Causes of Cognitive Impairment
Cognitive impairment can arise from virtually any poorly controlled 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, severe pain syndromes, obesity, sleep apnea, depression, anxiety,
bipolar disorder, obsessive compulsive disorder, attention deficit disorder,
multiple sclerosis, epilepsy, and alcohol, sedative, opiate or other chemical
dependency. Single or repeated head injuries can impair cognition. Certain
medications that get into the brain can impair cognition, such as tranquilizers,
anticonvulsants, antipsychotics, older antidepressants, pain medications,
and older bladder incontinence medications. Most of these conditions are
treatable, particularly when memory cognitive disorders are detected early
through annual monitoring of cognition after age 50 years old.
The degenerative brain disorders account for less than 50% of all people
with memory cognitive disorders in primary care medical settings. These
include Alzheimer’s Disease (AD), Parkinson’s Disease, Lewy
Body Disease, Frontal Temporal Lobe Disease, and prion disease.
Recent studies show that although Alzheimer’s disease is not curable,
it can be effectively treated to largely preserve independence and eliminate
institutionalization in most individuals. In 2008, Atri Ali and colleagues
at the Massachusetts General Hospital Memory Disorders Unit reported in
the journal, AD and Associated Disorders, one of the most well analyzed
longitudinal studies of Alzheimer’s disease. Patients treated for
up to four years with the combination of Namenda and a cholinesterase
inhibitor (Aricept, Exelon or Razadyne) delayed the functional rates of
decline during the MCI stage by 33%, and during the dementia stage by
50-60%. This means that over the 14-year course of the MCI and dementia
stages of AD, early detection, accurate diagnosis and combined therapy
with Namenda and a cholinesterase inhibitor can delay the functional decline
in AD patients by an average of 5-6 years. Since AD individuals spend
an average of 4 years in institutions, the proper current approach can
largely eliminate institutionalization.