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 Table of Contents  
GUEST EDITORIAL
Year : 2016  |  Volume : 3  |  Issue : 1  |  Page : 1-2

Cognition


1 Department of Psychiatry, JSS Medical College and Hospital, JSS University, Mysore, Karnataka, India
2 Assistant Editor, Indian Journal of Psychiatry and Consultant Neuropsychiatrist, Allahabad, Uttar Pradesh, India

Date of Web Publication6-May-2016

Correspondence Address:
T S Sathyanarayana Rao
Department of Psychiatry, JSS Medical College and Hospital, JSS University, Mysore, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2348-9995.181907

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How to cite this article:
Sathyanarayana Rao T S, Tandon A. Cognition. J Geriatr Ment Health 2016;3:1-2

How to cite this URL:
Sathyanarayana Rao T S, Tandon A. Cognition. J Geriatr Ment Health [serial online] 2016 [cited 2019 Dec 15];3:1-2. Available from: http://www.jgmh.org/text.asp?2016/3/1/1/181907

The word cognition has originated from the use of the word "cognito" (translated from Greek: "Gnosis") by Latin philosophers, which translates as knowledge (French: Connaissance, Italian: Conoscenza, German: Erkenntnis) as per the Western Philosophy. [1] Cognition in a much broader sense means information processing; a high level of processing of specific information including thinking, memory, perception, motivation, skilled movements, and language. The specific functions of cognition that are accessible for assessment are orientation, attention, skill learning, problem-solving, thinking abstractly, reasoning, judgment, and perception; it also includes processes of memory, mathematical ability, control over primitive reactions and behavior, language use and comprehension, and praxis. [2] Cognitive deficits may affect any of the above-mentioned processes including inability to respond to information quickly, think critically, plan, organize and solve problems, and initiate speech. [3] With increasing age, cognitive impairment sets in, and hence cognition becomes all the more important with advancing age. [4],[5]

All degenerative disorders begin insidiously and gradually progress; hence, early detection when symptoms are at a minimum would go a long way in the secondary prevention of dementia. Mild cognitive impairment (MCI) refers to newly acquired deficits in cognitive functioning (which are more severe than expected for that age and educational background), which are not currently leading to socio-occupational disruption. MCI has been proposed as a transition between normal, age-associated cognitive change, and early dementia. [6] The criteria for the nomenclature of MCI have been precisely described by the American Academy of Neurology. Prevalence rates of MCI vary from 3% to 59% with approximately 8-15% cases converting into dementia; hence highlighting the need for neuropsychological tests, neuroimaging, and other biological markers. [7] Indian studies have reported the relative proportion of Alzheimer's disease between 41% and 65% and the proportion of vascular dementia between 22% and 58%. [8],[9] In a study done in Varanasi district, in North India, Alzheimer's dementia was found to be the most common (55%), followed by vascular dementia (30%), Alzheimer's was reported to be common in both sexes, whereas vascular dementia was predominant in male subjects. Illiteracy, age, and undernutrition were reported to be the most important risk factors. [10]

Behavioral disturbances are an integral part of the symptomatology of individuals suffering from dementia; hence contributing adversely to the quality of life of patients and caregivers. Delusions and paranoid ideations ("People are stealing things," "One's house is not one's own," "Spouse (caregiver) is an imposter"), hallucinations, activity disturbances (purposeless wandering), aggressive symptoms, diurnal rhythm disturbances, affective (particularly depression: Rate ~ 0-87%), [11] and anxiety symptoms have been reported to be common. [12]

Among neuropsychiatric disorders, dementia and major depression account for one-quarter and one-sixth of all disability-adjusted life years, respectively. [13] Around 1.5 million people are affected by dementia in India currently, and this number is likely to increase by 300% in the next four decades. [14] Development of services for older people with mental health problems, in low- and middle-income countries such as India in resource-limited settings, is likely to remain a huge public health challenge; [15] hence, caregiver support becomes all the more important. [16] Imparting adequate skills to identify neuropsychiatric problems (especially in the elderly), at undergraduate medical education level is a must. Next is a dire need to integrate geriatric mental health care with primary care. Primary care needs to encompass long-term support and chronic disease management. [17] Currently, the family members are the primary caretakers for the elderly. Such care is associated with significant emotional and financial burden. Care of elderly people at home, especially those with disabling symptoms is likely to become increasingly difficult in the future; families are undergoing transition from joint to nuclear setups; hence, younger women who are usually responsible for taking care of elderly, are increasingly likely to work outside their homes. [18] The next level of care to be prioritized would be respite care, both in day centers and (for longer periods) in residential or nursing homes. Much needs to be done in this regard by the concerning governments. [17]

