The words 'cognition' and 'cognitive' crop up a lot in the field of dementia – but what do they really mean?
Cognition is a term for the mental processes that take place in the brain, including thinking, attention, language, learning, memory and perception. These processes are not discrete abilities – they are a raft of different, interacting skills which together allow us to function as healthy adults.
The mental process 'language' refers to the skills involved in all forms of communication, from understanding others to articulating thoughts. 'Perception' is translating the information received from our senses into a multi-sensory view of our surroundings.
'Learning' is the process of receiving new information and combining it with existing knowledge. Once something is learned, it must be encoded and stored so that it can be accessed later – that process is 'memory'. 'Attention' is the ability to focus on one particular thing. But this focus can lead to something called 'cognitive bias', where the brain is so occupied with one thing that it misses other things in the environment.
Last but not least, 'thinking' is involved in all of the other forms of cognition. It also covers more complex mental processes like decision-making, problem-solving and reasoning. Cognitive is the adjective to describe these mental processes – for example, cognitive tests assess these thinking skills, and cognitive psychology is the study of cognition.
Part of natural ageing is a limited amount of decline in cognitive abilities, but some conditions like dementia involve a more drastic deterioration. People with cognitive impairment have difficulty with one or more of these mental processes. Cognitive tests are used to assess how much difficulty a person has and pinpoint the specific aspects of cognition that they may be struggling with.
Lots of different cognitive tests have been developed. Traditionally, these have been lengthy questionnaire-style tests, but are now evolving into quicker, more precise assessments.
Some cognitive tests include:
- General Practitioner Assessment of Cognition (GPCOG) – a series of questions asked by a GP such as the date, recent news, and remembering addresses. It also requires patients to draw a clock face as this tests their visuospatial functioning.
- Mini-Mental State Examination (MMSE) – a test containing 30 questions that test a person's 'orientation' (understanding where they are and when this is taking place), attention, calculation (numeracy), memory and language.
- Integrated Cognitive Assessment (ICA) – an online tool where patients must quickly sort images into certain categories. It gives a sensitive, repeatable measure of overall cognitive function in just five minutes.
- Addenbrooke's Cognitive Examination (ACE) – a questionnaire testing the same things as the MMSE, while also including visual tests. It was designed to differentiate between different types of dementia.
As well as diagnoses, cognitive tests are used by dementia researchers to find out whether the thing they are investigating has improved their participants' cognition. They are also given to longitudinal cohort participants – groups of people with shared characteristics studied over a long period of time – to assess how their mental functioning has changed over their lifetime and gather insights into why this may be.
There are many simple and practical ways for everyone to improve their cognition – for example, exercising, watching educational programmes on TV, playing puzzles, cards and board games, and visiting museums. Actively looking after your mental health by understanding things that cause you stress and trying to limit your exposure to them can also make a big difference.
Check out our blog on keeping your brain healthy to learn more ways to improve your cognition and keep your brain functioning at its best.
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