Emerging Issue of Cognitive Impairment & Alabama Lawyer Assistance Program, 0915 ALBJ, 76 The Alabama Lawyer 298 (2015)
| Author | By Robert B. Thornhill, MS, LPC |
| Position | Vol. 76 5 Pg. 298 |
By Robert B. Thornhill, MS, LPC
The Alabama Lawyer Assistance Program is committed to providing confidential services and support to attorneys, judges and law students who may be struggling with alcohol or drug abuse, or mental health issues such as anxiety disorder, depression or bipolar disorder. However, with the aging of our society and the tendency for many in the legal profession to delay retirement, the issue of cognitive impairment is becoming a major concern. While much effort continues to be made to educate those in the legal profession regarding the inevitably worsening negative consequences of undiagnosed and untreated addiction or mental health issues, little has been done so far to address the increasingly prevalent issue of cognitive decline and cognitive impairment.
Age-based changes in cognition and cognitive abilities are normal for all of us as we get older. Declines in reaction time and processing speed can become evident as early as the late 20s, while other cognitive functions show decline in later decades. As we age, it is normal for information to be processed more slowly, retrieval of information to be less accurate and efficient and learning of new information to be more challenging. The ability to multi-task and to perform complex problem-solving also declines. On the positive side, our store of knowledge, emotional functioning, vocabulary and acquired wisdom can remain stable or even show improvement over time! These are all examples of normal cognitive aging.1
Abnormal cognitive changes that are not age-appropriate are biologically-based and are referred to as dementia, cognitive disorder or cognitive impairment. This kind of impairment manifests as problems with thinking abilities that represent a change or decline from a previous level of functioning, or cognitive deficits that cause significant impairment in occupational and/or social function. Examples include Alzheimer’s disease, vascular dementia (poor blood-flow to the brain due to multiple small strokes, diabetes, hypertension, etc.), Parkinsons disease dementia, traumatic brain injury (impact to the head or other mechanism of rapid-movement displacement of the brain within the skull), Huntington's disease and so on. Other behaviors and disorders that can negatively affect the brain and lead to cognitive impairment include Multiple Sclerosis, tobacco use, hypertension, heart disease, diabetes, brain tumor, elevated cholesterol, vitamin B 12 deficiency and alcohol/drug abuse.2
The most common cognitive disorders are neurodegenerative diseases that involve progressive deterioration of the brain over time. They generally have an insidious onset and gradually progress. The most commonly recognized is Alzheimer disease, but frontotemporal dementia, Diffuse Lewy Body disease and Parkinsons disease are also fairly common. It is known that...
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