Cognitive Decline/Brain Fog

What is Cognitive impairment or 'Brain fog'?

Brain fog is the feeling that you cannot think as clearly as you used too. It can affect memory, decision making, concentration and the speed at which you are able to process information.

Brain fog is a symptom of lots of things, including cognitive decline which is a normal part of ageing. Cognitive decline usually occurs because as we get older the neurons in our brain decrease in speed meaning than brain functions are slowed.

Sometimes brain fog is brought on by illnesses or injury. For example, Long COVID or a traumatic brain injury. This is usually referred to as cognitive impairment.

Brain fog in itself is not a mental health issue. However, it is very closely related to mental health as it can be both a symptom of common mental health conditions such as depression or stress, and a cause for others such as anxiety.

What are the signs and symptoms of brain fog?

For many people the symptoms of brain fog are hard to spot, and it might be your friends and family who notice a change in you before you do.

Common symptoms are:

• Short term memory problems. For example, starting to prepare food and then getting distracted and forgetting to finish, or forgetting important appointments.
• Losing the ability to concentrate. Finding it difficult to stay focused on one thing for too long, being easily distracted or having difficulty following instructions or directions.
• Feeling overwhelmed by making plans or having to organise tasks. The ability to make decisions, or think about the consequences of decisions, can be affected making planning difficult.

What is the difference between brain fog and age-related cognitive decline?

Some gradual cognitive decline is a natural part of aging. We all tend to become a little more forgetful as we get older. However, these declines to not affect overall functioning or our ability to live a normal life. Normal aging does not affect decision making, long-term memory or the speed at which we think.

Dementia is a condition closely associated with age-related cognitive decline. Dementia is a term that is used to describe a decline in mental function severe enough to interfere with daily living. Whilst a gradual cognitive decline might eventually lead to dementia it is not guaranteed.

Brain fog is a symptom rather than a diagnosis. It can be due to cognitive decline, cognitive impairment, dementia or it can be due to other issues.

What are the causes of brain fog?

It is believed that brain fog is a symptom of inflammation which can be triggered by viral infection, stress hormones, diet and even medication.

There are many things that can cause the feeling of ‘brain fog’. For example, illnesses such as Long COVID, Multiple Sclerosis or mental health conditions such as Major Depressive Disorder or Anxiety can cause brain fog.

Brain fog can also be caused by lifestyle factors such as lack of sleep, stress, poor diet and allergy medications.

What are the recent developments in research for cognitive decline and brain fog?

In 2022 MQ announced the launch of a new study into COVID related brain fog. This study is being led by researchers at Oxford University and was made possible by a generous grant from the Wolfson foundation.

The aim of this new study is to identify the specific cognitive deficits underlying long-COVID induced brain fog, identify the mechanisms in the brain that cause the impairments and to develop and test interventions.

It is also hoped that what we learn about COVID induced brain fog in this study will help us to better understand brain fog more widely, as it is also a common symptom in other long-term conditions such as Multiple Sclerosis.

This study will be led by Oxford University and will include clinical and data researchers from Imperial College London and the University of Leicester who have already gathered 12 months of research data from over 2,000 people with long COVID.

What help and resources are available for people who need support or further advice?

You can attempt to improve brain fog at home trying things such as:

• ensuring you get 8 to 9 hours of sleep per night
• managing stress by understanding your limits and avoiding excessive alcohol and caffeine intake
• engaging in regular exercise
• boosting cognitive function through activities such as volunteering or solving brain puzzles
• enjoying leisure activities that help you relax and unwind

If you feel that you have brain fog symptoms which won’t go away even if you get enough sleep, eat well and avoid alcohol then you should consult your GP.

If you are experiencing symptoms of brain fog following a recent COVID infection then you can read more on the NHS Your COVID Recovery website.