Cognitive impairment
Cognitive impairment can impact a person’s ability to communicate, think and remember. It is often dismissed or misdiagnosed in hospitals, leading to adverse outcomes. We introduced actions in our national standards to help health professionals detect and manage cognitive impairment and provide safer care.
What is cognitive impairment?
Cognitive impairment can affect anyone.
Cognitive impairment impacts a person’s cognitive functions; impeding communication, attention, memory, thinking and problem solving.
It affects what someone can understand, how they relate to others and interpret the environment they’re in, as well as a person’s ability to carry out tasks and recognise people or objects.
Cognitive impairment is a symptom caused by different conditions and can be mild, severe, temporary or permanent.
Common conditions associated with cognitive impairment include:
| Dementia | The most common form of cognitive impairment among older people. Dementia causes progressive cognitive impairment affecting memory, judgement, language and the ability to perform everyday tasks. Alzheimer’s disease is the most common type of dementia, predominately impacting people over 65. |
|---|---|
| Delirium | Sudden and short-lived disturbance of consciousness, attention and cognition that tends to fluctuate during the day. Delirium can be treated if diagnosed early and even prevented with the right care following a hospital admission. People with dementia are at a greater risk of developing delirium. |
| Injury or underlying conditions | Brain injury, stroke, or intellectual disability |
Why is understanding cognitive impairment important?
Cognitive impairment is often dismissed or misdiagnosed as a normal part of ageing or dementia. This can prevent people from getting care and put them at risk of preventable complications.
The first step to ensuring a person’s safety is understanding the different forms of cognitive impairment, the people who are at risk, and what we need to be alert to.
All cognitive impairment needs to be recognised, understood and acted on.
How we are improving cognitive impairment outcomes
Cognitive impairment in hospital is often associated with adverse outcomes, such as functional decline, increased risk of falls, morbidity and mortality.
These adverse outcomes can lead to longer stays in hospital and increased risk of entry into residential care for older people.
To address these concerns, we introduced specific actions in our National Safety and Quality Health Service Standards that focus on developing and using a cognitive impairment system and recognising and responding to acute deterioration.
There are also other critical actions in our standards that support safe and high-quality care for patients at risk of delirium or with cognitive impairment.
Our user guide for providing care for patients with cognitive impairment or at risk of delirium provides strategies for improvement and examples of good practice for all relevant actions.
Using psychotropic medicines to treat people with cognitive impairment or disability
Psychotropic medicines are medications that affect how the brain works and are used to manage conditions like anxiety, depression, bipolar disorder, schizophrenia and sleep problems.
In some cases, they can be considered in response to behaviours of concern in people with cognitive impairment or disability, however this should only be done following a documented clinical assessment and with clearly communicated intentions for use.
Our Psychotropic Medicines in Cognitive Disability or Impairment Clinical Care Standard aims to ensure the safe and appropriate use of psychotropic medicines in people with cognitive disability or impairment. Our easy read version can help people with cognitive disability or impairment understand what the clinical care standard says.
Learn more about our work to reduce the inappropriate use of psychotropic medicines.
Additional resources
- Delirium Clinical Care Standard
- Delirium Clinical Care Standard – Evidence sources
- My Healthcare Rights: A guide for people with cognitive impairment
- Easy English Guide: About healthcare rights for people with cognitive impairment
- A better way to care: Care for patients with cognitive impairment or at risk of delirium
- Safety and quality pathway for patients with cognitive impairment (delirium and dementia) in hospital
- Cognitive impairment: Actions for clinicians fact sheet
- Health outcomes for adults with cognitive impairment report