What’s causing your memory loss? Discover the various conditions that can lead to dementia-like symptoms, and learn how to identify reversible forms of cognitive decline that can be treated effectively.

Unraveling the Complexities of Dementia

Dementia is a complex and often misunderstood condition, with more than 50 different underlying causes that can lead to similar symptoms. While Alzheimer’s disease is the most common form of irreversible dementia, there are also several other degenerative disorders, vascular conditions, and infections that can result in cognitive decline. Distinguishing between these various types of dementia is crucial, as it determines the appropriate course of treatment and the potential for reversing the condition.

Reversible Dementias: Identifying Treatable Causes

Surprisingly, a small percentage of dementias are actually reversible, meaning that with the right treatment, the symptoms can be alleviated or even completely resolved. These reversible forms of cognitive decline are often accompanied by other, more obvious symptoms, making them easier to diagnose than irreversible dementias.

Delirium: A Medical Emergency

Delirium is a condition that can closely resemble dementia, but it is characterized by a rapid onset of mental changes, often within hours or days, as well as fluctuations in the level of consciousness. Delirium is considered a medical emergency, as it is usually the result of an underlying, potentially life-threatening illness. Prompt treatment of the underlying cause is crucial to resolving the delirium.

Medication-Induced Cognitive Decline

Medications are a common culprit in causing dementia-like symptoms, especially in the elderly. As we age, the liver and kidneys become less efficient at metabolizing and eliminating drugs, leading to an accumulation of these substances in the body. Elderly individuals and those taking multiple medications are at a higher risk of experiencing this type of reversible cognitive decline.

Depression and “Pseudodementia”

Depression can also manifest with symptoms that resemble dementia, a condition known as “pseudodementia.” In this case, the depressed mood precedes the onset of cognitive decline, and the person may often complain about memory loss or lack of concentration, rather than trying to conceal these issues.

Vitamin B12 Deficiency and Pernicious Anemia

Pernicious anemia, a rare condition caused by a deficiency in vitamin B12, can also lead to dementia-like symptoms, such as confusion, slowness, irritability, and apathy. Fortunately, B12 injections can effectively treat this reversible form of cognitive decline if caught early.

Recognizing the Importance of Early Diagnosis

Regardless of the underlying cause, it is crucial to report any signs of cognitive decline to a healthcare professional as early as possible. This ensures that the appropriate diagnostic tests can be performed, and the most effective treatment plan can be implemented, potentially reversing the symptoms before permanent brain damage occurs.

Distinguishing Irreversible Dementias

While some forms of dementia are treatable, the majority of cases involve irreversible conditions, such as Alzheimer’s disease, vascular dementia, and various neurodegenerative disorders. Identifying the specific type of dementia is important, as it guides the treatment approach and sets expectations for the course of the condition.

The Complexity of Dementia Diagnosis

Diagnosing the type of dementia can be a complex process, as the symptoms of different forms of cognitive decline can often overlap. Healthcare professionals must carefully consider the patient’s medical history, symptoms, and results from diagnostic tests to determine the most likely underlying cause.

Staying Vigilant for Early Signs of Cognitive Decline

By being aware of the various conditions that can lead to dementia-like symptoms, individuals can be proactive in seeking medical attention at the first signs of cognitive decline. This early intervention is crucial, as it increases the likelihood of identifying and treating any reversible causes before permanent brain damage occurs.

What’s Causing Your Memory Loss?

A Harvard Health article

It’s Not Necessarily Alzheimer’s

More than 50 conditions can cause or mimic the symptoms of dementia, and a small percentage of dementias are reversible. Two common examples are dementia caused by vitamin B12 deficiency or an underactive thyroid (hypothyroidism). Getting the right diagnosis is important so that you know what options you have, because symptoms subside when the underlying problem is treated.

Distinguishing between types of dementia

For physicians and families intent on pinning down a diagnosis, one major complicating factor is the existence of so many kinds of dementia. More than 50 conditions can mimic or cause dementia.

Alzheimer’s disease is by far the most common intractable condition. But other causes of irreversible dementia include blood vessel diseasevascular dementia), other degenerative disorders (frontotemporal lobar degeneration, Parkinson’s disease, Huntington’s disease), slow-growing brain tumors, or infections of the central nervous system (Creutzfeldt-Jakob disease, AIDS dementia, neurosyphilis).

In some types of dementia, treatment will improve mental functioning, and in a small percentage, the dementia is completely reversible if treatment begins before permanent brain damage occurs. That’s why it is important to report to a doctor any signs of dementia as early as possible.

Reversible dementias

Reversible dementias are often easier to diagnose than irreversible dementias because they are usually accompanied by other, obvious symptoms. In the following conditions or situations, however, dementia may be the primary, or even the only, symptom. Proper treatment may improve or even restore cognitive functioning.

Delirium

Delirium causes changes in mental functioning that can closely resemble dementia, but there are two important differences:

• Speed of onset. The mental changes in delirium develop quickly, often in a matter of hours or days. In contrast, dementia evolves over months or years.
• Level of consciousness. In delirium, consciousness is either clouded or fluctuates between drowsiness and alertness. Dementia doesn’t affect the level of consciousness.

Delirium is considered a medical emergency, in part because it’s often the main expression of a sudden, life-threatening illness. Elderly people are also susceptible to delirium after surgery.

Alcohol withdrawal syndrome presents the classic picture of delirium. Similarly, delirium can occur from abrupt withdrawal from benzodiazepines, a group of anti-anxiety drugs that includes diazepam (Valium), chlordiazepoxide (Librium), and alprazolam (Xanax).

Toxic reactions to drugs

Medications are common culprits in mental decline. With aging, the liver becomes less efficient at metabolizing drugs, and the kidneys eliminate them from the body more slowly. As a result, drugs tend to accumulate in the body. Elderly people in poor health and those taking several different medications are especially vulnerable.

The list of drugs that can cause dementia-like symptoms is long. It includes:

• antidepressants
• antihistamines
• anti-Parkinson drugs
• anti-anxiety medications
• cardiovascular drugs
• anticonvulsants
• corticosteroids
• narcotics
• sedatives

Depression

People sometimes manifest dementia-like symptoms—forgetfulness, disorientation, inattentiveness, and slowed responses—when they are depressed. This so-called pseudodementia can masquerade as the depression that often accompanies Alzheimer’s disease, but there are subtle differences.

• Pseudodementia. In pseudodementia, the depressed mood begins before there is any mental decline. Typically, the person complains about memory loss or lack of concentration, looks sad or worried, and speaks in a flat, expressionless tone.
• Depression. In Alzheimer’s-related depression, the mental decline comes first, and the person usually tries to conceal memory problems, rather than call attention to them.

Vitamin B12 deficiency

In older people, the first symptoms of pernicious anemia are often confusion, slowness, irritability, and apathy. Other symptoms of pernicious anemia include:Dementia could be a symptom of pernicious anemia, a rare condition caused by low levels of vitamin B12. In people with pernicious anemia, the bone marrow produces red blood cells that are both larger and less numerous than normal (see illustration).

• yellowish skin
• fatigue
• shortness of breath
• headaches
• numbness or tingling in the hands and feet
• trouble keeping balance

Usually the B12 deficiency that underlies pernicious anemia is not caused by a lack of B12 in the diet. That’s because this vitamin is plentiful in eggs, dairy products, meat, fish, and poultry, and it’s efficiently stored in the liver.

Instead, a B12 deficiency usually occurs because an individual can’t absorb the vitamin from food. Fortunately, B12 injections, if started early, can remedy the deficiency and alleviate the symptoms of pernicious anemia.

Hydrocephalus

Hydrocephalus (“water on the brain”) is an excess of cerebrospinal fluid around the brain. The fluid is secreted by the ventricles (cavities in the center of the brain). It circulates around the spinal cord and is absorbed by veins on the external surface of the brain.

Congenital hydrocephalus is usually diagnosed shortly after birth, but normal-pressure hydrocephalus occurs in a small number of elderly people. This condition can result from head trauma, brain hemorrhage, or meningitis (inflammation of the membrane covering the brain), but most cases occur spontaneously without an obvious preceding illness.

In addition to developing dementia, people with this condition lose bladder control and walk in a slow, hesitant manner, as if their feet are stuck to the floor. A surgically implanted tube (shunt) that drains fluid from a cavity in the brain (the lateral ventricle) to the jugular vein or to the abdomen brings rapid improvement, provided treatment is started soon after the symptoms appear.

Tumors

Brain tumors may be malignant (cancerous) and therefore capable of invading surrounding tissue. Or they may be benign (self-contained).

Brain tumors can interfere with cognitive functioning and cause personality changes. Depending on their location, they can trigger other symptoms, such as headaches, seizures, or vomiting.

The first symptoms of slow-growing tumors frequently resemble dementia, especially in older people.

Subdural hematomas

Hematomas are blood clots caused by bruising. When they are located in the subdural area, between the brain surface and the thin membrane that covers it (the dura), they can cause symptoms that mimic Alzheimer’s disease. Such subdural hematomas can also be life-threatening, causing coma and death.

Most subdural hematomas are caused by severe head trauma sustained in automobile crashes.

But elderly people sometimes develop subdural hematomas after a very minor (and, therefore, often forgotten) head injury. As blood oozes into a closed space, the hematoma enlarges and begins to interfere with brain function.

Removing the clot within weeks of the injury may restore mental function. However, the symptoms often evolve so slowly that diagnosis is delayed for months.

Thyroid disease

An overproduction of thyroid hormones (hyperthyroidism) is commonly caused by Graves’ disease, while an underproduction (hypothyroidism) usually results from Hashimoto’s thyroiditis. Both disorders can cause dementia-like symptoms.

• Hyperthyroidism. To diagnose hyperthyroidism, physicians use a simple blood test that measures levels of thyroid hormones. Surgically removing the thyroid or destroying it with radioactive iodine usually corrects the cognitive problems.
• Hypothyroidism. This is diagnosed by measuring the level of thyroid-stimulating hormone circulating in the blood. Physicians usually recommend thyroid hormone replacement, but this treatment doesn’t always reverse the dementia.

