Conceptual issues in 'cognitive impairment'.

PURPOSE OF REVIEW: This review aims to set out the recent writings relevant to acquired cognitive impairment in an attempt to reveal some of the underlying conceptual issues.

RECENT FINDINGS: The huge strides being taken to diagnose Alzheimer's and other dementias early, including pre-symptomatically, raise important ethical issues. But there are broader conceptual issues too, around the notion of normal ageing. New techniques, such as deep brain stimulation, raise further ethical concerns, but may be relevant to deeper philosophical issues. Meanwhile, capacity continues to be of interest to researchers in the field of cognitive impairment, but the 'United Nations Convention on the Rights of Persons with Disabilities' is raising questions about our understanding of the nature of capacity. These new ideas reflect shifts in our understanding of personhood. How we think about the person is relevant to how we think about dilemmas over artificial nutrition and is also pertinent to debates about rational suicide in response to a diagnosis of dementia. A person-centred view allows us to think more broadly about cognitive impairment.

SUMMARY: Cognitive impairment challenges us to think broadly, to see such impairment as something to be dealt with in the context of our multifaceted life-worlds.