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Leading Causes of Cognitive Impairment in Old Age

July 26, 2023

With age, the thought of cognitive impairment can loom large, casting a shadow on what should be your golden years. You’re not alone in this journey. This article is dedicated to exploring the main causes of cognitive impairment in old age and providing practical, actionable guidance to optimize brain health. It’s never too late to make positive changes, every small step can make a significant difference.


We’ll delve into everything from medical conditions like dementia to the potential side effects of medications, dietary factors, and the importance of mental health. Even the simple act of prioritizing a good night’s sleep can play a significant role in maintaining your cognitive health.


The intention here is to empower you with knowledge and strategies, so you can live a fulfilling life, irrespective of where you are on this journey. Cognitive impairment is not a definite, but even if you are touched by it, life can still be vibrant and meaningful. With the right care and approach, we can face these challenges head-on and continue to enjoy life.


Leading Causes of Cognitive Impairment in Old Age


Dementia is often the first thing that comes to mind, and for a good reason. It’s an umbrella term that encompasses several types of cognitive disorders, with Alzheimer’s disease being the most common. Other types include vascular dementia, Lewy body dementia, frontal temporal dementia, Parkinson’s dementia, and several others. When a person is diagnosed with a dementia disorder, cognitive impairment is often the main symptom.


Medication is another significant factor that can contribute to cognitive impairment. This might be a side effect of a particular medication or an interaction between two medications that don’t pair well together, causing cognitive impairment, especially in older individuals.


Vascular disorders also play a role in cognitive impairment. These conditions impact blood circulation to the brain, potentially leading to issues such as vascular dementia or stroke. Essentially, any disorder that hampers the blood flow to the brain can potentially lead to cognitive impairment.


Depression, too, can manifest as cognitive impairment in some older adults, particularly affecting memory, processing information, and concentration. It’s crucial to identify and treat depression because it can significantly impact cognitive function. Thankfully, depression is highly treatable in older adults, and treating it can indeed improve a person’s cognitive functioning.


Nutritional deficiencies, like dehydration, and deficiencies in vitamin B12 and D, are common in older adults and can significantly impact brain functioning. The silver lining here is that once we identify these deficiencies, they can often be easily corrected, alleviating cognitive impairment.


Chronic diseases, such as diabetes, hypertension, heart disease, kidney disease, can also impact cognitive functioning. If you’re living with these conditions, maintaining your health by following medical advice is crucial.


And let’s not forget sleep! Insomnia is a significant issue for many older adults. Without enough sleep, our brain just doesn’t operate at its best. So, securing a good night’s sleep is absolutely important.





Why is understanding what’s causing cognitive impairment so important?


  1. Understanding and Addressing the Underlying Causes of Cognitive Impairment

    First and foremost, understanding the root causes of cognitive impairment is crucial, as many of these can be readily addressed. Depression, nutritional deficiencies, and certain medications are common culprits. To tackle these, we might opt for vitamin B12 injections or vitamin D supplements for nutritional deficiencies. Similarly, we could explore depression treatment options, considering it’s highly treatable in older adults. Moreover, revisiting our medication plan with a healthcare provider might lead us to alternatives that have less of a cognitive impact.

  2. Managing Cognitive Impairment Related to Chronic Diseases or Vascular Disorders

    As we progress to more complex causes like chronic diseases or vascular disorders, it’s vital to work hand in hand with your healthcare provider to manage your health effectively. Even though these conditions may elevate the risk of cognitive impairment, that risk can be lessened by carefully managing your medical care and leading a healthy lifestyle. Your doctor is the best person to advise you on the appropriate diet if you’re living with conditions like diabetes or heart disease. They can also recommend an exercise regimen that could improve your overall brain health.

  3. Living Your Best Life with Dementia Disorders 

    Finally, when cognitive impairment stems from dementia disorders, it’s just as important to understand the cause. We need to ensure that those living with dementia are leading the best life they possibly can, working to optimize their health and brain function. This often involves providing education and guidance on what to expect when living with a dementia disorder, equipping patients and their families with the knowledge and strategies to navigate this journey.


The take-home message is this: cognitive impairment is not a given. Partnering with your healthcare provider to pinpoint the cause of any cognitive impairment is vital, and don’t ever give up hope! There are ways to optimize your brain health, even when living with chronic conditions or neurocognitive disorders.


For professionals and caregivers working with or caring for older adults, you’re in a crucial position. With accurate assessments, compassion, empathy, and education, we can ensure older adults with cognitive impairment are not walking this challenging journey alone.


Remember, just as you’re there for your clients or loved ones, I’m here for you. If you’re a professional, I’ve put together a free training on how to navigate cognitive impairment when it shows up in your clinic. Simply click here to access this free training now. 





Regina Koepp, PsyD, ABPP

Dr. Regina Koepp is a board certified clinical psychologist, clinical geropsychologist, and founder and director of the Center for Mental Health & Aging: the “go to” place online for mental health and aging. She is currently the lead medical psychologist at University of Vermont Medical Center. Dr. Koepp is a sought after speaker on the topics of mental health and aging, caregiving, ageism, resilience, sexual health and aging, intimacy in the context of life altering Illness, and dementia and sexual expression. Learn more about Dr. Regina Koepp here.