Alcoholism

Wernicke-Korsakoff syndrome, an irreversible state of confusion and amnesia in alcoholics, results from thiamine deficiency due to long-term malnutrition. But consuming excessive amounts of alcohol for a decade or more can also cause impaired thinking that resembles Alzheimer’s disease.

In dementia due to alcoholism, memory, orientation, and attention deteriorate, although verbal skills are not always severely affected. In this type of dementia, abstinence may partly restore mental functioning.

Irreversible dementias

Although there are many causes of irreversible dementia, the following conditions are among the most common. In some cases, prompt treatment can prevent further damage, but lost cognitive functioning cannot be restored.

Alzheimer’s disease

Alzheimer’s is distinguished from other dementias at autopsy by the presence of sticky beta-amyloid plaques outside brain cells (neurons) and fibrillary tangles within neurons. Although such lesions may be present in any aging brain, in people with Alzheimer’s these lesions tend to be more numerous and accumulate in areas of the brain involved in learning and memory.

The leading theory is that the damage to the brain results from inflammation and other biological changes that cause synaptic loss and malfunction, disrupting communication between brain cells. Eventually the brain cells die, causing tissue loss (see illustration). In imaging scans, brain shrinkage is usually first noticeable in the hippocampus, which plays a central role in memory function.

The hallmark symptom of Alzheimer’s is difficulty in recalling new information. As Alzheimer’s progresses, the following may occur:

• Memory loss. This may be severe enough to disrupt daily life (for example, the person may get lost in a previously familiar neighborhood).
• Cognitive decline. The individual may also experience decline in cognitive ability (finding it hard to make decisions, solve problems, or make good judgments).
• Mood or personality changes. An individual with Alzheimer’s may undergo significant changes in mood and personality (such as becoming more irritable, hostile, or apathetic).

Alzheimer’s is severely debilitating, and death usually occurs within three to nine years after it is diagnosed. Five drugs have been approved for treating Alzheimer’s, but they alleviate symptoms only slightly.

Vascular dementia

Some cognitive problems stem from insufficient blood flow to portions of the brain. The decrease in blood flow is often the result of atherosclerosis (the accumulation of fatty deposits on artery walls) in the blood vessels that feed the brain. The resulting interruption of blood flow creates areas of dead tissue.

These events—which are in fact tiny strokes—often go unnoticed, because each one damages just a small part of the brain and doesn’t cause long-term impairment. But the cumulative damage can lead eventually to large areas of dead brain tissue, and symptoms such as confusion, impaired thinking, slurred speech, and paralysis may arise.

People with vascular dementia usually have one or more of the following risk factors:

• hypertension (high blood pressure)
• cardiovascular disease
• diabetes
• a history of stroke

The classic symptom of vascular dementia is an abrupt mental change, sometimes accompanied by paralysis or slurred speech. The mental deterioration proceeds in a “stairstep” pattern—a person suffers a sudden cognitive decline, the decline levels off, and then new strokes cause another sudden decline.

Degenerative diseases

Most dementias are caused by degenerative diseases, conditions whose deterioration cannot be stopped. Alzheimer’s disease is the degenerative disease that is most often responsible for dementia, accounting for more than 50% of cases. Frontotemporal lobar degeneration, Parkinson’s disease, and Huntington’s disease account for approximately 25% of all dementias.

Frontotemporal lobar degeneration. This group of diseases, formerly called Pick’s disease, is characterized by atrophy of the front part of the brain, including the frontal and temporal lobes. It is often confused with Alzheimer’s disease because the symptoms are sometimes identical. Some experts believe it may be the second most common dementia, after Alzheimer’s disease.

The cause of frontotemporal lobar degeneration is unknown, but some variants can run in families, and it is sometimes associated with gene mutations. People with frontotemporal lobar degeneration exhibit symptoms such as:

• prominent aphasia (impaired ability to use language) early in the illness
• loss of inhibition, resulting in sociopathic or hypersexual behavior
• loss of emotional responses such as fear
• compulsively putting objects in their mouths.

Parkinson’s disease. This is a movement disorder resulting from a deficiency of dopamine, a neurotransmitter involved in coordinating muscle activity as well as memory function.

Its hallmarks include tremors, rigid limbs, and difficulty starting or stopping movement. Mild cognitive problems are common early in the disease, and dementia occurs in 30% to 80% of Parkinson’s patients in the late stages.

Some people with Parkinson’s disease develop dementia because they also have Alzheimer’s disease. In other cases, the dementia is associated with hallucinations and appears to be linked to damage in the limbic and cortical areas of the brain. This variant of Parkinson’s is called Lewy body dementia.

Drugs that increase dopamine transmission, such as levodopa (Sinemet), help control the physical symptoms of Parkinson’s but don’t improve mental function.

Huntington’s disease. Huntington’s disease is a rare inherited disorder linked to an abnormal gene on chromosome 4. Its symptoms include involuntary writhing movements and dementia, and they often begin between the ages of 20 and 40.

Mental disturbances may occur before or after physical problems appear, and people are often difficult to care for because of their irritability, aggressiveness, and erratic behavior. Medications can control the movement and mood disorders, but they don’t stop the disease from progressing.

Infectious dementias

Virtually any infectious agent that attacks the central nervous system can cause dementia.

Creutzfeldt-Jakob disease. This is a rare, rapidly progressive dementia caused by a type of infectious agent called a prion. The initial symptoms are fatigue and subtle changes in behavior. Typically, the disease progresses to movement problems, seizures, coma, and—within a year—death.

AIDS dementia. This form of dementia occurs in people with AIDS. The dementia can develop rapidly, sometimes in a matter of weeks, and consists of forgetfulness, inattentiveness, and thinking difficulties.

Neurosyphilis. Before the introduction of penicillin, up to 30% of dementia patients admitted to mental institutions had neurosyphilis. This disorder, which develops about 15 years after syphilis infection, is now rare, because syphilis is typically treated before it reaches that point.

What is Cerebral (Brain) Atrophy?

Brain atrophy, or cerebral atrophy, is a condition in which the brain or regions of the brain literally shrink in size. It ranges in severity, the extent of which determines its impact.

A mild degree of brain atrophy is not always a concern. Substantial brain atrophy can be associated with major neurological diseases, such as a large stroke or progressive dementia. In some instances, it isn’t clear whether cerebral atrophy caused the medical condition or vice versa.

Based on what experts know about brain atrophy, there may be some ways of preventing it or slowing it down. If you or a loved one has been diagnosed, it helps to understand the implications and to learn if there is anything you can do about this condition.

PASIEKA / Getty Images

Causes

A variety of things cause cerebral atrophy. It may be the consequence of a progressive neurological disease, brain damage, or be present at birth.

Progressive Diseases

A number of neurological syndromes are characterized by degeneration of certain cells in the brain.

Parkinson’s disease and Alzheimer’s disease are the most recognized neurodegenerative conditions that affect the brain. Others include:

It is not clear why these conditions develop, and experts suggest a mix of genetic and environmental factors may be involved.

Sometimes, an acquired condition, such as AIDS, can be associated with cerebral atrophy and degenerative dementia. Wernicke-Korsakoff syndrome can cause progressive brain atrophy and behavioral changes in association with alcohol abuse.

Some experts suggest that aging is associated with slowly progressive atrophy, and researchers aren’t sure whether this has any effect on a person’s abilities or not.

Brain Damage

In some instances, cerebral atrophy occurs due to sudden brain damage, such as a:

• Stroke
• Head trauma
• Brain infection (encephalitis)
• Brain tumor

These causes differ from degenerative neurological disease because they involve an episode rather than a progression of damage.

Recurrent head trauma can cause multiple episodes of brain damage, resulting in severe cerebral atrophy and a condition described as chronic traumatic encephalopathy (CTE).

Recurrent strokes can cause multiple areas of atrophy, typically with behavioral changes and vascular dementia. Sometimes multiple sclerosis (MS) can cause areas of brain atrophy as well.

After a region of the brain becomes damaged, the area may be exposed to inflammation and swelling. Eventually, this can cause necrosis of the affected brain cells.

Cerebral palsy (CP), a congenital condition, may also be associated with cerebral atrophy, but brain atrophy is not always present in CP.

Congenital

It is also possible for cerebral atrophy to be present at birth.

Symptoms

Brain atrophy essentially means that neurons and their connections to each other have undergone necrosis (cell death). The affected areas cannot function as they should. Where this occurs determines what symptoms you experience.

Atrophy in the brain can be focal or generalized:

• Focal brain atrophy affects one or more specific regions.
• Generalized cerebral atrophy affects the whole brain about equally throughout all regions.

Usually, with cerebral atrophy, there are still some functioning neurons among those that have undergone necrosis, so the symptoms may be partial rather than complete.

Progressive atrophy typically occurs during adulthood, manifesting with a loss of skills. It tends to be generalized, although there may be areas of the brain that are more affected than others. The symptoms tend to slowly worsen over the course of months or even years.

Symptoms of progressive brain atrophy include:

Acute focal brain atrophy, that which occurs weeks after the sudden symptoms of a stroke, head trauma, or infection, can produce:

• Weakness of the face, arm and/or leg
• Numbness
• Vision changes
• Problems with balance

Congenital brain atrophy tends to affect certain areas of the brain, rather than the whole brain equally. Symptoms may be noticeable during infancy or early childhood and can include:

• Seizures
• Trouble walking
• Delayed speech
• Learning difficulties

Diagnosis

Typically, cerebral atrophy is identified with brain imaging tests. These tests can include:

Your medical team might request that you have a brain CT or MRI if you develop symptoms such as weakness, numbness, vision, loss, or personality changes.

In general, PET and SPECT are often done for research purposes rather than in the clinical setting. These tests may identify generalized cerebral atrophy or areas of focal cerebral atrophy.

