Wise Up

The latest on aging and memory

Understanding Cognition

All of the skills necessary for us to successfully function in everyday life

In “Wise Up," an important issue to acquaint yourself with is cognition, specifically, what it is and how can it be studied. Cognition describes all of the skills necessary for us to successfully function in everyday life. These include areas such as paying attention, remembering what we see or hear, expressing ourselves and understanding what people say, being oriented to our surroundings such that we can travel from place to place, juggling multiple tasks, and reasoning through problems. With psychiatric or medical illnesses, some or all of a person’s cognition can be affected. It is often difficult to measure cognition with the naked eye as many of us try to do. When deficits are particularly subtle, they often go unnoticed. Moreover, they can be masked by mood-related issues, such as depression or anxiety. Consequently, a full cognitive evaluation in the form of neuropsychological assessment is recommended to spell out a person’s strengths and deficiencies and thereby assist with diagnosis.

A neuropsychological assessment consists of administering various tests that examine a set of identified skill areas controlled by brain systems. Its underlying aim is to look at brain-behavior relationships.

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The following domains should be assessed in any comprehensive neuropsychological battery:

a. Attention and Processing Speed - capacity to sustain focus in any mental activity and take in information

b. Learning and Memory - ability to encode, store, and retrieve information

c. Executive Functions - ability to achieve insight and self-awareness, to reflect on, initiate, evaluate, and regulate thinking and behavior, and to incorporate feedback

d. Abstract Thinking - ability to use generalized information and apply it to specific, new situations

e. Language - ability to verbally comprehend, repeat, express, and write

f. Visual Perception/Construction - ability to recognize, perceive, and construct drawings/puzzles

g. Sensory/Motor Functions - ability to detect normal visual, auditory, and tactile sensations. Ability to perform gross and fine motor tasks

h. Emotional control - ability to function in many life-situation depends on one's mood, temperament, and personality traits

Simon Tan, Psy.D., A.B.P.P., is a clinical neuropsychologist specializing in geriatric neurological and psychiatric disorders at Stanford University Medical Center.

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