As ageing progresses, there may be a gradual limitation or decline in functional capacities, but this does not mean it is normal to experience a pathological loss of functionalities.
In other words, conditions such as dementia or Alzheimer’s are not natural ageing processes. In this case, we are discussing diseases that lead to cognitive impairment. The degrees, symptoms and approach will depend on the specific pathology suffered. There are a variety of ways in which this deterioration can occur.
It is important to note that, given longer life expectancy, the incidence and prevalence of this problem have increased considerably in recent decades.
Below we explain the basics of cognitive impairment to help you understand it better.
Cognitive impairment is the loss or impairment of mental functions such as memory, language, behaviour, orientation or visual recognition.
When these functions are impaired, the performance of the cognitively impaired person’s daily activities and social interaction are affected to a greater or lesser extent.
Like ageing, cognitive impairment is a heterogeneous condition whose causes, not always clear, are also highly variable and go far beyond the passage of time.
For example, exposure to and/or accumulation of heavy metals (such as aluminium, lead, mercury, arsenic, etc.) can lead to dementia of metabolic origin. Thus, heavy metal toxicity can lead to impaired cognitive abilities, even in young people.
This is important in order to address the problem, as well as to be able to implement any measures we can to help prevent damage to our capacities.
In the case of cognitive impairment caused by heavy metal toxicity, present in both natural (e.g. fish) and processed foods, we can take preventive measures by ensuring a good supply of silicon in our diet.
This essential trace element is a chelator of those heavy metals that are harmful to our health. In other words, it is key to detoxifying aluminium, mercury and other heavy metals and preventing them from accumulating and causing cognitive impairment.
Therefore, a good diet, lifestyle habits and incorporating supplements or complexes containing, for example, organic silicon will help reduce the risk of suffering this type of damage.
If we also opt for a supplement containing biotin, even better, as biotin is important for the proper functioning of the nervous system and psychological functions.
In short, although cognitive impairment tends to be more evident at older ages, this condition is not exclusive to older people. In any case, it can present itself in different degrees and forms, as we will see below.
The degree of cognitive impairment a person has is key to determining treatment and anticipating the progression of the problem.
Therefore, different tests and cognitive impairment tests are carried out to assess the level of impairment suffered by the person, which may be:
- Mild cognitive impairment:
Mild cognitive impairment involves memory loss or mild impairment of cognitive skills but does not affect the performance of normal activities.
When this impairment is present, the affected person experiences greater difficulty in remembering things and details that he or she used to remember automatically. However, it cannot be said that dementia or a pathological situation exists.
This is a subjective deficit, as the person affected is aware of his or her forgetfulness, but it is not alarming for the family and close environment.
In any case, the person can continue to lead a completely normal life, with autonomy and independence.
- Mild dementia or mild cognitive impairment:
When the person begins to perceive limitations or failures in their functional and cognitive abilities, we speak of mild dementia or mild cognitive impairment.
For example, the affected person may feel lost or confused at certain times or experience greater difficulty in remembering specific details, such as a date.
In some cases, behavioural disturbances that are not too obvious to the affected person’s environment, such as mood swings that occur abruptly, may manifest themselves.
- Moderate dementia:
We speak of moderate dementia when there is already a considerable cognitive deterioration, perceptible and worrying for the environment of the person who suffers from it.
The affected person often has the inability to understand concepts as well as to learn something new.
In addition, there is significant difficulty in carrying out everyday tasks, and behavioural impairment is accentuated, with frequent attacks of anger or anxiety.
It is also common to experience episodes of disorientation or where the person does not recognise him/herself in the environment, feeling confused or out of place.
- Advanced cognitive impairment:
When there is this degree of impairment, we speak of severe dementia.
In these cases, the affected person can no longer perform basic tasks (eating, toileting, going to the toilet…) and experiences severe memory loss.
These are, therefore, situations where a person or caregiver is already required to assist and care for a person with severe cognitive impairment.
Cognitive impairment, like the brain itself, is very complex and variable.
To understand this in a simple way, we have discussed the classification of the degree of mild, medium, considerable and advanced or severe impairment.
However, it should be noted that cognitive impairment can be classified in alternative ways.
For example, 7 different degrees of impairment are distinguished using the Reisberg Global Impairment Scale. These range from no deficits (grade 1) to severe Alzheimer’s disease (grade 7).
Not all dementias are the same, although they all share or are characterised by altered behaviour and cognitive functions.
There are different types of cognitive impairment or dementia, which is how we usually and generically refer to this group of conditions.
The progression of cognitive impairment and symptoms will depend on the root cause and the affected areas of the brain. Although there are different approaches, the types of dementia or cognitive impairment can be distinguished as follows:
- Depending on the possibility of recovery.
This distinction is simple, as it is limited to differentiating between reversible and irreversible deterioration.
Potentially reversible dementia would be caused by brain tumours, trauma or infections.
The types of irreversible cognitive impairment would include all those for which there is no cure, such as vascular dementia or impairment due to different neurodegenerative diseases.
- Depending on the areas of the brain affected.
In this case, using a more anatomical approach, three types of dementia are distinguished: cortical, subcortical or mixed.
The cerebral cortex is mainly affected in the cortical ones, and the classic example of this type of deterioration is Alzheimer’s disease.
In subcortical dementias, areas of the brain below the cortex are damaged, and this type of affectation can result from pathologies such as Parkinson’s or Huntington’s disease.
As the name suggests, mixed dementias involve a combination of different causes and involvement of both brain areas.
As you can see, this is a very complex issue with many variants.
Therefore, it is important that you go to a professional who can assess you properly if you detect any cognitive impairment in yourself or other people.
Keep in mind that, although not in all cases will we be able to prevent it, there are always things we can do to maintain good cognitive function and minimise the likelihood of cognitive decline.
Reading, playing board games, learning new things, doing tasks requiring mental effort or changing routines are simple daily activities that can help you keep your cognitive abilities in good shape.
As mentioned, nutrition is also essential for proper brain health.
In addition, we must protect our brains from harmful aggressions such as the accumulation of heavy metals.