Sometimes when regions of atrophy are noted on a brain imaging examination, it can help in diagnosing the medical condition. For example:

• Alzheimer’s disease: The hippocampus, which helps form new memories, and the temporo-parietal lobes are affected by atrophy in most patients with Alzheimer’s disease.
• Fronto-temporal dementia: The frontal and temporal lobes are the most severely affected by atrophy.
• Lewy body dementia: The midbrain, hypothalamus, and substantia innominata are the areas with the most atrophy in this condition.
• Parkinson’s disease: The substantia nigra and midbrain may appear smaller at late stages.
• Stroke: Areas of the brain that have been damaged by bleeding or loss of blood supply may undergo atrophy, producing small “holes” in the brain.

Some types of atrophy—such as vascular dementia, CTE, MS, and atrophy due to encephalitis or AIDS—may result in cerebral atrophy in different regions of the brain.

Treatment

It’s not possible to reverse brain atrophy after it has occurred. However, preventing brain damage, especially by preventing a stroke, may reduce the amount of atrophy that you develop over time.

Some researchers suggest that healthy lifestyle strategies could minimize the atrophy that’s normally associated with aging.

Medications

Prescription medications used for the prevention of strokes may help prevent atrophy, such as:

• Blood thinners
• Cholesterol-lowering agents
• Antihypertensive medications

These medications are not for everyone, but they can be beneficial if you have certain risk factors.

Medications used to treat Alzheimer’s disease, including Aricept (donepezil) and Namenda (memantine), may help slow down atrophy, but the effect is believed to be small, if any.

Lifestyle Strategies

Maintaining a lifestyle that includes physical exercise, a low-cholesterol diet, blood sugar control, and a healthy weight may prevent or reduce the speed of cerebral atrophy by reducing the effects of inflammation on the brain.

Certain fats, specifically trans fats, have a harmful effect on the body and can increase the risk of strokes. Therefore, avoiding trans fats can help prevent strokes and, consequently, cerebral atrophy.

Stress management may reduce brain atrophy because emotional stress is associated with conditions such as hypertension, heart disease, and stroke—all of which lead to vascular dementia. Furthermore, researchers are starting to see evidence that stress may contribute to dementia as well.

A Word From Verywell

The thought of your brain shrinking is something that certainly would stop anyone in their tracks. However, it’s important to know that a very slow and steady rate of brain atrophy may not cause any effects at all.

If you’ve been diagnosed and your case is more substantial and producing symptoms, be sure to follow up with your doctor and to use medications and/or lifestyle strategies to reduce the impact and progression of your condition.

Causes of dementia – NHS

Dementia is a term used to describe the symptoms that occur when there’s a decline in brain function.

Dementia is not a single disease. There are different diseases that can cause dementia. Many of these diseases are associated with an abnormal build-up of proteins in the brain.

This build-up causes nerve cells to function less well and ultimately die. As the nerve cells die, different areas of the brain shrink.

Causes of Alzheimer’s disease

Alzheimer’s disease is the most common type of dementia.

Alzheimer’s disease is thought to be caused by the abnormal build-up of 2 proteins called amyloid and tau.

Deposits of amyloid, called plaques, build up around brain cells. Deposits of tau form “tangles” within brain cells.

Researchers do not fully understand how amyloid and tau are involved in the loss of brain cells, but research into this is continuing.

As brain cells become affected in Alzheimer’s, there’s also a decrease in chemical messengers (called neurotransmitters) involved in sending messages, or signals, between brain cells.

Levels of 1 neurotransmitter, acetylcholine, are particularly low in the brains of people with Alzheimer’s disease.

Medicines like donepezil increase levels of acetylcholine, and improve brain function and symptoms.

These treatments are not a cure for Alzheimer’s disease, but they do help improve symptoms.

Read more about treatments for dementia.

The symptoms that people develop depend on the areas of the brain that have been damaged by the disease.

The hippocampus is often affected early on in Alzheimer’s disease. This area of the brain is responsible for laying down new memories. That’s why memory problems are one of the earliest symptoms in Alzheimer’s.

Unusual forms of Alzheimer’s disease can start with problems with vision or with language.

Read more about Alzheimer’s disease.

Causes of vascular dementia

Vascular dementia is caused by reduced blood flow to the brain, which damages and eventually kills brain cells.

This can happen as a result of:

• narrowing and blockage of the small blood vessels inside the brain
• a single stroke, where the blood supply to part of the brain is suddenly cut off
• lots of “mini strokes” that cause tiny but widespread damage to the brain

Not everyone who has a stroke will go on to develop vascular dementia.

Read more about vascular dementia.

Mixed dementia

Because both vascular dementia and Alzheimer’s disease are common (especially in older people) they may be present together.

This is often called mixed dementia because a mix of these 2 conditions is thought to be the cause of the dementia.

It can be difficult to know how much each cause is contributing to a person’s problems.

Causes of dementia with Lewy bodies

Lewy bodies are tiny clumps of a protein called alpha-synuclein that can develop inside brain cells.

These clumps damage the way the cells work and communicate with each other, and the brain cells eventually die.

Dementia with Lewy bodies is closely related to Parkinson’s disease and often has some of the same symptoms, including difficulty with movement and a higher risk of falls.

Read more about dementia with Lewy bodies.

Causes of frontotemporal dementia

This is an important cause of dementia in younger people. It’s most often diagnosed between the ages of 45 and 65.

It’s caused by an abnormal clumping of proteins, including tau, in the frontal and temporal lobes at the front and sides of the brain.

The clumping of these proteins damages nerve cells in the frontal and temporal lobes, causing brain cells to die. This leads to shrinking of these areas of the brain.

Frontotemporal dementia is more likely to run in families than other, more common causes of dementia.

Read more about frontotemporal dementia.

Rarer causes of dementia

There are many rarer diseases and conditions that can lead to dementia, or dementia-like symptoms.

These conditions account for only 5% of dementia cases in the UK.

They include:

Mild cognitive impairment

Mild cognitive impairment (MCI) is not a cause of dementia.

it’s a term used to describe minor memory and thinking problems, such as:

• memory loss
• difficulty concentrating
• problems with planning and reasoning

These symptoms are not severe enough to cause problems in everyday life.

MCI can be caused by an underlying illness, such as depression, anxiety or thyroid problems.

If the underlying illness is treated or managed, symptoms of MCI often disappear and cause no further problems.

But in some cases, people with MCI are at increased risk of going on to develop dementia, which is usually caused by Alzheimer’s disease.

Read more about how to prevent dementia.

Take part in dementia research

There are many dementia research projects and clinical trials going on around the world, many of which are based in the UK.

If you have a dementia diagnosis or are worried about memory problems, you can help scientists understand more about it, and develop possible treatments, by taking part in research.

Carers can also take part, as there are studies into the best ways to care for someone with a dementia diagnosis.

Sign up to take part in trials on the NHS Join Dementia Research website.

Sign up for the Dementia Information Service emails

Video: early onset dementia

In this video, an expert explains the value of early diagnosis and planning for the future.

Media last reviewed: 1 July 2021
Media review due: 1 July 2024

Page last reviewed: 11 January 2021

Next review due: 11 January 2024

Cognitive Decline – How Others Have Benefited

Cognitive decline is the gradual loss of brain function, loss of memory, and shrinking of the brain mass. This can lead to confusion or to the diagnosis of dementia or Alzheimer’s. The symptoms of cognitive decline are subtle and may only be noticeable to the patients. If you notice that your symptoms are getting worse, contact your local physician.

Get Started on Your Cognitive Decline Treatment

Types of Cognitive Decline

Mild Cognitive Impairment (MCI)

MCI’s are in the middle of the spectrum between cognitive decline that comes with aging and on the other, more serious end, dementia. Symptoms of an MCI include problems with memory, speech, and the ability to think clearly.

Subjective Cognitive Impairment (SCI)

SCI is a form of cognitive impairment in which you experience frequent confusion and memory loss. An SCI can also be a sign of Alzheimer’s disease or dementia.

Neurocognitive Disorders (NCDs)

An NCD differs from other types of cognitive decline because it affects more than one cognitive domain. A neurocognitive disorder not only affects your memory and perception, but speech, your social cognition abilities, and your attention span.

Learn More About Cognitive Decline

What are the Symptoms of Cognitive Decline?

Slower Thought Process

Our brain processing speed indicates the rate at which we can absorb new information, make a judgment, and develop a response. As we get older, our ability to process information lessens. The cognitive decline in our brain processing speed can be caused by the aging of or a traumatic insult to the brain. Maintaining a balanced diet, getting regular exercise, and mentally stimulating your brain can all help to improve the functionality of your brain.

Memory Loss

Memory loss is part of the aging process. However, if memory loss is affecting your capacity to complete everyday tasks, it may be something more a symptom of cognitive decline. Signs of memory loss include:

• Telling the same story or asking the same question repeatedly
• Forgetting the names of loved ones
• Having trouble finding your words
• Inability to stay focused

Similar to the improvement of brain processing speed, you can help improve your memory loss by exercising at least twice a week, eating a healthy diet, getting a good night’s rest, and avoiding drinking and smoking.

Brain Fog

When you have brain fog, you will notice that it is difficult to complete tasks. The term “brain fog” refers to your mind feeling cloudy and unclear when you are trying to think. Things such as communicating, whether this is verbal or written, decision making, loss of concentration, forgetfulness, and fatigue are just a few of the symptoms of cognitive decline due to brain fog.

If you or a loved one are experiencing any of the symptoms listed above, get in touch with a BHR specialist today to discuss treatment.

Schedule a Cognitive Decline Assessment 

What You Can Do to Improve These Symptoms

There are a couple of things you can do to improve the symptoms of cognitive decline, they include:

Eat a balanced diet – Incorporate foods that are rich in omega 3-fatty acids, antioxidants, and B vitamins.

• Leafy Greens – Kale, spinach, and broccoli contain nutrients such as vitamin K, folates, and beta carotenes.
• Fish – It is recommended that you eat fish 1-2 times a week.  Salmon, tuna, and cod are all fairly low in mercury and contain lots of omega 3-fatty acids.
• Fruits & Berries – Strawberries and blueberries contain flavonoids. Flavonoids are what give your fruits and berries their beautiful, bright coloring; and have also been known to help with improved memory function.
• Coffee – Research has shown that people who drink caffeinated beverages such as tea or coffee has a positive effect on your mental focus and functionality.

