Cognitive Processes Chapter 4 HPR 452

Cognitive Abilities  Fear of loss of memory and inability to learn are feared  These losses have impact on independence and functioning  Components of cognitive functioning identified by CDC and Alzheimer’s Association (2007) Language Thought Memory Executive Function (ability to plan and carry out tasks) Judgment Attention Perception Skills such as driving Ability to lead a purposeful life

Competence is the Cornerstone of Ulyssean Living  Managing finances  Taking medications  Shopping  Using the phone  Housekeeping chores  Transporting oneself  Preparing meals

 Losses do not imply deficit of functioning  Variability in these just as physical abilities  Environmental support  “Use it or lose it” concept  Generally losses are too minimal to have significant impact on quality of life  Some aging individuals dwell on the losses which could make the effect more debilitating for them

Intelligence  Inferred from actions and behaviors – performance  Crystallized intelligence – reflecting culturally based and general knowledge  Fluid intelligence – based on ability to reason, categorize and sort information, (mechanical component of intelligence)  Crystallized grows with age and fluid deteriorates  Fluid can be improved through training

Abilities that underlie human intelligence  Verbal (vocabulary)  Spatial orientation – relating to 3 dimensions  Inductive reasoning (essential in problem-solving)  Numeric abilities (addition and subtraction)  Perceptual speed  Verbal memory (recalling what has been read)  Great variation in loss between and among aging individuals

Practical Intelligence  “Knowing how” rather than “knowing that”  Comes from experience and measured in real life rather than in a laboratory  Cross-sectional studies comparing cohorts have shown that intelligence increases until early adulthood, plateaus until 4 th decade and decreases 5 th decade on – Could be due to changes in educational system and cultural values rather than actual losses  Longitudinal studies show slight decline in some areas and improvements in others during aging

Back to Selective Optimization with Compensation  Strategy of mastery that permits effective management of one’s aging despite age-associated losses in mental and physical reserves  Focus on strengths, practice and use remaining abilities and find compensatory mechanisms when needed  Surgeon General reported 4 variables crucial Education, strenuous activity at home, peak pulmonary flow rate, self-efficacy (belief in ability)

Ulyssean Approach  Cognitive training (memory, association, etc)  Leisure activities such as crossword puzzles, jigsaw puzzles linked to maintaining fluid and crystallized intelligence – Cognitive stimulation  Allow time – speed vs effective  Education on cardiovascular health  Eradicate myths of declines during aging – self- fulfilling prophecies  Social interaction important

Learning and memory  Fear and anxiety of loss plays major role  Memory lapses cause anxiety and fear  When is memory loss a problem? We all forget things Forgetting how to make change, use the phone, find your way home, etc – problem Learning = process of encoding info into memory Memory = retrieving the information

Memory  Sensory – through sight, sound, smell – very short processing period  Primary – processed, labeled and prepared to be sent to secondary memory – if not used or given further meaning it is displace (short-term memory)  Secondary – Encoded, given meaning, and organized into a concept for prolonged memory – sent back to short-term memory when needed – if it can’t be retrieved it is considered forgotten (long-term memory)  Older individuals have difficulty with encoding and retrieving

Other forms of “Memory”  Remote Memory – “old” or “tertiary” memory – recalling memories from the distant past  Explicit Memory – conscious recollection of facts (i.e., names, phone numbers, directions)  Implicit Memory – capacity to learn skills and procedures – relies on previously learned skills – doesn’t rely on conscious recollection (i.e., riding a bike, dancing, playing sports) area of the brain responsible for motor activities is involved

 Working Memory – ability to do 2 things at once – (i.e., subtract 2 large numbers in your head – remembering the numbers while subtracting)

 AAMI – age-associated memory impairment is viewed as normal part of aging – approx 40% over 65 have some AAMI  Recall vs. Recognition  Retrieval is impaired  Relevance – is it important to me?  Medications impair memory  Also depression, dehydration, nutrition, thyroid problems, stress, infection, sleep deprivation, emotional problems, etc

Ulyssean Approach Environmental support  Face the individual  Speak slowly and keep tone of voice low  Present 1 idea at a time  Focus on concrete rather than abstract  Provide sufficient time for them to answer  Keep distractions to a minimum  Variety of cues (auditory, visual, tactile)  Connect new learning to things in the past  Use creative teaching strategies

Internal and external aids  Associating a name with an unusual feature  Associating terms with list of letters or acronyms  String around finger  Medication next to coffee pot  Agendas, lists, calendars, written medication schedules, technology, repetition, medication, social support/encouragement, exercise

How can we help? Encourage…  Learn a new skill  Volunteering  Social interaction  Memory tools  Adequate sleep and rest  Exercise  Limit alcohol use  Reduce stress  Activities such as puzzles  Medical help for depression and other health problems

Creativity  Can turn an old person into a young person  Creativity declines with age  Enthusiasm and originality are replaced with experience and sophistication  Adapting to physical changes and social losses may represent the ultimate challenge to creativity – no prizes because it is done gradually  Retirement can open doors to creativity  The need for creativity never ends

Ulyssean Approach  Provide encouragement and opportunities  Assess past skills and encourage renewing the skills  Propose thought provoking questions Name 5 inventions which haven’t been invented List 10 ways to use scotch tape Describe 3 new uses for a computer