance intoxication or withdrawal (i.e., due to a drug of abuse or to a medication), or exposure to a toxin, or is due to multiple etiologies.”

Major Cognitive Disorder

“Evidence of significant cognitive decline from a previous level of performance in one

or more cognitive domains (complex attention, executive function, learning and memory,

language, perceptual-motor, or social cognition) based on:

  • Concern of the individual, a knowledgeable informant, or the clinician that there has been a significant decline in cognitive function; and
  • A substantial impairment in cognitive performance, preferably documented by standardized Neuropsychological testing or, in its absence, another quantified clinical assessment.

The cognitive deficits interfere with independence in everyday activities (i.e., at a minimum, requiring assistance with complex instrumental activities of daily living such as paying bills or managing medications).

The cognitive deficits do not occur exclusively in the context of a delirium.

The cognitive deficits are not better explained by another mental disorder (e.g., major depressive disorder, schizophrenia).”

Mild Neurocognitive Disorder

“Evidence of modest cognitive decline from a previous level of performance in one or more cognitive domains (complex attention, executive function, learning and memory, language, perceptual motor, or social cognition) based on:

  • Concern of the individual, a knowledgeable informant, or the clinician that there has been a mild decline in cognitive function; and
  • A modest impairment in cognitive performance, preferably documented by standardized neuropsychological testing or, in its absence, another quantified clinical assessment.

The cognitive deficits do not interfere with capacity for independence in everyday activities (i.e., complex instrumental activities of daily living such as paying bills medications are preserved, but greater effort, compensatory strategies, or accommodation may be required).

The cognitive deficits do not occur exclusively in the context of a delirium.

The cognitive deficits are not better explained by another mental disorder (e.g., major depressive disorder, schizophrenia).”

Cognitive Disorder Treatment

Cognitive disorder treatments may include the following:

  • Medication
  • Cognitive Behavior Therapy
  • Behavior Therapy
  • Rehabilitation
  • Social Skills Training
  • Neurofeedback
  • Neuroplasticity based interventions
  • Treatment of the underlying physical condition (Tumor or lesion)

Conclusion

In this brief guide, we will look at some prevalent cognitive disorders, types of cognitive disorders, cognitive disorders in the DSM 5, and Cognitive Disorders treatment.

Cognitive disorders can be very debilitating and in most cases they do not get better without treatment either, so it is important being aware of the various facets of these problems.

Cognitive disorders also make a fascinating subject to research as information about them is still not nearly enough, and they need to be studied further to ascertain what can be done about them.

If you have any questions or comments about cognitive disorders, please feel free to reach out to us at any time.

Frequently Asked Questions (FAQs): Cognitive Disorders

What are the different types of cognitive disorders?

Here are some of the different types of cognitive disorders:

Alzheimer’s disease.
Behavioral variant frontotemporal dementia.
Corticobasal degeneration.
Primary progressive aphasia.
Progressive supra nuclear palsy.
Huntington’s disease.
Lewy body dementia (or dementia with Lewy bodies)
Mild cognitive impairment.

What are examples of cognitive deficits?

Here are some examples of cognitive deficits:

Memory loss. 
Reasoning and judgment. 
Motor Problems
Language problems. 
Attention and concentration
Complex decision-making processes

What causes a cognitive disorder?

Causes of cognitive disorder can range anywhere from a chronic disease of the brain or the body’s organs, including hypertension, high cholesterol, heart disease, stroke, peripheral vascular disease, hypothyroidism, diabetes, chronic obstructive lung disease, kidney disease, infections, or severe pain, to something acute like a brain trauma or aneurysm.

Substance use, especially when it is prolonged, can also cause cognitive disorders.

What is major cognitive disorder?

Major neurocognitive disorder refers to an acquired disorder of cognitive function that is usually characterized by impairments in memory, speech, reasoning, intellectual function, and/or spatial-temporal awareness.

Citations

https://www.longdom.org/scholarly/cognitive-disorders-journals-articles-ppts-list-2527.html#:~:text=Cognitive%20disorders%20are%20a%20category,amnesia%2C%20dementia%2C%20and%20delirium.

https://en.wikipedia.org/wiki/Cognitive_disorder

https://www.psychguides.com/neurological-disorders/cognitive/

Divya is currently a Clinical Psychology Trainee in a Master of Philosophy program and holds a Master’s in clinical psychology. She has a special interest in Personality studies and disorders, having researched the subject before, and Neuropsychology; with an additional interest being Mood disorders. She likes to write about Psychiatric issues, having worked in multiple specialty setups during her time as a clinical psychology student, and in her free time she likes to cook and read.