Often we hear of impairments in cognition concerning how information is processed especially in stroke or dementia patients. As we seek guidance from professionals, it is helpful to know the difference between these impairment groups because the approach to treatment is different. The following are examples of how various cognitive losses can be manifested. Impairment of memory usually means that the individual has trouble remembering recent events. Some individuals will confabulate just to fill in the gaps, perhaps choosing the most plausible connection or logic of thought. Impairment of orientation may mean that the person may not know where they are, what the day is, or who their loved ones are. Impairment of learning, reasoning, and judgment may mean that the decision-making processes are impaired and critical thought is clouded, inaccurate, or slow. Impairment of emotional control involves emotional responses that are over-reactive, under-reactive, provocative or blunted. Impairment of initiation is often called “loss of executive function,” where knowing what to do next or follow through concerning a basic function is nearly impossible. Impairment of ethical or propriety conduct may mean that an individual is experiencing a lowering of personal standards, hygiene, and values. Impairment of receptive and expressive communication can result in difficulty comprehending or expressing written or oral language. Impairment of visuospatial ability means that the person is having difficulty coordinating movement and construction to desired performance, such as handwriting, drawing, or assembly of objects. Impairments involving the brain can be selective or manifest themselves in a global manner; therefore, it is important to get a professional assessment with the first sign or symptom of change in any cognitive ability.
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