Manifestations of Mild Cognitive Impairment: Attention

Attention is really a subcategory of memory that is most closely linked to working memory. (see post “The Role of Attention For Working Memory”). Dopamine brain chemical system determines brain’s voltage which in turn determine brain’s ability to focus attention, stay on task, and get job done. It also controls working memory. People with naturally high levels of dopamine have high traditional IQ and can quickly master new skills with intense focus and concentration.

Dopamine deficiency occurs when brain is either burning too much dopamine or not producing enough. Typically dopamine level decreases as we age. Dopamine deficiency decrease brain voltage, leading to decreased attention and mental intensity. Low dopamine slows thinking and decision making, making one feel sluggish and also slow body’s metabolism. Dopamine deficiency also causes craving for temporary energy boosting food: high sugar fast-digesting simple carbohydrates. These food, although can temporary increase dopamine production, but are not healthy carbs as opposed to complex carbs. Because simple carbs cause other problems that actually accelerate aging. (see post “Dietary Habits That Accelerate Aging”). Even a small decrease in voltage has a major impact on cognitive capacity, mood and psychological state.

Attention deficits reveals more with aging. What’s more, attention decreases are one of the initial signs of mild cognitive impairment (MCI) and can begin as early as age 30. There are 4 core forms of attention errors:

  • Omission is the lack of response to a stimulus. Examples are: not answering a direct question; missing social cues
  • Commission is the inappropriate response to a stimulus. Examples are: talking over someone in conversation, impulsive buying or behavior
  • Reaction time is the unusually long delay in response to a stimulus. Examples are: not immediately removing the hand that is touching something hot; watching bleeding before addressing a wound
  • Variability is the inconsistent response to a stimulus. Examples are: highly distracted thinking. Variability errors are related to more or excessive level of dopamine and hyperactivity, rather than a deficit. This problem of attention is not associated with aging.

Adult attention deficits are rarely hyperactive and the attention problems are the consequence of a slower and less intensive brain. Declining attention of MCI is very different from adult attention deficit hyperactive disorder (ADHD), a clinical diagnosis for people who have never had the ability to focus clearly. The manifestations of adult ADHD are much the same as that of the age-related attention deficit of MCI. There is computerized screening for attention deficit of MCI known as TOVA (Test of Variable Attention). A list that mimics the results of TOVA is presented in this post:

  • accident prone
  • avoid new situations and meeting new people
  • consistent forgetfulness of tasks, even after instructions have been given
  • easily forgot the task after interruption or distraction, such as a phone call
  • feeing slow when processing information
  • frequent interruption of thoughts
  • frequent misplacing items
  • difficulty in concentrating on tasks requiring sustained attention
  • difficulty organizing material for a task
  • difficulty sticking to a single activity
  • lose track of time
  • misses stop signs
  • not attending to tasks quickly
  • often acts before thinking
  • procrastinating
  • have problems during conversation
    • dysphasia
    • difficulty following or joining a conversation
    • difficulty initiating a conversation
    • losing thought in the middle of a conversation
    • repeating questions, stories. or statements
    • struggling with vocabulary
    • using words incorrectly
  • impulsive behavior (reacting without thinking first)
    • agreeing to complete something without thinking about whether it is feasible
    • interrupting during conversations
    • making rash or quick decision
    • impulsive buying

Addiction is one of the causes of MCI (see post”Causes of Mild Cognitive Impairment And How To Reverse It”). Research has found that frequent exposure to addictive behavior decreases the number of dopamine receptors in the brain. With fewer receptors, less dopamine are activated, causing more intense cravings and increased stress. Dopamine genetics appear to predict a very high predisposition for various addictions. Studies have shown that a dysfunction of D2 dopamine receptors in the brain can lead to addiction, aberrant substance-seeking behavior and aggression. There is a correlation between adult ADD and drug abuse. In many instances, people with attention deficits have the same dysfunctional D2 dopamine receptors and are prone to addictive behavior. Addiction disturbs dopamine system which give an initial feeling of rush or excitement, this could lead to the addiction to dopamine which increases the craving for the substance.

Researchers claim that our ability to focus is being undermined by information overloading (email, text messages, phone calls and other electronic disruptions) with the technological progress. The stimulation provokes a dopamine release similar to a response to addiction. Not only the attention level is affected, so is the level of addiction. Too much information, even when only doing one task at a time causes distraction. Researchers proved that when people are faced with overwhelming array of choices, they are apt to make no decision at all. The prefrontal lobe houses working memory than can hold only seven different pieces of information at any given time. Any more must be processed into long term memory. When the brain are exposed to information overloading, the brain instinctively struggles to figure out what to keep and what to put into storage. In order to reduce the distracting effects of information overloading, several strategies can be used. Make a practice of filtering out all the extraneous information. Frequently prioritize attentions to get rid of the extraneous noise that is clogging up the thinking.

A comprehensive protocol that may reverse the attention problems of MCI and bring dopamine chemical into balance is presented in post “A 7- Step Action Plan For Preventing And Treating Memory Loss”.

Reference: book by Eric R. Braverman, MD.

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