 
  References Top

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Maria A, Brandimonte MA, Bruno N, Collina S. Cognition. In: Pawlik P, D′Ydewalle G, editors. Psychological Concepts: An International Historical Perspective. Hove, UK: Psychology Press; 2006.  Back to cited text no. 1
    
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Campbell RJ. Campbell′s Psychiatric Dictionary. 8 th ed. Oxford: Oxford University Press; 2004. p. 131.  Back to cited text no. 2
    
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Trivedi JK. Cognitive deficits in psychiatric disorders: Current status. Indian J Psychiatry 2006;48:10-20.  Back to cited text no. 3
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Galimberti D, Scarpini E. Progress in Alzheimer′s disease research in the last year. J Neurol 2013;260:1936-41.  Back to cited text no. 4
    
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Ramlall S, Chipps J, Pillay BJ, Bhigjee AL. Mild cognitive impairment and dementia in a heterogeneous elderly population: Prevalence and risk profile. Afr J Psychiatry (Johannesbg) 2013;16.  Back to cited text no. 5
    
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Petersen RC, Smith GE, Waring SC, Ivnik RJ, Tangalos EG, Kokmen E. Mild cognitive impairment: Clinical characterization and outcome. Arch Neurol 1999;56:303-8.  Back to cited text no. 6
    
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Pinto C, Subramanyam AA. Mild cognitive impairment: The dilemma. Indian J Psychiatry 2009;51 Suppl 1:S44-51.  Back to cited text no. 7
    
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Rajkumar S, Kumar S. Prevalence of dementia in the community - A rural-urban comparison from Madras, India. Australas J Ageing 1996;15:9-13.  Back to cited text no. 8
    
9.
Shaji S, Promodu K, Abraham T, Roy KJ, Verghese A. An epidemiological study of dementia in a rural community in Kerala, India. Br J Psychiatry 1996;168:745-9.  Back to cited text no. 9
    
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Gambhir IS, Khurana V, Kishore D, Sinha AK, Mohapatra SC. A clinico-epidemiological study of cognitive function status of community-dwelling elderly. Indian J Psychiatry 2014;56:365-70.  Back to cited text no. 10
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Allen H, Jolley D, Comish J, Burns A. Depression in dementia: A study of mood in a community sample and referrals to a community service. Int J Geriatr Psychiatry 1997;12:513-8.  Back to cited text no. 11
    
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Shaji S, Bose S, Kuriakose S. Behavioral and psychological symptoms of dementia: A study of symptomatology. Indian J Psychiatry 2009;51:38-41.  Back to cited text no. 12
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13.
Murray CJ, Lopez AD, editors. The Global Burden of Disease. A Comprehensive Assessment of Mortality and Disability from Diseases, Injuries and Risk Factors in 1990 and Projected to 2020. Cambridge: Harvard School of Public Health, Harvard University Press; 1996.  Back to cited text no. 13
    
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Ferri CP, Prince M, Brayne C, Carol B, Brodaty H, Fratiglioni L, et al. Global prevalence of dementia: A Delphi consensus study. Lancet 2005;366:2112-7.  Back to cited text no. 14
    
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Dening T, Shaji KS. Psycho geriatric service delivery with limited resources. In: Draper B, Melding P, Brodaty H, editors. Psychogeriatric Service Delivery: An International Perspective: Oxford University Press; 2005. p. 327-44.  Back to cited text no. 15
    
16.
Shaji KS, Jithu VP, Jyothi KS. Indian research on aging and dementia. Indian J Psychiatry 2010;52 Suppl 1:S148-52.  Back to cited text no. 16
    
17.
Sathyanarayana Rao TS, Shaji KS. Demographic aging: Implications for mental health. Indian J Psychiatry 2007;49:78-80.  Back to cited text no. 17
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18.
Shaji KS, Smitha K, Lal KP, Prince MJ. Caregivers of people with Alzheimer′s disease: A qualitative study from the Indian 10/66 Dementia Research Network. Int J Geriatr Psychiatry 2003;18:1-6.  Back to cited text no. 18
    




 

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