患病后或长期新冠引发的“脑雾”：何时需要进行认知评估

Brain fog is the term many people use when their thinking feels slow, fuzzy or unreliable. It can make it hard to concentrate, find words or remember what you were doing, and it often follows an illness such as COVID-19.

For most people, brain fog is not a sign of dementia. It can still have a real effect on work, study and family life. This guide explains common causes, how brain fog relates to long COVID, when a cognitive assessment may help, and practical ways to manage.

What is brain fog?

healthdirect describes brain fog as having difficulty with thinking and memory. Health professionals may call it cognitive dysfunction or cognitive impairment. Common experiences include:

• forgetting things, such as names or dates
• trouble following conversations
• difficulty concentrating
• struggling to find the right word
• finding it hard to multitask
• trouble planning or solving problems

Many people describe feeling as though their brain is working through a thick layer of cotton wool. Tasks that used to be automatic, like following a recipe or answering emails, take more effort and leave them drained.

healthdirect is clear that brain fog is not the same as dementia or delirium. That reassurance matters, because worry about dementia can add to the stress.

Common causes of brain fog

Brain fog is a description, not a diagnosis. healthdirect lists a range of possible causes:

• Lifestyle factors: not getting enough sleep, lack of exercise, poor nutrition and stress
• Long COVID: where inflammation is thought to play a role
• Menopause: hormonal changes can affect thinking
• Medical treatment: medicines used during surgery or for cancer treatment
• Health conditions: depression, anxiety, chronic pain, diabetes and anaemia (low iron or red blood cells)

Often more than one factor is involved. For example, a person recovering from an illness might also be sleeping poorly, feeling anxious about work, and less physically active than usual. Each of these can make thinking harder.

Brain fog and long COVID

Long COVID is the name for ongoing symptoms after COVID-19. A review by the Australian Institute of Health and Welfare found that estimates of long COVID in Australia, defined as symptoms lasting more than 12 weeks, ranged from 5% to 10% of COVID-19 cases. It named brain fog, meaning difficulties with thinking, attention and memory, as one of the most frequently reported neurological symptoms.

healthdirect’s long COVID page notes that more than 200 symptoms have been reported. Along with brain fog, these include fatigue, headaches and post-exertional malaise, which is when symptoms get worse after physical or mental activity. healthdirect advises seeing your doctor if you have had symptoms for 4 weeks or more and are worried. Researchers are still working to understand why long COVID affects thinking and which treatments work.

Why post-exertional malaise matters

If mental effort makes your symptoms worse, pushing through can backfire. A long day of concentrating might be followed by a day or more of feeling much worse. This is important for work, study and also for how an assessment is planned.

When a cognitive assessment can help

Start with your GP, who can check for medical causes such as anaemia, diabetes or medicine side effects. A cognitive or neuropsychological assessment may then help if:

• brain fog has lasted for several months and is not improving
• it is affecting your ability to work, study, drive or manage at home
• you, your employer or your university need clear information about your strengths and difficulties to plan adjustments
• an insurer, compensation scheme or support service needs objective evidence
• you want to understand how much mood, sleep, pain or fatigue are contributing
• there is a question of whether another condition, such as ADHD, a brain injury or early memory decline, is part of the picture
• you would like a baseline so that recovery can be measured

An assessment does not diagnose long COVID itself. That is a medical diagnosis. What it can do is describe how your thinking is working, compared with people of a similar age, and turn that into practical recommendations.

What the assessment involves

A neuropsychological assessment usually includes a detailed interview, questionnaires about mood, sleep and fatigue, and tests of attention, memory, processing speed, language and executive functions (planning, organising and problem solving). The neuropsychologist will also ask how you managed before you became unwell, so any change can be judged against your own usual level.

If fatigue or post-exertional malaise is part of your picture, tell the clinic when you book. The assessment can often be adapted, for example by:

• splitting testing across shorter sessions
• scheduling appointments at the time of day when you usually feel better
• building in more rest breaks
• doing parts of the interview by telehealth

Afterwards, you receive feedback and a written report. Recommendations might cover energy management, memory aids, workplace or study adjustments, and referrals to other health professionals.

Managing brain fog day to day

healthdirect suggests healthy sleep, regular movement within your limits, eating well, reducing stress, staying mentally active and using memory aids. For long COVID, it recommends three Ps:

• Pace: break activities into smaller tasks and rest between them.
• Plan: spread demanding activities across the week.
• Prioritise: focus your energy on what matters most, and let some things go.

Other practical ideas include:

• keep one diary or calendar, and set phone reminders
• do one task at a time and reduce background noise
• write down key points during meetings or appointments
• do thinking-heavy work when your energy is highest
• tell trusted people what helps, so they can support you

Returning to work or study

Brain fog can make a full workload feel impossible, even when you look well to others. A gradual return often works better than going straight back to full hours. Adjustments that people commonly find useful include:

• shorter or flexible hours, with the option to build up over time
• working from home on some days to save the energy used in travel
• written instructions and meeting notes
• a quieter workspace with fewer interruptions
• extra time for assessments or deadlines at school or university

A letter from your GP or a report from an assessment can help your employer or education provider understand what you need. You do not have to share every detail of your health, only what is relevant to the adjustments you are asking for.

If your mood is low or you feel overwhelmed, reach out for support. If you are in danger, call 000. For 24-hour crisis support, call Lifeline on 13 11 14.

Invictus Health 能提供哪些帮助

Our neuropsychologists provide neuropsychology assessments that can be adapted for people with fatigue. Our anxiety and stress counselling can help with the emotional side of a long illness. You can book most assessments without a GP referral, and see our 费用页面 费用方面。.

This article is general information only. Please talk with your GP or another qualified health professional about your own symptoms.