Home > Diagnosis > The Five A’s of Impaired Cognition

The Five A’s of Impaired Cognition

(This is adapted from a list that someone sent me several years ago. If anyone knows where the original list originated, please let me know so I can provide the appropriate credit.)

Attention — We must be able to attend to information before it can be stored or remembered. This includes the ability to screen out irrelevant stimuli, to shift attention between two or more things, or to attend to more than one thing at a time.

Amnesia — Memory deficits are the main impairment In many dementias. This should not be confused with the inability to learn new information, which inevitably appears at some point as the dementia progresses. For example, a person may be unable to remember how to find her room.

Aphasia – Difficulty with language, it can apply both to comprehension and expression. (For example, the person may have difficulty understanding more than very simple verbal directions, or be unable to name objects in his environment.)

Agnosia – An inability to recognize various types of sensory input. For example, a person may not recognize her husband’s face, even though she knows his name and may recognize his voice. Or, she may recognize his face but be unable to interpret his facial expressions.

Apraxia – The inability to execute a voluntary motor function despite having the necessary muscle function. It is not related to lack of understanding or any kind of paralysis. This is often seen with swallowing, when a person is unable to correctly sequence the necessary movements for chewing and swallowing, even though there is no actual muscle weakness or incoordination.

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