Attention cognitive impairments

Delirium is an acute disorder that affects cognition and attention. Delirium or confusion is more frequent in advanced age. The incidence also increases with high number of medications, frailty, comobirdity and previous cognitive impairment. 

Attentional or cognitive impairments have also been observed in rodent models of nicotine withdrawal. These include impaired performance of a test of sustained attention (Shoaib and Bizarro 2005), disrupted contextual fear conditioning (Davis and Gould 2007 Davis et al. 2005), disrupted operant behaviors (Vann et al. 2006), and decreased prepulse inhibition, a test of selective attention (Semenova et al. 2003). 

Of particular importance in the geriatric patient Impaired attention, agitation, decreased concentration, sedation, anticholinergic effects, cognitive impairment, vertigo, headache, dry mouth, urinary retention... 

Downes JJ, Sharp HM, Costall BM, et al Alternating fluency in Parkinson s disease. An evaluation of the attentional control theory of cognitive impairment. Brain 116 887-902, 1993... 

Mood disorders are frequently associated with cognitive impairment. In younger depressives attention and concentration are primarily affected, and responses in speed-related tasks may be abnormally slowed. Complaints about serious cognitive dysfunction, which are particularly frequent in older patients with depression, cannot always be fully substantiated by means of objective tests (O Hara et al., 1986). Nevertheless, significant deficits in the following areas have been found ... 

Paradoxical effects cognitive impairment and perseverative behavior are occasionally seen in children treated with psychostimulants. According to Greenhill et al. (1999) such phenomena are indicative of a drug overdose and will improve at dose reduction. Constriction of attention or overfocusing as a consequence of treatment with psychostimulants has been another critical issue (Breggin, 1999). Based on an extensive review of the literature and their own experience, Wilens and Biederman (1992) assert that there is no evidence of such phenomena at doses up to 1.0 mg/kg of methylphenidate. 

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