Journal of Child and Adolescent Behavior
Open Access

Cognitive impairment; Neurocognitive disorder

Introduction

The American Academy of Neurology’s (AAN) clinical practice guideline on mild cognitive impairment from January 2018 stated that clinicians should identify modifiable risk factors in individuals with MCI, assess functional impairments, provide treatment for any behavioral or neuropsychiatric symptoms, and monitor the individual’s cognitive status over time. The AAN guideline also stated that clinicians who choose to prescribe cholinesterase inhibitors for the treatment of MCI must inform patients about the lack of evidence supporting this therapy. As a result, they and their loved ones are left in limbo with no idea what the future holds for them and the possibility of dementia. Additionally, the lack of services fails to inform them of effective dementia prevention strategies like exercise and social interaction. As MCI may represent a prodromal state to clinical Alzheimer’s disease, proposed treatments for Alzheimer’s disease, such as antioxidants and cholinesterase inhibitors, could potentially be useful. However, as of January 2018, there is no evidence to support the efficacy of cholinesterase inhibitors for the treatment of mild cognitive impairment. Two medications used to treat Alzheimer’s disease have been evaluated for their ability to treat MCI or prevent progression to full Alzheimer’s disease. Rivastigmine did not stop or slow the progression of Alzheimer’s disease or improve cognitive function in people with mild cognitive impairment. Donepezil had significant side effects and only minor short-term benefits [1-5].

After surgery, cognitive issues like memory, learning, and the ability to concentrate are referred to as postoperative cognitive dysfunction (POCD). Although very little research has been done on POCD, there are reports that it is more common with age and can last for up to two to three months, making it a long-term condition.

Discussion

POCD has been concentrated on through different establishments starting from the origin of the IPOCDS-I concentrate on focused in Eindhoven, Netherlands and Copenhagen, Denmark. Hypoxia, low blood pressure, and POCD were not found to be linked in this study. POCD was found to be linked to age, anesthesia duration, intraoperative complications, and postoperative infections. Agrammatism, omission of functional words, changes in sound production, dyslexia, dysgraphia, and difficulties with comprehension and production are typical signs of damage to the Broca’s area. Broca’s aphasia is a sign that the brain’s posterior inferior frontal gyrus has been damaged. However, an impairment following brain damage does not necessarily mean that the damaged area is entirely responsible for the impaired cognitive process. For instance, a lesion that damages both the left visual field and the connection between the right visual field and the language areas (Broca’s area and Wernicke’s area) destroys the ability to read in pure alexia. However, people with pure alexia can still write, speak, and even transcribe letters without understanding their meaning. Lesions to the fusiform gyrus frequently result in prosopagnosia, the inability to distinguish faces and other complex objects from one another. Lesions in the amygdala would eliminate the enhanced activation seen in the occipital and fusiform visual areas in response to fear with the area intact. This does not mean that people with Lesions of the amygdala alter the functional pattern of activation for emotional stimuli in areas away from the amygdala [6].

To distinguish POCD from postoperative delirium, it lasts longer and does not fluctuate in impaired cognitive functioning. At three months, it was discovered that some patients who had POCD at 10–14 days had improved scores, while others had POCD for more than a year. This suggests that POCD may cause permanent cognitive dysfunction in some at-risk patients.

The medical treatment and rehabilitation of a brain injury victim may involve a variety of professions. Physiatrists, neurologists, and neurosurgeons are doctors who treat brain injuries. Neuropsychologists (particularly clinical neuropsychologists) are clinicians having some expertise in grasping the impacts of mind injury and might be engaged with evaluating the seriousness or formulating recovery techniques. Word related specialists might be associated with running restoration projects to assist with re-establishing lost capability or help re-acquire fundamental abilities. With constant medication administration and neurological monitoring, including the use of the Glasgow Coma Scale, which is utilized by other health professionals to quantify extent of orientation, registered nurses, such as those who work in hospital intensive care units, are able to maintain the health of severely braininjured patients [7-10].

Conclusion

In addition, physiotherapists play a significant role in brain injury rehabilitation. Sensory stimulation is the process of regaining sensory perception through the use of modalities. Physiotherapy treatment during the post-acute phase of a traumatic brain injury (TBI) may include functional training, fitness and aerobic training, serial casting and splinting, and sensory stimulation. There is no proof to help the adequacy of this intervention. Sequential projecting and supporting are in many cases used to decrease delicate tissue contractures and muscle tone. Serial casting can be used to improve passive range of motion (PROM) and reduce spasticity, according to evidence-based research. Functional training can also be used to treat TBI patients. In general, studies suggest that patients with TBIs who participate in more intensive rehabilitation programs will see greater benefits in functional skills. More research is required to better understand the efficacy of the treatments mentioned above. At this time, there are no studies that support the efficacy of sit to stand training, arm ability training, or body weight support systems (BWS).

1. Elster AB, Kznets NJ (2000) American guide lines for adolescent preventing services (GAPS). Recommendation and Rationale.

Indexed at, Google Scholar 

2. Taffa N, Haimanot R, Dessalegn S, Tesfaye A, Mohammed K (1999) Do parents and young people communicate on sexual matters? The situations of Family Life Education in rural town in Ethiopia. Ethiop J Health Dev 139: 205-210.

Google Scholar     

3. Taffa N, Johannes, Holm Hansen C, Bjune SG (2002) HIV prevalence and socio-economic contexts of sexuality among youth in Addis Ababa, Ethiopia. Ethiop J Health Dev 16: 139-145.

Google Scholar  

4. Ghana Statistical Service (GSS), Ghana Health Service (GHS), and ICF International 2015 Ghana Demographic and Health Survey 2014. Rockville, Maryland, USA: GSS, GHS, and ICF International.
5. Ghana Statistical Service (GSS) (2014) Ghana Living Standards Survey Round 6 (GLSS 6), Main Report, 2012/2013. GSS: Accra, Ghana.
6. Coughlin J (2016) Teenage pregnancy in Ghana: Assessing situation and moving forward.

Google Scholar     

7. Government of Ghana, Ministry of Gender, Children and Social Protection (MoGCSP) (2014) Child Protection Baseline Research Report. MoGCSP: Accra, Ghana.
8. Osei-Asibey Y (1998) Problems of teenage pregnancy in Nkwanta District of Volta region, School of Public Health: University of Ghana, Legon.

Indexed at, Google Scholar

9. Ghana Statistical Service (2018) Multiple Indicator Cluster Survey (MICS 2017/18). Survey Findings Report. Accra, Ghana: GSS.
10. Planned Parenthood Minnesota (2011) Promoting Parent-Child Connectedness in Your Family North Dakota, South Dakota.