Frequently Asked Questions
Cognition is the mental process of processing and acquiring information.
Cognitive decline describes a disruption in thinking abilities, and can include impairment in memory, concentration, language, orientation in time and space, and executive abilities. Often, such impairment is not isolated and is also accompanied by emotional and behavioral changes.
What is cognitive neurology?
Cognitive function is a complex process that involves many areas of the brain and requires resources. It is important to remember that there are many diseases and conditions that can lead to a decline in cognitive ability – both brain diseases and systemic disorders that affect the brain. Examples of this can be found in vitamin deficiencies, effects and side effects of medications, hormonal imbalances, sleep disorders, and more.
There are also many examples of brain diseases that can cause cognitive impairment. Starting from vascular diseases of the brain - such as stroke or hemorrhage, inflammatory diseases such as multiple sclerosis, brain tumors, head injuries, infectious diseases such as AIDS and syphilis, as well as degenerative diseases of the brain - such as Alzheimer's disease.
In some of these diseases, there are additional symptoms beyond cognitive impairment, whether other physical or neurological symptoms.
In addition, there are developmental conditions of cognitive difficulty starting in childhood, such as attention deficit hyperactivity disorder (ADHD) and learning disabilities, which are sometimes not diagnosed until adulthood.
What causes cognitive decline?
In the event that there is a cognitive complaint, it is recommended to contact a cognitive neurologist in order to characterize whether cognitive decline is indeed present and its severity. A plan will then be formulated to clarify the medical cause of the impairment, and, based on the results, recommendations will be made regarding appropriate treatment and follow-up as needed.
In what situations is it recommended to consult a cognitive neurologist?
It is recommended to come with a companion who knows the patient well, who lives with them or meets them frequently. It is very important to receive reliable information about cognitive difficulties and their impact on daily functioning, and often it is the companions who notice cognitive difficulties, even if the patient himself is not aware of them.
In addition, it is advisable to bring (if available):
A brief summary of underlying diseases and medical history from the family doctor, including a current medication list.
Previous visit summaries for these complaints (if an investigation was initiated by a neurologist/geriatrician)
Results of previous cognitive tests and diagnoses (performed by a neurologist/geriatrician/neuropsychologist/occupational therapist).
Interpretations and discs of imaging tests (head CT/brain MRI/brain mapping).
Results of laboratory tests such as blood tests.
What is recommended to bring to an appointment with a cognitive neurologist?
A cognitive neurological examination begins with an in-depth questioning (anamnesis) of the patient and a companion, in order to characterize the cognitive complaint and its severity, and to determine the possibility of the existence of diseases that affect cognition. Subsequently, a test must be performed to assess the cognitive status objectively and quantitatively. Common tests used in Israel include the Mini-Mental State Examination (MMSE) and the MoCA test. Sometimes it is necessary to perform more comprehensive cognitive tests, and then a neuropsychological diagnosis is performed, also called a cognitive diagnosis. For this purpose, a neuropsychologist must sometimes be consulted.
In addition, the neurologist performs a physical neurological examination, which includes, for example, a reflex test or a test of motor function.
After performing this assessment, the cognitive neurologist will refer for additional ancillary tests, depending on the case and need, which include brain imaging tests such as CT and MRI, and brain mapping (PET and SPECT), various blood tests, vascular examination, and sometimes also lumbar puncture or advanced brain mapping.
Weighing all the findings will assist the cognitive neurologist in determining a diagnosis, making treatment decisions, and providing recommendations tailored to the patient.