Exercise

Keeping up with a regular exercise routine can help improve your cognitive functioning. Research has shown that adults who spend at least an hour to an hour and a half participating in some sort of physical activity, had better glucose metabolism. Not only does exercise work to improve cognitive function, but it also helps strengthen the parts of your brain that deal with reasoning.

Stimulate Your Brain

It is important to mentally stimulate your brain. Here are a couple of ways to do so:

• Continue learning new things – This can be as simple as reading a book, reading or writing a blog about a topic of interest, attending seminars, or watching informational or inspirational videos.
• Take Up a New Hobby – Similar to learning new things, you can stimulate your brain by picking up a new hobby.
• Remember that Alone Time is Healthy – While it may seem odd, it is healthy to have that alone time. Time for you to relax, reflect, and remove yourself from distractions.

Get a Good Night’s Sleep

If you experience trouble with falling asleep, staying asleep, or just poor sleep quality in general, these are potential risks associated with cognitive decline or impairment. To learn more about sleep and how you can get a better night’s sleep, check out our blog.

Contact a BHR Specialist

Dementia symptoms and areas of the brain

Alzheimer’s disease

In Alzheimer’s disease, among the areas often damaged first are the hippocampus and its connected structures. This makes it much harder for someone to form new memories or learn new information. A person with Alzheimer’s may struggle to remember what they did earlier that day, or what they have just said, meaning they may repeat themselves in conversation.

The hippocampus is needed for retrieval of memories, but retrieving those from longer ago may depend on it less. This is why someone in the earlier stages of Alzheimer’s (with a damaged hippocampus but an intact cortex) may remember a childhood holiday but struggle to remember what they ate for breakfast that morning.

In Alzheimer’s disease, the amygdala is generally affected later than the hippocampus. So a person with Alzheimer’s will often recall emotional aspects of something even if they don’t recall the factual content. They may therefore respond more according to how they feel about a place or person than in a more logical way.

As Alzheimer’s disease damage spreads through the brain, additional areas and lobes become affected. The cortex overall becomes thinner (so memories from longer ago are lost) and the brain gradually shrinks.

Damage to the left hemisphere is linked to problems with semantic memory and language, so someone may struggle to find the right word for something.

Damage to the visual system in the temporal lobes makes recognising familiar faces and objects harder. The person may seem to forget who a familiar person is. However, because the pathways for vision and hearing are separate, they may still know who that person is once they hear them speak. The person with Alzheimer’s disease may also respond to someone at an emotional level even if they seem not to recognise them.

If there is damage to the right parietal lobe then the person might have problems with judging distances in three dimensions. Navigating stairs is a common difficulty.

As the damage spreads to the frontal lobes, someone with Alzheimer’s may struggle with decision-making, planning or organising (eg family finances). A more complex task with a sequence of steps, such as following a new recipe, might also become much harder.

In contrast to these losses, many abilities are retained, particularly those acquired long ago. Learned skills such as dancing or playing the piano rely on procedural memories, and so are mostly stored deep within the brain. In Alzheimer’s disease, these skills are often retained the longest.

How COVID-19 attacks the brain

As the COVID-19 pandemic rocketed around the globe, it quickly became clear that this was not your average respiratory illness. The disease appears to affect a number of body systems, including the heart and the brain. Early on in the pandemic, there came reports that many people with the disease had lost their sense of smell, a curious symptom suggesting the virus may affect the nervous system. As more people became infected, accounts of strokes and other neurological complications started coming in. (For more on the possible disease processes involved in these neurological complications, see Multiple disease processes below.)

“There’s documented evidence that patients who are hospitalized with moderate and severe COVID-19 experience a range of neurological, cognitive, psychological and psychiatric symptoms—and I’ve seen them myself,” says Robert Stevens, MD, FCCM, a physician in the intensive care unit (ICU) at Johns Hopkins Medicine who treats patients with critical neurological illnesses. “Virtually all the COVID-19 patients I’ve treated in the ICU have delirium.”

It’s not yet clear how common neurological side effects are in hospitalized patients, let alone in people with less severe respiratory symptoms who don’t spend time in hospitals. “The picture is still evolving,” Stevens says.

In a review of case reports from 901 COVID-19 patients, Mark Ellul, at the University of Liverpool, and colleagues reported a range of neurological manifestations, including loss of smell and taste, confusion, encephalitis (inflammation in the brain), and Guillain-Barré syndrome (a disorder in which the immune system attacks the body’s nerves) (The Lancet Neurology, published online, 2020). A case report of 58 patients from France described neurological findings in 67% of patients (Helms, J., et al., The New England Journal of Medicine, Vol. 382, No. 23, 2020).

The prevalence of neurological problems remains an open question, but it’s safe to conclude that “neurological problems are not rare for COVID-19 patients,” says Majid Fotuhi, MD, PhD, medical director of NeuroGrow Brain Fitness Center and lead author of a comprehensive review of COVID-19’s effects on the nervous system (Journal of Alzheimer’s Disease, Vol. 76, No. 1, 2020). “Our best estimate so far is that 30% to 50% of hospitalized patients have neurological issues,” he says.

In their review, Fotuhi and his colleagues describe the variety of neurological complications in patients with COVID-19. “There’s a wide range of symptoms, including headaches, dizziness, weakness, confusion, eye movement problems, seizures and paralysis,” he says. “The two most common neurological problems seem to be stroke and delirium.”

In general, people who experience more serious symptoms of COVID-19 tend to have more brain-related complications, Fotuhi says. “Broadly speaking, the sicker they are, the more neurological issues they have.” But there are exceptions to that rule. A study by scientists in England of 43 patients with severe neurological complications from COVID-19 found that some patients had relatively mild respiratory symptoms (Paterson, R.W., et al., Brain, published online, 2020).

Pandemic neurology: Past, present & future

As researchers continue to gather evidence about COVID-19 and the brain, they’re turning to past epidemics for clues. “The 1918 influenza pandemic was associated with a surge in neurological problems, many of which became apparent months or years later,” Stevens says. The SARS outbreak in 2003 and MERS outbreak in 2012—both caused by coronaviruses similar to the one that causes COVID-19—were also associated with neurological illnesses, including inflammation in the brain. And following each of those outbreaks, Stevens says, “there were reports of people suffering long-lasting neurological injuries.”

Neurology experts are concerned that COVID-19 could leave a similar legacy. But many questions remain, Fotuhi says. “The first step is to document what neurological symptoms occur, at what frequency, and what treatments have or have not affected the neuropsychological symptoms.”

So far, studies of patients with the disease haven’t really drilled down into neuropsychological outcomes, Stevens says. “Trials of antivirals and other therapies being tested to treat COVID-19 are looking at some very coarse outcome measures, like survival or duration of hospitalization. The scientific community needs to include neurological, psychological and psychiatric outcomes as well,” he says.

Experts around the world are working to make that happen. Researchers from 70 sites and 15 countries have registered with the Global Consortium to Study Neurological Dysfunction in COVID-19. The collaborative effort, endorsed by the Neurocritical Care Society, is collecting data and evaluating functional and cognitive outcomes to inform treatment strategies (Frontera, J., et al., Neurocritical Care, Vol. 33, No. 1, 2020). But physicians shouldn’t wait until all the data are in to start intervening, Stevens suggests. Existing therapies are available to treat autoimmune encephalitis, for example. “But these haven’t yet been studied specifically in COVID-19 patients,” he says.

The faster such treatments are tested, the better, Stevens adds, since some of the brain damage from COVID-19 may be irreversible. But Fotuhi is hopeful that for some people, interventions may restore brain function. “Targeted brain training may be able to address specific cognitive symptoms, such as difficulty with executive function or memory,” he says. “I think there will be a great need for psychologists to get involved, to help patients recognize their symptoms and seek treatment for them.”

10 Causes & What the Doctor Should Check

Have you been worried about an older person’s memory or thinking abilities?

Maybe your parent has seemed more confused recently. Or you may have noticed that your aging spouse is repeating herself, or struggling to do things that didn’t use to pose much of a problem.

These are very common concerns, and they often lead to questions such as:

• Is this normal aging or something more significant?
• What is wrong?
• Could this be Alzheimer’s? Or some other form of dementia?
• Can this be treated or reversed?
• What should we do about this??

The answer to the last question is this: if you are worried about memory or thinking, then you should seek out some kind of medical evaluation.

That’s because when families worry about an older person’s cognitive abilities, there often are some underlying health issues affecting the mind’s function.

Those need to be detected, and treated if at all possible. So, you’ll need to request help from a health professional, and in this article, I’ll explain what that initial help should consist of. This way you’ll know what to expect, and what the doctor might ask you about.

Technically, these kinds of problems are called “cognitive impairment.” This is a broad term that means some kind of problem or difficulty with one’s memory, thinking, concentration, and other functions of the conscious brain, beyond what might be expected due to normal “cognitive aging.”

(For more on “cognitive aging” and what types of changes are considered normal aging, see this article: 6 Ways that Memory & Thinking Change with Normal Aging, & What to Do About This.)

Cognitive impairment — which is also called “cognitive decline” — can come on suddenly or gradually, and can be temporary or more permanent. It may or may not keep getting slowly worse; it all depends on the underlying cause or causes.

In this article, I’ll share with you the more common causes of cognitive impairment in older adults.

I’ll then share a list of 10 things that should generally be done, during a preliminary medical evaluation for cognitive decline in an older adult.

Common causes of cognitive impairment in older adults

Cognitive impairment, like many problems in older adults, is often “multifactorial.” This means that the difficulties with memory, thinking, or other brain processes are often due to more than one cause.

Common causes of cognitive impairment in older adults include:

• Medication side-effects. Many medications interfere with proper brain function.
• “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 is especially known to be affected by low levels of vitamin B12, other B vitamins, and folate.
• Delirium. This is 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.
• 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 include Alzheimer’s disease, Lewy-Body disease, Parkinson’s disease, and frontotemporal degeneration.
• Infections.
  • This is not as common in 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.

