cognition

see also:

• neurology
• dementia
• cognitive testing:
  • mental state - delirium vs dementia vs psychosis
  • AMTS cognitive impairment test
  • CAM confusion assessment test for diagnosis of delirium
  • Clock test - a measure of frontal and executive functioning and need for further dementia testing
  • Geriatric depression scale
  • Mini-mental state examination
  • Modified Mini-Cog Test
  • Differentiating conversion disorder from malingering
  • Western Health CPG 8.2 Cognitive Impairment Identifier (WH intranet only)

• the following is from basic to advanced cognition

• the comatose patient

• spatial attention
  • ability to prioritise signals from a given spatial location
• selective or focused attention
  • ability to prioritise some forms of information and to suppress others on the basis of a functional goal
• divided attention
  • ability to share attention between simultaneous tasks
• arousal or sustained attention
  • ability to self-maintain an alert or ready to respond state

• difficulty listening or concentrating on a task
• difficulty following conversational speech
• reduced ability to decide on importance of information
• difficulty in comprehending written material
• difficulty in concentrating to the end of a meal
• easily distracted eg. burning toast making breakfast, difficulty shopping with a shopping list
• difficulty in writing down messages whilst listening to a conversation on a phone

• orientation in space
• enables safe locomotion
• facilitates interaction with other objects and people
• allows for the expression and understanding of visual symbols of communication

• spatial neglect of one side in a stroke
  • bumping into objects
  • difficulty putting clothes on
  • unsafe crossing roads
  • unable to locate digits on one side of a phone
  • unable to be aware of persons on the neglected side

• see also: memory
• implicit memory
  • priming and conditioning
  • procedural (motor skills)
• explicit memory
  • events (episodic)
  • semantic (facts)
• working memory
  • new learning requires:
    • registration
    • acquisition (encoding)
    • storage and rehearsal
    • retrieval
• forgetting
  • active loss of memories appears to be an important physiologic process to allow further memories
  • process may involve the protein scribble which appears to combine the Rac1 and dopamine pathways together into a single dynamic pathway that controls active forgetting

• difficulty remembering what they were going to say
• disorientation to time, place, person
• inability to recall how to perform tasks
• failure to remember safety precautions
• inability to learn strategies

• complex functions such as:
  • adaptive behaviour
  • abstract conceptual thinking
  • set shifting and mental flexibility
  • problem solving
  • planning and organisation
  • sequencing of behaviour
  • personality factors such as motivation, inhibition.