Defining the 6 Key Domains of Cognitive Function

Our brains are incredible and complex organs that control virtually every aspect of our existence, from how we process information to how we move, yet the brain is often looked at solely as the center of memory. This is why neurological diseases, like Alzheimer’s disease, are often perceived as diseases of memory. While memory is an important part of cognitive function and plays an essential role in our everyday lives, this is just one aspect of the brain’s functionality that neurological diseases impact.

The brain controls much more than just our memory; it controls both cognitive and functional aspects of our brain, meaning it controls how we think and move. Due to the high complexity of the brain, there are many different ways to categorize its functions. However, the functions are most commonly split into six categories. While this framework is not absolute, the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) defines six key domains of cognitive function.

Below we detail each of these six key domains, how they play into how we assess brain health and diagnose neurological diseases, and how diagnosis and, consequently, patient treatment and care can be improved.

Defining the Six Key Domains of Cognitive Function

The DSM-5 defines six key domains of cognitive function: complex attention, executive function, learning and memory, language, perceptual-motor control, and social cognition. Below we provide simple explanations of each key domain.

Image courtesy of Jane S Paulsen

Complex Attention

Complex attention is our ability to focus on multiple things at once and our ability to choose what to pay attention to and what to ignore. We don’t think about it very often, but our capacity to remain focused, particularly when there are distractions and parallel tasks involved, requires significant effort from our brains.

Executive Function

Executive functions refer to high-level cognitive abilities required to control and coordinate other cognitive abilities and behaviors. In other words, these are the functions we need to plan, prioritize, make decisions, respond to our environments, and move between tasks. This includes all the sequencing, planning, and organization of sets of tasks. 

Learning and Memory

Learning and memory, which is the most well-known aspect of cognitive function, is our ability to record information, such as facts or events, and retrieve it when needed. Memory functioning is one of the most complex and multifaceted cognitive domains and is composed of many subdomains, including working memory, procedural memory, and prospective memory, among others.

Language

Language links strongly with our ability to communicate, whether through writing, reading, or speaking. Language abilities include things like naming objects, finding the right words, the fluidity and flow of our speech patterns, grammar and syntax, as well as receptive language.

Perceptual-Motor Control

Perceptual-motor control is our ability to coordinate our bodies’ movements in response to what is happening around us. In other words, it is our ability to interact with the environment around us by combining the use of our senses, like vision and touch, and motor skills.

Social Cognition

Social cognition is how we process, remember, and use information in social contexts to explain and predict our behavior as well as the behavior of others. This includes our ability to control our desires to act on impulses, express empathy, recognize social cues, read facial expressions, and motivate ourselves. 

The Role of Key Cognitive Domains in Neurological Disease Diagnosis

Several of these key domains of cognitive function are utilized in assessments to help diagnose neurological diseases, such as Alzheimer’s disease, Parkinson’s disease, vascular dementia, and Lewy body dementia. Conventional neuropsychological assessments, such as the Mini-Mental State Exam and the Montreal Cognitive Assessment, aim to detect the presence of impairment to determine if further testing is needed. However, these assessments only assess aspects of cognition, meaning they do not adequately assess true neurocognitive (cognitive and functional) function.

Advancing Our Understanding of Neurocognitive Function to Improve Disease Diagnostics

While the DSM-5 categorizes cognitive function into six key domains, it is important to understand that there are both cognitive and functional domains that span across them, and each of the six key domains contains subdomains. To paint a true picture of neurocognitive function, it is important to assess a breadth of both cognitive and functional domains. With a more granular and accurate depiction of an individual’s neurocognitive function, early diagnosis and more personalized patient treatment and care can be achieved.