Now that I’ve covered the most common causes of cognitive impairment in older adults, here’s what an initial medical evaluation should generally cover.

10 Things the Doctor Should Do When Evaluating Cognitive Impairment in an Older Adult

Here are ten specific things the clinician should ask about, check on, or do, as part of an initial evaluation for cognitive impairment in an older adult.

The following list reflects my own practice and that of most geriatricians. It is in line with most syntheses of guidelines and best practices, including the UpToDate.com chapter on this subject.

Most experts agree that these steps can be done by primary care clinicians.

1. Ask about and document the patient’s concerns about memory and thinking.

At a minimum, the clinician should ask an older person something like “So, have you noticed any changes in your memory or thinking abilities?”

Now, many older adults will either have noticed nothing or won’t want to talk about it. This is in of itself worth noting, especially if family or others have voiced concerns.

If the older person does have concerns or observations, these should be explored. It’s especially important to ask when the problems started, whether they seem to be getting worse, and how quickly things seem to be changing.

2. Obtain or request information on memory or thinking difficulties from family members or other “informants.”

Older adults with cognitive impairment are often unaware of — or reluctant to reveal – the difficulties they are experiencing. For this reason, a health provider who has been alerted to the possibility of cognitive impairment should make an effort to get information from a family member or other knowledgeable informant.

The best is to ask a family member to complete a validated questionnaire, such as the AD-8 informant interview. (This questionnaire asks about 8 behaviors that may indicate a dementia such as Alzheimer’s disease.)

It’s sometimes necessary for the health provider to be diplomatic about requesting and getting information from family members, especially if the older person finds it upsetting. People may think that HIPAA doesn’t allow doctors to talk to family over an older person’s objections, but actually, clinicians do have some leeway in these situations. (See my HIPAA article here.)

Family members can facilitate this process by bringing in a written summary of what difficulties they’ve observed. Be sure to include information on when the problems started and whether they seem to be getting worse.

3. Ask about difficulties managing instrumental activities of daily living (IADLs) and activities of daily living (ADLs).

The ideal is for the health provider to ask both the patient and the family about this. Older adults with cognitive impairment are often not reliable reporters of what difficulties they’re having.

Instrumental activities of daily living (IADLs), in particular,  are often affected by cognitive impairment. So it’s important to ask if the older person is having difficulty with problems with tasks such as:

• Driving and other forms of transportation
• Management of finances
• Grocery shopping and meal preparation
• Home maintenance
• Managing the telephone, the mail, and other forms of communication
• Medication management

The provider should also ask about ADLs, which are the more fundamental self-care tasks such as walking around, feeding oneself, getting dressed, managing continence, and so forth.

You can learn more about ADLs and IADLs here: What are Activities of Daily Living (ADLs) & Instrumental Activities of Daily Living (IADLs)?

Difficulties with IADLs and ADLs (which geriatricians refer to as “functional impairment”) are important to document. They offer a practical lens on how “severe” an older person’s cognitive impairment might be, and on what steps could be taken to support an older person while these cognitive issues are getting evaluated.

Functional impairments may correspond with safety issues that need to be addressed; if an older person is having difficulty with finances, it may be a good idea to check for signs of financial exploitation, or otherwise take steps to protect the person financially.

Last but not least, impairment in daily functioning is also a criterion that separates mild cognitive impairment (MCI) from more significant impairment (including dementia). In MCI, a person may be experiencing some cognitive impairment, but it should not be bad enough to significantly interfere with performing their usual daily life tasks.

4. Check for the presence of other behavioral, mood, and thinking symptoms that may be related to certain causes of cognitive impairment.

These include:

• Hallucinations
• Delusions
• Personality changes
• Apathy (losing motivation)
• Depression symptoms
• Anxiety symptoms
• Getting lost
• Confusion about visual-spatial tasks (e.g. having difficulty figuring out how to put on one’s shirt)

5. Ask about any new symptoms or changes in physical health.

It’s especially important to ask about symptoms related to neurological function, such as new difficulties with walking, balance, speech, and coordination. Checking for tremor and stiffness (both of which are associated with Parkinsonism) is also recommended.

The exact questions the clinician asks will depend on the person’s particular medical history, and the other signs and symptoms that have been brought up.

6. Ask about substance use and consider the possibility of substance abuse and/or withdrawal.

Excessive use of alcohol, certain prescription drugs (such as tranquilizers), or of illicit drugs can affect cognitive function. Health providers should inquire about an older person’s use of these substances.

Suddenly stopping or reducing the use of alcohol or other substances can also occasionally cause or worsen cognitive function.

7. Review all medications, with a focus on identifying those known to worsen cognitive function.

Certain types of medications tend to dampen brain function, and may cause a noticeable worsening in cognitive abilities. The health provider should especially ask about use of:

• Benzodiazepines, which are often prescribed for either insomnia or anxiety
  • Commonly prescribed benzodiazepines include lorazepam, diazepam, temazepam, alprazolam (brand names Ativan, Valium, Restoril, and Xanax, respectively)
• Prescription sleeping pills, such as zolpidem (brand name Ambien)
• Anticholinergics, a broad category of medications which includes most over-the-counter sleeping aids, sedating antihistamines, drugs for overactive bladder, muscle relaxants, and others.
  • For a list of commonly prescribed medications that are anticholinergic, see here.

For more on medications that affect brain function, see 4 Types of Medication to Avoid if You’re Worried About Memory.

8. Perform a physical examination.

At a minimum, the health provider should check vitals (blood pressure and pulse) and should also complete a basic neurological evaluation, including an observation of the person’s gait, balance, and coordination.

The purpose of the physical exam is to look for physical signs that may correspond to causes of cognitive impairment, or that may relate to other symptoms the patient or family brought up.

9. Assess the person’s orientation and perform some type of office-based cognitive test.

Assessing “orientation” means checking to see whether the patient knows things like the day, date, month, year, and where he or she is.

Some office-based testing should also be done, to check and document the older person’s memory and thinking abilities.

Probably the shortest well-validated test is the Mini-Cog, which involves a three-item recall and a clock draw.

A more detailed office-based cognitive test that can be done in primary care is the MOCA test (Montreal Cognitive Assessment Test). This takes 10-20 minutes to administer, so it often requires scheduling a separate visit.

There are some other “intermediate” length tests that can be done in the primary care office, such as the SLUMS (St. Louis University Mental Status Examination). The Mini-Mental State Exam is another option, although most experts (including myself) consider it less useful than the MOCA or SLUMS.

10. Order laboratory testing (unless recently done) and consider brain imaging.

In most cases, it will be appropriate for the health provider to order blood tests, to check for common health problems that can cause or worsen cognitive impairment.

Blood tests to consider include:

• A complete metabolic panel, which assesses electrolytes, kidney function, and liver function tests
• Vitamin B12
• Thyroid function tests

Additional tests, such as a complete blood count,  may be ordered as well, depending on the person’s past medical history, current symptoms, and risk factors. For more on tests that are often ordered in older adults, see Understanding Laboratory Tests: 10 Commonly Used Blood Tests for Older Adults.

As for brain imaging, some expert guidelines recommend it for everyone and other guidelines suggest it be used “selectively.”

(In most cases, brain imaging reveals non-specific findings such as signs of cerebral small vessel disease and perhaps some mild atrophy of the brain. These are common findings in many older adults and tend to have a variable correlation with symptoms. Most causes of cognitive impairment cannot be definitely ruled in or ruled out by brain imaging.)

In Summary

Overall, an initial medical evaluation should result in these four key things happening:

• Documentation of the patient’s and family’s cognitive concerns.
  • This means documenting what the patient and family have noticed, in terms of difficulties and changes in memory, thinking, behavior, or personality.
• Documentation of any functional impairment the older person is experiencing.
  • This means documenting what the patient and family have noticed, in terms of difficulties managing life tasks (IADLs and ADLs).
• An objective assessment of the older person’s memory and thinking skills.
  • This best done through some form of short standardized office-based test, such as the Mini-Cog.
  • Clinicians can also document their impressions and observations based on talking to the older person. (Did the person seem confused? Paranoid? Repetitive? Tangential? Was the person able to answer detailed questions?)
• An evaluation for common medical causes and contributors of cognitive impairment.
  • This means checking for those common problems that can cause or worsen cognitive impairment.

Generally, it will take at least two primary care visits to complete an evaluation for cognitive impairment.

The second visit is often used to do a cognitive test such as the MOCA, and can enable the clinician to follow up on laboratory tests that were initially ordered.

And then what?

Well, what happens next depends on several things, such as:

• Whether the health provider was able to draw conclusions about what is likely causing the cognitive impairment
• Whether treatable conditions were identified
• How the patient and family feel about the evaluation
• Whether the older person is willing and able to cooperate
• Whether the clinician feels that referral to a specialist is necessary
• Whether the clinician is willing and able to help the older person and the family (or refer them for help) addressing any functional impairment or safety issues

You may be wondering: should you expect a diagnosis or “an answer” after this evaluation?

I’ll be honest here: probably not. Even with an adequate initial evaluation, cognitive impairment may take a few months (or even longer) to completely evaluate and diagnose. For instance, it’s often necessary to try treating one or more potential causes, to see if the cognitive problems improve or not.

Other causes of cognitive decline — notably neurodegenerative conditions such as Alzheimer’s and some of the other dementias — can take a while to diagnose because clinicians are first supposed to exclude the other potential causes, and that can take a while. (For more on the diagnosis of dementia, see “How We Diagnose Dementia: The Practical Basics to Know.)

What to expect from an initial evaluation for cognitive decline

It may not be realistic to expect definite answers. But that doesn’t mean you can’t expect some explanations.

Your health provider should be able to explain:

• How substantial the cognitive impairment appears to be, based on the office-based testing and the evaluation so far,
• What was checked for, and what has been ruled out (or deemed unlikely) as a cause for the problems you’ve been worried about,
• Whether any of the medications might be making memory or thinking worse, and what the options are for stopping or reducing those medications,
• What the healthcare team proposes to do next, to further evaluate the issues or follow up on the problems.

