Cognitive impairment

Cognitive impairment, like many problems in older adults, is often “multifactorial.” anf often ignored in usual hospital care. This means that the difficulties with memory, thinking, or other brain processes are often due to more than one cause and complicates heath care for older people.

Vijiji International  is conducting a study on common causes of Cognitive Impairment in older adults in Mbeya, Tanzania. The project will review several causes of Cognitive Improvement in relation to HIV/AIDS that will include:

Medication side-effects;  Many medications interfere with proper brain function.

Sedatives, tranquilizers, and anticholinergic medications are the most common culprits. For

“Metabolic imbalances.” This term refers to abnormalities in one’s blood chemistry.

Examples include abnormal levels of blood sodium, calcium, or glucose.

Kidney or liver dysfunction can also cause certain types of metabolic imbalances, and these sometimes affect brain function.

Problems with hormones, such as thyroid hormones.

Imbalances in estrogen and other sex hormones may also affect cognitive function.

Deficiencies in vitamins and other key nutrients.

Brain function;  especially known to be affected by low levels of vitamin B12, other B vitamins, and folate.

Delirium as a state of worse-than-usual mental function that can be brought on by just about any type of serious illness.

Delirium is very common in hospitalized older adults, and can also occur due to infection or other health problems in older people who are not hospitalized.

Psychiatric illness; Most psychiatric conditions can cause problems with memory, thinking, or concentration. Psychiatric illnesses can also cause paranoia and other forms of late-life psychosis.

Depression and anxiety; are probably the most common psychiatric conditions in older adults.

It is also possible for older adults to have bipolar disorder, schizophrenia, or other forms of major mental illness; these have often been diagnosed earlier in life.

Substance abuse and/or substance withdrawal; Both acute intoxication and chronic overuse of certain substances (such as alcohol, illicit drugs, or even prescription drugs) can impair brain function.

Damage to brain neurons; due to an injury.

“Vascular” damage to neurons means damage caused by problems with the blood vessels, such as strokes or some form of cerebral small vessel disease.

Head injuries are also associated with temporary or longer-lasting cognitive impairment. These morbidities have not well explored in Africa.

Damage to brain neurons, due to a neurodegenerative condition. Neurodegenerative conditions tend to slowly damage and kill neurons. This can cause mild cognitive impairment, and then eventually dementia.

The more common neurodegenerative conditions that Vijiji International will focus on include Alzheimer’s disease, Lewy-Body disease, Parkinson’s disease, and frontotemporal degeneration.

Infections and HIV co-ininfection; Vijiji International will screen older adults as the other causes above, but certain chronic or acute infections can affect brain cells directly. (If cognitive impairment is caused by an infection outside the brain, such as pneumonia or a urinary tract infection, this would be considered delirium.)

Toxins are another potential cause of cognitive impairment. Research is ongoing as to the cognitive effects of toxins people may be exposed to, such as heavy metals, air pollutants, contaminants in our drinking water, pesticides, and others.