What causes cognitive decline?

As we age, a certain extent of cognitive change is normal -- this is referred to as age-related cognitive decline. In some people, however, we see more change than would be expected for someone of their age. This is often referred to as mild cognitive impairment, and these individuals may be at heightened risk for dementia.

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Mild cognitive impairment and dementia are believed to be caused by a number of different factors:

• Vascular disease (e.g., stroke, ischemia) which can be exacerbated by lifestyle factors such as smoking;

• Damage to the integrity of the white matter or gray matter of the brain;

• Abnormal, excessive accumulation of proteins in the brain (e.g., amyloid, tau, alpha-synuclein, Lewy bodies) which may be related to genetic factors (e.g., APOE, SNCA);

• Inflammation following infection or disease.

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Many individuals with psychiatric conditions have mild cognitive impairment (or are likely to develop it). However, it is unclear why this happens. In the Neurocognitive Disorders Lab, we are currently investigating:

• Whether Alzheimer's disease proteins (tau, amyloid) are related to mild cognitive impairment in bipolar disorder

• Whether early markers of Lewy body dementia are more common in adults with attention-deficit/hyperactivity disorder

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