So if you’ve been worried about memory or thinking problems, ask for that medical evaluation. If your health provider skips any of the steps I listed, don’t be shy and ask about it. (Either it’s an oversight or they should be able to explain why it’s not necessary.)

You probably won’t get all the answers and certainty that you’re hoping for, but you’ll have gotten started and that’s vitally important.

Of course, you may well be facing the problem of not being able to get your older loved one to go to the doctor. That’s a very common issue, but it’s too complicated to cover in an article. (So I’ve written a book! Learn more below.)

In the meantime, especially if it’s a challenge to see the doctor for some reason, then it’s all the more important to the most out of your medical evaluation when you do manage to get there.

This article was originally published in 2018, and reviewed by Dr. Kernisan in Dec 2020.

90,000 Memory problems in young people

Forgetfulness, attention disorders are attributed to people of advanced age. However, memory problems are becoming more common among young people. The reasons for this phenomenon are varied – from improper lifestyle and overwork to serious disturbances in the work of the brain and internal organs.

Causes of memory impairment at a young age

Memory impairment in the elderly is usually caused by age-related changes in the body.Atherosclerosis, micro-strokes, Alzheimer’s disease – these pathologies negatively affect cognitive functions.

The reasons for forgetfulness at a young age are different, they can be divided into 4 groups.

1. Brain lesions.
2. Diseases of internal organs.
3. Adverse effects of external factors, violation of the daily routine.
4. Chronic intoxication of the body.

Brain disorders are the main cause of memory impairment

The cerebral cortex is responsible for the work of long-term memory.The hippocampus, which is located in the temporal lobes, starts the process of translating short-term information into long-term memory. There are other memory centers in the brain. Therefore, any damage to this organ provokes the development of forgetfulness, inattention.

Causes of memory problems in young people:

1. Traumatic brain injury. The area of ​​impact does not matter. After any stroke, there is short-term or long-term memory loss, retrograde or antegrade amnesia.
2. Stroke. In case of impaired blood circulation, the functions of the memory centers are impaired.
3. Malignant and benign neoplasms. Tumors affect nearby tissues, including memory centers located in them.
4. Encephalitis, meningitis. The infection negatively affects the functioning of the brain and memory.
5. Post-surgical asthenic syndrome.

After any injuries and diseases of the brain, it is necessary to constantly be monitored by a neurologist.This will help to identify memory impairments and cognitive disorders in a timely manner.

What diseases of internal organs negatively affect memory

The normal functioning of the brain largely depends on the well-coordinated work of the whole organism. Many dysfunctions can indirectly affect concentration and memory.

The hormonal background affects the memorization process. Testosterone, vasopressin, prolactin, estrogen help transform short-term memory into long-term memory.Oxytocin impairs the memory process.

Major diseases:

1. Hypertension, other diseases of the cardiovascular system. They provoke a deterioration in the blood supply to the brain.
2. Violation of exchange processes. When metabolic failure occurs, brain tissue suffers from nutritional deficiencies. Resources are allocated to vital areas, and the center of memory is not prioritized on this list.
3. Angiopathy – pathology develops against the background of diabetes mellitus.The vascular walls thicken, small vessels overlap and stop working. Blood circulation is impaired in all organs, and the brain also suffers.
4. Hypothyroidism – a lack of thyroid hormone leads to the development of iodine deficiency.
5. Mental disorders – schizophrenia, epilepsy, depression.
6. Cervical osteochondrosis. Deformed vertebrae pinch blood vessels, and the brain suffers from oxygen and nutrient deficiencies.

In case of kidney disease, verbal memory deteriorates.Cognitive functions decrease with an increase in creatinine levels, a decrease in the glomerular filtration rate. The study was carried out for 5 years by scientists from the United States.

Neurologist

Neurologist of the highest qualification category

Adverse effects of external factors, lifestyle

If memory problems occur in young people, the causes are often associated with an unconscious dysfunction of the brain.But these causes, unlike diseases, are easier to eliminate. When you change your lifestyle, forgetfulness will gradually disappear.

Reasons for memory impairment:

1. Information overload. The human brain freezes if it is unable to process the entire amount of information received. The principle of multitasking has already been recognized as ineffective, since it leads to a deterioration in memory capabilities, attentiveness, and nervous disorders.
2. Avitaminosis. For the brain to function properly, it is necessary to constantly replenish the supply of B vitamins.These substances protect cells from aging and overload, participate in oxygen metabolism and the synthesis of certain neurotransmitters, and ensure the normal functioning of the central nervous system.
3. Stress, nervous and emotional overwork. In such conditions, physiological processes associated with memory are blocked. With prolonged stress, information is not remembered at all.
4. Chronic sleep deprivation. During sleep, new cells are synthesized. If a person does not get enough sleep, the brain does not have time to recover, the process of memorizing and reproducing information is disrupted.
5. Junk food abuse. Food with food coloring contains aluminum. The substance accumulates in the body and is poorly excreted. The result is a deterioration in memory, thinking, attention.
6. Caffeinated beverages. Constant stimulation of the brain leads to a decrease in memory.
7. Poisoning with lead, mercury and other heavy metals.
8. Long-term and uncontrolled intake of tranquilizers, sedatives and antihistamines, antipsychotics.Anticholinergics, antidepressants, barbiturates negatively affect the work of the brain.

Smoking destroys the brain. Heavy smokers suffer from memory problems, the ability to perceive new information, logical thinking deteriorates. Active and passive smoking is equally dangerous, memory indicators decrease by 25-30%.

Daily consumption of 36 g of pure alcohol leads to early memory impairment. But a complete rejection of alcohol negatively affects the brain.It is safe to consume up to 4 glasses of dry red wine per week.

Drugs are neurotoxic substances that disrupt the process of receiving, processing and sending information. Even with a single use, irreversible damage to the serotonin system of the brain often occurs.

Associated symptoms

Forgetfulness, inability to memorize and reproduce information are not the only signs of poor memory.

For what symptoms you need to see a doctor:

• information that has no personal value is not assimilated;
• memory lapses – large or small fragments from the past are forgotten;
• the line between the past and the present is lost;
• disturbed by false memories, frequent attacks of deja vu;
• problems with short-term memory, a person cannot remember where he was going, find the right thing;
• difficulties with concentration, the formulation of thoughts, since it is not possible to remember the right word;

90,011 people often repeat themselves, confuse the days of the week and months;

• increased anxiety due to the fact that it is impossible to remember whether you closed the door, turned off the iron, water.

Often memory problems are accompanied by migraine attacks, tinnitus, hearing and vision impairment, heart rhythm disturbances, and chronic fatigue.

How to solve memory problems

If memory often fails, visit a neurologist. After examination, collection of anamnesis and initial diagnosis, it may be necessary to consult a therapist, neuropsychologist, psychotherapist, oncologist.

Neuromonitoring begins with an assessment of the neurological status.The doctor checks the functioning of the cranial nerves, determines the amplitude of eyeball movement, the symmetry of the tongue and teeth grin, and evaluates facial and voluntary movements.

Assess hearing, vision, smell, reflexes, speech. To diagnose memory disorders, tests are used that show the ability to remember and reproduce new information. To identify impaired cognitive functions, the doctor prescribes a general and biochemical blood test, a study of cerebrospinal fluid, EEG, MRI and CT of the brain.Based on the results of the diagnosis, treatment methods and medications are selected.

Prevention

Memory needs to be trained daily. Exercises according to the method of Lawrence Katz will help improve brain function.

How to avoid memory problems:

1. Perform habitual actions with closed eyes, walk in the dark.
2. Comb, brush your teeth with your non-dominant hand. Right-handed left, left-handed right.
3. Learn poems, foreign languages, solve crosswords and logic problems, play chess.
4. Limit the time you watch TV, work at the computer.
5. Increase resistance to stress – yoga, meditation, regular physical activity have a positive effect on the psycho-emotional state.
6. Eat right, give up fatty and salty foods, sweets.
7. Timely vaccinate, treat viral and bacterial diseases, strengthen the immune system.
8. Observe the drinking regime. The brain is 70-80% water, so it reacts sharply to the slightest dehydration.The optimal volume in the absence of contraindications is 1.5-2 liters of clean water per day.

Memory problems do not always indicate serious illness at a young age. Try to have a good rest, sleep well, not be nervous, get rid of bad habits. Include foods high in vitamin B in your diet, and remember to drink plenty of water. If no improvement is observed, contact a specialist, you should not select drugs for treatment on your own.

90,000 Neurologists named the causes of memory and attention problems after COVID-19 :: Society :: RBK

Coronavirus pandemic,

30 Nov 2020, 03:16

0

The most common complications are due to stress, fear, and impaired lung function.

The number of complaints about problems with memory, orientation in time and space after suffering COVID-19 is growing, said doctors interviewed by RBC.They attribute this to the effect of infection on internal organs and psychosomatics.

Photo: Eduardo Munoz Alvarez / AP

Patients in Russia began to complain more often about memory impairment, concentration of attention after suffering a coronavirus.This was reported by neurologists and experts interviewed by RBC.

The growth in the number of such appeals began in the fall, surgeon and rehabilitologist Konstantin Lyadov told RBC. “We are recording the growth of such requests. If at first, when these patients only appeared, in April-May, we did not see patients with these complaints, now there are complaints of weakness and decreased concentration, ”he said. Lyadov emphasized that not all patients with coronavirus address such complaints, but they nevertheless exist.

“The number of complaints of such symptoms is increasing,” said Alexander Komarov, a neurologist, chief physician of the Doverie rehabilitation center, to RBC.

“I myself have had a mild illness, like some of my friends, from neurological consequences – severe neuromyalgia, back pain
the outer surface of the legs, from the buttocks to the lower leg, which cannot be removed. Moreover, this is a common symptom, my colleagues who have recovered have it,
in patients.As for the problems with orientation in time and space, as well as impairment of cognitive functions in general, this is often encountered, unfortunately, ”said Evgeny Seredkin, head of the neurology department of the Central Clinical Hospital No. 1 of the Russian Railways.

