Cognitive impairment

Cognitive Impairment

Description, Causes and Risk Factors:

Abbreviation: CI.

Cognitive impairment

Alternative Name: Mental retardation, intellectual disability.

Cognitive impairment is a disability characterized by significant limitations both in intellectual functioning and in adaptive behavior as expressed in conceptual, social, and practical adaptive skills. This disability originates before age 18. Generally speaking, the disability is characterized by well below average intellectual functioning due to low IQ scores that result in deficits in adaptive behavior.

A number of medical or psychiatric conditions and treatments can cause cognitive impairment, including heavy metal poisoning (in particular mercury poisoning), menopause, fibromyalgia, ADHD, and sleep disorders.

It may also result from a birth injury, such as a lack of oxygen and some defect in baby's formation. A cognitive impairment also may occur later in life, following an injury or as part of a disease. It may also be the result from abuse of prescription medicines, chemicals, street drugs, or alcohol.

In a recent study says the presence of an apolipoprotein E (APOE) gene e4 allele in women increased the odds of developing cognitive impairment more than fourfold by age 95.

Levels of cognitive impairment severity are defined by specific IQ ranges:

    Mild Cognitive Impairment - IQ of 50 to 70.

  • Moderate Cognitive Impairment - IQ of 35 to 55.

  • Severe Cognitive Impairment - IQ 20 to 40.

  • Profound Cognitive Impairment - Below 20.


Signs may include:

    Delays in reaching early childhood developmental milestones.

  • Difficulty retaining information and learning simple routines.

  • Confusion and behavior problems in new situations or places.

  • Short attention span.

  • Lack of curiosity.

  • Difficulty understanding social rules.

  • Sustained infantile behavior into toddlerhood or preschool years.

  • Difficulty understanding consequences of actions.

  • Limited and/or inconsistent communication skills.

  • Lack of age-appropriate self-help and self-care skills.


The evaluation of cognitive impairment is a process that requires a team of professionals.Time must be taken to ensure that information regarding all aspects of a student's developmentand needs are gathered. The goal of a school-based evaluation for cognitive impairment is notto provide a clinical diagnosis for students, but to determine eligibility as well as the need forspecial education services based upon the characteristics manifested. Because thedetermination of cognitive impairment is a subjective process given numerous exclusionaryclause considerations, it is essential that at least one member of the evaluation team have abroad experience with individuals with cognitive impairment to avoid under- or over-identificationbased on exposure to a limited number of students.

Comprehensive skill areas assessed in diagnosing include:


  • Academic.

  • Physical.

  • Behavioral.

  • Behavioral.

  • Communication.

Lab testing may include: Screening for vitamin B12 deficiency and hypothyroidism. Routine laboratory studies such as a complete blood count, electrolytes, glucose, and renal and liver function tests may be ordered. Red blood cell folate should be ordered in patients with ethanol dependence. Screening for neurosyphilis, rapid plasma reagin (RPR), is recommended if there is a high clinical suspicion.

Imaging Tests:

    Cranial CT scan.

  • Cranial MRI.

  • Spinal tap.


After a cognitive impairment has occurred, there may be ways to improve the problem. If the cause is known, it can sometimes be eliminated. In this case, the symptoms may improve without further treatment.

A doctor who specializes in cognitive problems is called a physiatrist. Other professionals may also be involved in treatment. These include psychologists, rehabilitation nurses, physical therapists, occupational therapists, and speech therapists.

    Therapy may help improve thinking skills, such as memory, concentration, and problem-solving.

  • Aids such as alarms or earplugs can also be used.

  • If the person has trouble controlling emotions, psychotherapy may help.

  • Controlling the person's surroundings can also help prevent outbursts. Behavior problems may also be helped with cognitive behavioral therapy. Teaching a person how to behave in different situations is useful, as well. If behavior problems are severe, the person may require supervision.

An individual with a continuing cognitive impairment will have regular visits with the healthcare provider. Any new or worsening symptoms should be reported to the provider.

Disclaimer: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.

DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.


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