What is cognitive impairment?
Cognitive Impairment (CI) is a decline in neurological functioning that can range from mild to severe. It affects a patient’s ability to problem solve, retain memories, pay attention, and learn new information. It slows down motor speed and reaction times, and diminishes overall executive functioning.
There are TWO common cognitive impairment syndromes:
|
(1) Acute, fluctuating |
(2) Chronic |
| Medical Diagnosis |
• Delirium |
• Subjective Cognitive Decline
• Mild Cognitive Impairment ((MCI), Mild Neurocognitive Disorder)
• Dementias (Major Neurocognitive Disorder)
|
| Characteristics |
Rapid onset; triggered by chronic illness, medication, surgery, infection, or metabolic imbalance |
Lasting, persistent, or progressive |
| Prevalence |
More prevalent in decompensated HF |
More prevalent in stable HF |
(Pi-Figueras et al 2004; Inouye 2006)
Common chronic cognitive impairment syndromes prevalent in stable heart failure (HF) include:
Subjective Cognitive Impairment
- Subjective complaints, no objective findings of deficits
- Does not interfere with daily life or function
Mild Cognitive Impairment (MCI)
- Subjective complaints and objective findings
- Single or multiple domain deficits
- With or without memory impairment
- Deficits are severe enough to be noticed by others
- Deficit does not interfere with daily life and function. Eg. Patient is able to maintain baseline function by using memory aids (notes, calendars, phone reminders)
- Increased risk of developing dementia
Dementia
- Progressive impairment in more than one cognitive domains
- Deficits interfere with daily life and function
- Patient may not report subjective complaints
- Most dementias have memory impairment especially in the later stages
- There are many different types of neurodegenerative dementia (e.g. Alzheimer’s, Lewy body, Frontotemporal)
- Dementia may also have vascular origin – Vascular Dementia or Vascular Cognitive Impairment