There may be several reasons for the occurrence of such consequences, the doctors said. “Firstly, it has to do with psychosomatic components, with stress and fear. This causes pressure, increases the risk of vascular problems, and can lead to decompensation of chronic ischemia or to acute ischemia.The second point is the very neurotoxic effect of coronavirus infection, ”Alexander Komarov told RBC.

What you need to know about stroke memory loss and recovery?

All accumulated life experience (acquired skills and knowledge, feelings and experiences) is stored in human memory. So it is customary to designate the higher mental function of the brain, consisting of such processes as the collection, storage and reproduction of information. The memory mechanism is, in fact, a complex system of stable connections between neurons in different parts of the brain.A stroke, as a result of which these connections are disrupted, since some of the neurons die, can affect the patient’s memory in the most unpredictable way – he can forget who he is and not recognize loved ones, or he can forget how to use the objects around him, because he does not remember that it is such.

It is believed that full recovery of memory after a stroke is impossible, just as it is impossible in principle to “revive” dead brain cells, but using workarounds, from some part the memory process can be restored.

Stroke, memory recovery – what does the process depend on and how much recovery is possible?

In post-stroke patients, partial, and in especially difficult cases, complete memory impairment is noted. This, along with the loss of the ability to concentrate, is one of the most common complications caused by impaired cerebral circulation. For the preservation of various experiences – social, professional, everyday, etc. different parts of the brain respond.The extent, number and location of lesions determines which part of the memory mechanism is erased, and to what extent there will be memory impairments. A post-stroke patient may lose self-care skills, but retain their professional knowledge in detail, and vice versa.

It is believed that the processes of work of short-term and working memory, which captures what is happening at the moment, are much more difficult to recover than long-term memory, which stores situations, skills that are often repeated in the patient’s past.This is explained not only by the strength of the formed connections, but also by the fact that a large number of neurons and brain regions were involved in these connections (as information was accumulated), therefore, the destruction of some of these connections does not lead to a complete loss of information about the past. The only exceptions are cases of extensive stroke with multiple lesions, when most of the connections were destroyed.

It should be noted that amnesia can happen suddenly – during a stroke, or it can stretch in time and appear much later (due to the destruction of certain areas as a result of secondary complications).Therefore, the work of the interdisciplinary team (neurologist, therapist, physiotherapist, rehabilitologist) of the neurological center, where the patient is going to undergo rehabilitation after a stroke, will initially focus on preventing complications. The period of memory recovery after a stroke can also take a long time.

Stroke, methods of memory recovery (memorization mechanisms)

In severe memory impairments and dementia, drugs are prescribed in accordance with international standards – AChE (acetylcholinesterase) inhibitors and nmda receptor blockers.Along with the selected drug therapy in the rehabilitation of the stroke patient, cognitive training plays an important role, during which the patient performs tasks and exercises aimed at developing the memorization process. During such training, under the guidance of a neuropsychologist, the patient learns again to realize the lost functions, relying on the intact links of the memorization mechanism and compensating for the impaired ones.

It is extremely important during the rehabilitation process to involve the patient’s loved ones as his support, because often, no matter how successful the recovery is, some of the lost functions can be realized only by relying on the external environment.Informing, teaching relatives how to help a patient cope with the consequences of a stroke is one of the important factors in effective rehabilitation.

90,000 Coronavirus can enter the brain, disrupt the nervous system and cause other complications

• Nikolay Voronin
• Science Correspondent

April 28, 2020

Photo author, Getty Images

Covid-19 infection is not limited to respiratory tract infection.As practical studies show, in a significant number of patients, the virus also affects the nervous system.

The mechanism of its effect on nerve cells has not yet been studied, but scientists have no doubt that there is some connection: a temporary loss of taste or smell was recognized as specific symptoms of Covid-19 back in mid-March.

In addition, from the nasopharynx, the virus is able to penetrate directly into the brain, and this, in turn, can provoke a number of complications, disrupting the normal functioning of almost any organ.

The list of possible comorbidities is huge: from digestive problems and vascular blockages to heart failure and encephalitis.

The many-sided virus

Four months after the start of the epidemic, scientists still know very little about the disease-causing SARS-CoV-2 virus and its effects on the human body.

The overall picture of the infection is formed bit by bit, from hundreds of articles in scientific journals, where doctors from all over the world share their experience in treating coronavirus patients.

As a result, the list of possible symptoms of Covid-19 continues to expand (there are already more than a dozen of them), and with it our ideas about what other organs the virus can infect and what complications the disease can result in, in addition to pneumonia.

Photo author, Getty Images

Most often, doctors describe disorders of the nervous system. Two studies at once – in France and in China – concluded that more than a third of those infected experience neurological symptoms in one form or another.

However, in general, the new infection has a much more versatile and even individual approach.

But the virus can also affect the nervous system in very different ways – it’s far from just a temporary refusal of feelings.

In particular, several cases of encephalitis (inflammation of the brain), as well as Guillain-Barré syndrome, are described as side effects of Covid-19: the patient’s immune system begins to attack its own nerve cells, which leads to muscle weakness, and in severe cases, to paralysis …

American doctors are alarmed by reports that in New York alone, five cases of massive strokes were recorded in coronavirus patients in two weeks – moreover, in relatively young people (under 50), without other pronounced symptoms of Covid-19.

According to preliminary data, as a side effect of inflammation, the coronavirus provoked the formation of blood clots in large vessels in them – which ultimately led to an acute violation of cerebral circulation.

However, mainly neurological disorders are still observed in severely ill patients.In such cases, these symptoms sometimes persist even after patients recover from Covid-19.

Photo author, Getty Images

Why are the complications so different?

The virus can disrupt the work of the nervous system both indirectly, through excessive activation of the immune system (the so-called cytokine storm), and directly. This became clear as a result of the autopsy of the bodies of the victims of Covid-19.

Viral particles were found in the victims, including in the brain.There is a version that the infection gets there from the respiratory tract through the olfactory receptors in the nose.

This is not some unique ability of the new coronavirus. Several other viruses, including influenza and measles, can cause a similar infection of the brain – which also sometimes leads to neurological disease, albeit quite rarely.

However, in the case of Covid-19, the situation is a little more complicated. Firstly, the number of infected has already exceeded 3 million – which means that even rare cases in the aggregate turn out to be quite a few.And secondly, if the virus nevertheless entered the brain, further infection is almost inevitable: the very membrane receptor ACE2 is present on the surface of the brain cells, through which the virus easily penetrates inside, causing inflammation.

The same receptor is also found in the cells lining the inner surface of blood vessels – therefore, in severe cases, the virus breaks out of the respiratory organs into the general bloodstream. As a result, thrombotic complications occur in almost every third patient with coronavirus pneumonia.

With blood, the virus can get into any organs, including the brain. However, according to the latest data, almost half of all infected people carry Covid-19 without any symptoms at all.

Trying to understand why in some people the disease proceeds completely unnoticed, while in others it leads to such serious consequences, several thousand pairs of identical twins were studied in Britain.

According to preliminary data, the severity of the infection, many of its symptoms, and possibly the very likelihood of infection, depend quite strongly on genetic factors, that is, heredity.

Neurological diseases in adults – Dr. Domodedoff Medical Center in Domodedovo

“All diseases are from the nerves.” There is a lot of truth in this comic floorboard, since most diseases are associated with the nervous system.

13.03.2017

From the moment of birth to a ripe old age, our body accumulates damaging factors from an improper lifestyle, stress, and environmental influences. The nervous system reacts to this, trying to compensate for the negative impact.But the possibilities of our body are not endless, and over the years the body does not get younger. Thus, the older a person gets, the more likely it is to develop neurological disorders.

Pathological conditions of the nervous system can be divided into three groups:

1. a group of diseases with damage to the central nervous system

2. a group of diseases with damage to the peripheral nervous system

3. a group of diseases involving both the central and peripheral nervous systems.

Of course, there are diseases and symptoms with which patients more often than others turn to a neurologist. We will talk about them.

One of the most formidable categories of pathological conditions of the nervous system is the one associated with the vessels of the brain. Acute cerebrovascular accident (stroke) , as a rule, leads to irreversible impairment of brain function and disability. Stroke is classified into ischemic (most common) and hemorrhagic.Ischemic stroke is caused by blockage of blood vessels due to compression or thrombosis. Hemorrhagic stroke is a hemorrhage in the brain due to dissection of an aneurysm or rupture of a vessel. A stroke requires immediate hospitalization. Transient ischemic attack (TIA) is a transient ischemic stroke. With such a picture (against the background of treatment), the symptoms disappear within a day.

Risk factors leading to cerebrovascular accident are: arterial hypertension, coronary heart disease, heart rhythm disturbances, diabetes mellitus, obesity, high cholesterol levels, blood clotting disorders, vascular diseases, smoking, alcohol and others.

Stroke symptoms: facial asymmetry, speech impairment, weakness and loss of strength in the limbs on one side, visual impairment, impaired sensitivity (numbness) of the face and limbs, impaired coordination (instability), dizziness, vomiting, loss of consciousness.

The sooner a patient with a stroke is admitted to the hospital and treatment begins, the more chances there are to avoid death and to minimize irreversible changes in the functions of the nervous system.In addition to acute circulatory disorders of the brain, there is often a chronic dysfunction of the cerebral vessels, as a rule, of atherosclerotic etiology, which manifests itself with varying degrees of memory impairment, changes in intelligence, behavior, autonomic symptoms, coordination disorders, etc.

In addition to strokes, there are many serious diseases of the nervous system, such as epilepsy. Epilepsy is a chronic disease of the central nervous system, manifested by uncontrolled attacks of disturbance or changes in consciousness, convulsive (tonic, clonic) muscle tension or paroxysmal loss of muscle tone.The causes of seizures can be: damage to the child’s brain at the time of childbirth, genetic diseases, brain tumors, traumatic or metabolic damage to the central nervous system. The morphology of epileptic seizures is diverse. It is customary to divide epileptic seizures into generalized (spreading to the entire brain) and focal (limited to one or several areas of the brain). In turn, generalized include:

1. Generalized convulsive seizure, which is manifested by a sudden loss of consciousness, a fall, first by tonic tension of the muscles of the body and limbs, then clonic convulsive muscle contractions, involuntary urination, tongue bite, further confusion.

