Cognitive dysfunction (or brain fog) is defined as unusually poor mental function, associated with confusion, forgetfulness and difficulty concentrating.[1][2] A number of medical or psychiatric conditions and treatments can cause such symptoms, including heavy metal poisoning (in particular mercury poisoning),[3] menopause,[2] chronic fatigue syndrome, fibromyalgia, mood disorders, ADHD (primarily inattentive), drug abuse, and sleep disorders (including disrupted sleep).[2] The term brain fog is not commonly used to describe people with dementia or other conditions that are known to cause confusion and memory problems, but it can be used as a synonym for sleep inertia or grogginess upon being awakened from deep sleep.
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Postoperative Cognitive Dysfunction (POCD) refers to cognitive problems (with memory, learning and the ability to concentrate) following surgery. There has been very limited research into POCD, but existing reports suggest that the incidence of POCD increases with age, it can last for long periods of time, with 2–3 months considered long-term.
POCD has been studied through various institutions since the inception of the IPOCDS-I study centred in Eindhoven, Netherlands and Copenhagen, Denmark. This study found no causal relationship between hypoxia and low blood pressure and POCD. Age, duration of anaesthesia, introperative complications, and postoperative infections were found to be associated with POCD.
POCD to be differentiated from postoperative delirium has a longer duration and no lability or fluctuations in impaired cognitive functioning. Some patients who demonstrated POCD at 10–14 days were found to have improved scores at 3 months, while others continued to demonstrate POCD at periods longer than 1 year. This suggests that in certain at risk patients, POCD may be a permanent alteration of cognitive functioning.
Treatment generally involves correcting any underlying medical conditions. For example, if the patient is found to be suffering a form of hypothyroidism, the mental declining effects associated with hypothyroidism can be corrected with thyroid hormone replacement therapy, although many times patients continue to endure confusion and a sense of dementia. Additionally, occupational therapy may be helpful for some people. Neurofeedback can improve symptoms for some people.[4][5][6]
In Fibromyalgia patients, cause for cognitive dysfunction (sometimes referred to as "fibro fog") is often related to the inability to fall into a restorative REM sleep, thus, treatment may include a prescription sleep aid or medication normally prescribed for shift work disorder.[7]