What causes cognitive difficulties?

In this article below, Dr Joseph Mole, a highly experienced and esteemed neuropsychologist and clinical psychologist, explains the relationship between cognitive functions and the brain.

What are cognitive functions?

Cognitive functions are a group of skills supported by the brain. These include simple skills, such as object recognition, and more complex ones, such as problem-solving.

Cognitive functions are typically grouped into what are referred to as ‘cognitive domains’. Cognitive domains are different kinds of abilities, supported by somewhat different parts of the brain. For example, cognitive abilities are often grouped into memory, language, visual functions, speed of thinking, and what are referred to as ‘executive functions’ (complex thinking skills).

How does the brain support cognitive functions?

It is generally understood that different parts of the brain play a role in different cognitive abilities. As a rule of thumb, the areas in the front parts of the brain are generally involved in more complex cognitive abilities, such as planning and reasoning.

However, it is also important to understand that different brain areas are connected to one another as part of larger networks, so the relationship between cognitive functions and the brain is far from straightforward.

What causes cognitive difficulties?

Due to the fact that cognitive functions are supported by the brain, it is not surprising that cognitive difficulties are common in people with neurological conditions. There are a wide range of conditions that affect how the brain functions but some of the most prevalent are stroke, traumatic brain injury, and dementia (including Alzheimer’s disease). 

Cognitive difficulties can also be caused by other conditions that affect the brain’s functioning indirectly. This includes any factor that limits a person’s ability to perform at their best. As you might expect, this can include a wide range of factors, including but not limited to anxiety, depression, long COVID, chronic pain, chronic fatigue syndrome and menopause.

It is also important to emphasise that, as part of the normal ageing process, some cognitive skills may get better as we age but some may worsen. Typically, as we get older, we can become wiser and more knowledgeable but may experience certain difficulties, such as trouble finding words. 

In recent years, there has also been growing awareness of neurodiversity. We are beginning to appreciate that we do not all have the same strengths and weaknesses. Many people with diagnoses such as Attention Deficit Hyperactivity Disorder (ADHD), dyslexia and Autism Spectrum Disorder (ASD), may be better than other at performing some tasks but may also experience difficulty with specific aspects of cognitive functioning, such as attention.  

What is a cognitive assessment?

Cognitive assessment (often referred to as neuropsychological assessment) is a way of measuring a person’s cognitive abilities. This typically involves a clinical interview and completing tests of functions such as memory, language and speed of thinking.

This is a complex and highly specialist area of expertise, so it is vital that it is performed by someone who is qualified and has extensive experience of conducting neuropsychological assessment. A cognitive assessment should be conducted by a qualified clinical psychologist or Neuropsychologist, with a great deal of experience of working with people with cognitive difficulties.

Why is cognitive assessment important?

A cognitive assessment can be important for a range of reasons. One is to help medical professionals to diagnose and measure the impact of certain neurological conditions. For example, for someone who is worried that they may have dementia, a cognitive assessment can help to ensure that they receive the right diagnosis and management.

For someone who may have suffered a traumatic brain injury, a cognitive assessment can be important to help that person to understand the nature and extent of the challenges they face and can help them to develop strategies to overcome them. This is also important in medico-legal contexts, such as personal injury claims.

However, regardless of the cause, if someone is experiencing cognitive difficulties a cognitive assessment can help that person to understand the nature of their challenges and put a plan in place to manage their difficulties.

What can you do to manage cognitive difficulties?

While cognitive difficulties can have an impact on a person’s life, they can also be managed. Many clinical psychologists/neuropsychologists will offer what is referred to as cognitive rehabilitation or neuropsychological rehabilitation. This is a way of working with someone to help them to develop practical strategies to manage cognitive difficulties.

There is now a solid evidence-base demonstrating that, when people are equipped with a basic understanding of their difficulties and a set of simple strategies for managing them, they are more able to live richer, more meaningful lives.

To book an appointment with Dr Joseph Mole, just visit his Top Doctors profile.