2. Myoclonic seizure is manifested by a sharp short contraction of certain muscle groups.

3. Absance . This is an attack that manifests itself as a short-term blackout, but without falling and without convulsive contractions. The patient suddenly freezes, stops the started activity, stops speech. After the seizure has ended, speech and activity continue.

Focal seizures include:

1. Focal epileptic seizure with loss or change in the level of consciousness.As a rule, with a focal epileptic seizure, involuntary tonic tension occurs in one limb or muscle group (involuntary movement of the limb or turning the head or eyes).

2. Focal seizure without change in consciousness with convulsive manifestations.

3. A focal attack without a change in consciousness and without seizures, which is manifested by changes in sensitivity, hallucinations (gustatory, olfactory, auditory, visual), autonomic manifestations, mental disorders.

Every epileptic seizure has a negative impact on the normal functioning of the brain. Therefore, epilepsy must be treated. Modern anticonvulsant drugs are highly effective and have minimal side effects. To diagnose epilepsy, examinations are carried out: electroencephalography (EEG), video EEG monitoring, magnetic resonance imaging.

In addition to diseases of the central nervous system, a neurologist is often consulted with symptoms of peripheral nerve damage. Neuritis – inflammation of the peripheral nerve (infectious, traumatic, toxic, vascular etiology). Most often, patients are treated with facial neuritis, trigeminal neuritis, sciatic nerve neuritis, radiculopathy, intercostal neuralgia, etc. Symptoms of neuritis: impaired sensitivity, pain, movement disorders (paresis), trophic disorders, vegetative manifestations. For the treatment of neuritis, non-steroidal anti-inflammatory drugs, B vitamins, physiotherapy methods of treatment, massage, and acupuncture are used.In difficult cases, hormonal drugs are prescribed for treatment.

The most common reason for visiting a neurologist is headache.

There are many reasons for headache. Migraine presents with attacks of headache on one side, ending with vomiting, bringing relief. Before a migraine attack, an aura may occur – visual phenomena (visual disturbances, flickering, lightning), unpleasant sensations (photophobia, sound fear, increased sensitivity of odors).Then comes an attack of severe headache, which does not allow you to work or rest normally. Analgesics do not help with this picture. Special medications are required.

In addition to migraine, there is tension headache , which occurs due to constant tension of the muscles of the scalp of the skull. Vascular headache occurs against the background of cerebral vasospasm, increased blood pressure. With a brain tumor, there is a headache caused by vascular compression or cerebrospinal fluid disturbances.As well as other types of headaches.

In addition to these diseases, there are many more pathological conditions, such as CNS injuries, congenital pathologies, progressive demyelinating diseases, myopathies, polyneuropathy, sleep disorders, memory impairments and many others.

At the Dr. Domodedoff Medical Center, an experienced neurologist, epileptologist, who will conduct a competent examination, prescribe examinations and carry out effective treatment, is receiving an appointment.

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90,000 The biologist spoke about the danger of loss of smell in COVID-19 for the brain: Society: Russia: Lenta.ru

Loss of smell during coronavirus infection may not be a harmless symptom, but indicate a violation of the barrier that protects the human brain from damage. Anch Baranova, a biologist and professor at the School of Systems Biology at George Mason University, spoke about this live on her YouTube channel.

According to her, recently German scientists from the Humboldt University (Berlin) found that coronavirus can enter the human brain through the olfactory epithelium – cells in the nasal cavity.

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“In fact, this is not a joke at all, because the olfactory epithelium is the most advanced part of the brain. And through this olfactory epithelium [coronavirus] can enter our brain. Yes, we have a blood-brain barrier that separates the blood from the brain, (…) and it keeps the coronavirus out. But the olfactory epithelium is a weak point, ”Baranova said.

The biologist noted that a decrease or complete absence of smell after suffering a coronavirus may mean the risk of brain damage. She cited as an example that in patients with Alzheimer’s disease for a year or two before the decline in cognitive functions, there is a decrease in the ability to recognize odors.

“That is, the destruction of the blood-brain barrier or disruption of its functions is partial – it contributes to the fact that our brain begins to” go down, “she said. – Therefore, the restoration of the sense of smell is very important.If you have a “hole” left there, between the external environment and the brain, and this hole can be diagnosed, because we do not have such a good sense of smells than before, or a complete lack of smell, then into this hole after the coronavirus has left , something else might creep in. And it is very important to close this hole somehow ”.

Therefore, the restoration of the sense of smell is a signal that the barrier has recovered, Baranova suggested. At the same time, she noted that the penetration of coronavirus into the brain does not occur in all patients.

Earlier, Baranova warned about the premature aging of those who suffered from COVID-19.

Stories without censorship and prohibitions – in the “Tape of the Bottom” in Telegram

90,000 Brain Areas – Learn more about the different parts of your brain

What is our brain made of? The brain is one of the most complex organs of the human body. It consists of various parts or structures, each of which has its own function, but they work together and in a coordinated manner through the thousands of connections that form between them and all other parts of our body.Below will be shown the structure of the brain, its region and the function of each zone.

The structure of the brain

The Central Nervous System consists of the brain and spinal cord.

• The brain is the main part of the central nervous system and is located in the skull.
• The spinal cord is a long, whitish cord located in the spine that connects the brain to the entire body. It acts as a kind of information highway between the brain and the body, transmitting information from the brain to the body.

So the brain and the brain are not the same thing. To understand the difference between the brain and the brain, one should study how the CNS (central nervous system) of the embryo develops. In general terms, during development , the human brain is divided into three different “brains” according to their level of phylogenetic development: the rhomboid brain (rhombencephalon), mesencephalon (“midbrain”), and proencephalon (“forebrain”).

ROMBOID BRAIN: The oldest and least developed brain structure found in all vertebrates.The structure and organization of the diamond-shaped brain is the simplest. Responsible for regulating basic survival functions and controlling movement. Damage to this part of the brain can lead to death or serious damage. Located in the upper part of the spinal cord and consists of several sections:

• Medulla oblongata or bulb : helps control automatic functions such as breathing, blood pressure, heart rate, digestion … etc.d.
• Varoliev bridge or bridge : part of the brain stem located between the medulla oblongata and midbrain. It connects the spinal cord and medulla oblongata to the upper cortex and / or cerebellum. It controls the automatic functions of the body, as well as regulates consciousness and levels of arousal (anxiety), sleep.
• Cerebellum : Located under the occipital lobes of the cerebral hemispheres, it is the second largest structure in the brain.The cerebellum integrates all the information coming from the senses and the motor area of ​​the brain, and therefore its main function is to control movement. It also controls posture and coordination of movements, which allows us to move, walk, ride a bicycle … Damage to this department leads to problems associated with movement, coordination and postural control, and also causes impairments to a number of higher cognitive processes.

MEZENCEPHALON or MEDIUM BRAIN – is a structure that connects the back of the brain with the front, directing motor and sensory impulses between them.Its correct functioning is necessary for the implementation of conscious actions. Injuries to this part of the brain cause a number of movement disorders such as tremors, rigidity, strange movements …

FRONT BRAIN or PROZENCEPHALON: is the most developed and evolved part of the brain with the most complex organization. Consists of two main divisions:

• Diencephalon: is located inside the brain and consists of such important structures as the thalamus and hypothalamus.
• Thalamus: is a kind of transmission station of the brain: it transmits most of the perceived sensory signals (visual, auditory and tactile) and makes it possible for them to be processed by other parts of the brain. Also involved in motor control.
• Hypothalamus: This gland located in the central base of the brain plays a critical role in regulating emotions and many other bodily functions such as appetite, thirst and sleep.
• Terminal or large brain: is known as the brain covering the entire cerebral cortex (a thin layer of gray matter collected in folds that form the grooves and gyrus), the hippocampus and the basal ganglia.

Anatomy and function of the brain

In this section, we will look in detail at the anatomy of the brain and the functions of its departments.

BASAL GANGLES: subcortical neural structures responsible for motor functions. They receive information from the cortex and the brain stem, process it and re-project it into the cortex, medulla oblongata and the brain stem, providing coordination of movements. They consist of several departments:

• The caudate nucleus is a nucleus in the shape of the letter C, involved in the control of conscious movements, as well as in the processes of learning and memory.
• Shell
• Pallidum
• Tonsil, which plays a key role in controlling emotions, especially fear. The amygdala helps to store and classify memories triggered by emotions.

HIPPOCAMP: is a small subcrustal structure in the shape of a seahorse. Plays a critical role in the formation of memory – both in the classification of information and in the organization of long-term memory

BRAIN CORTEX: A thin layer of gray matter collected in folds that form grooves and convolutions that give the brain its characteristic appearance.The convolutions are separated by grooves and cerebral grooves, the deepest of which are called slits. The cortex is divided into two hemispheres, right and left, separated by an interhemispheric fissure and interconnected by the corpus callosum, through which information is transmitted from one hemisphere to another. Each hemisphere controls one side of the body, while control is asymmetric: the left hemisphere controls the right side, and the right one controls the left side of the body. This phenomenon is called brain lateralization.

EACH HEMISPHERE, IN ITS ORIGIN, DIVIDED INTO 4 SHARES: these lobes are limited by four cerebral grooves (central or Roland’s groove, lateral or Sylvian groove, parieto-occipital groove and cingulate groove: 903 909108): 9000 the largest lobe of the cerebral cortex. Located in front of the skull, behind the forehead. Extends from the front to the Roland furrow. This is the center of command and control of the brain, orchestra conductor. It is closely related to executive functions (Miller, 2000; Miller and Cohen, 2001), vol.e. is responsible for planning, reasoning, problem solving, judgment, impulse control, as well as for the regulation of emotions such as empathy and generosity, behavior.

Squire, L.R. (1992) Memory and the hippocampus: a synthesis from findings with rats, monkeys and humans.