Cognitive Development in Late Adulthood Chapter 19: Cognitive Development in Late Adulthood

Cognitive Functioning in Older Adults

Cognitive changes in adulthood are multidimensional: Cognitive mechanics tends to decline with aging: Includes speed and accuracy of processes. Strongly influenced by biology and heredity. Cognitive pragmatics may improve with aging: Reading, writing, and educational qualifications. Professional skills and language comprehension. Knowledge of self and life skills. Influences of the culture.

Theorized Age Changes in Cognitive Mechanics and Cognitive Pragmatics Performance 25 70 Life course (years of age) Fig. 19.1

The Relation of Age to Reaction Time 50 80 70 60 40 30 20 1.0 1.5 2.0 0.5 Age (years) Average reaction time (seconds) Fig. 19.2

Declines in older adults’ processing speed often results from decline in CNS & brain function. Selective attention is affected by competing stimuli; older adults have less ability to focus. Divided attention—older adults’ ability decreases when competing tasks become more complex. Older adults sustain attention as well as younger and middle-aged adults.

Memory changes with age, but areas tend to be multidirectional: Not all aspects of memory decline with age. Decline occurs mainly in older adults’ episodic and working memory, not in semantic or implicit memory. Decline in perceptual speed is linked to memory decline. Successful aging does not mean eliminating memory decline, but reducing or adapting to it.

Memory for Spanish as a Function of Age Since Spanish Was Learned 50 5 75 100 25 10 15 35 Number of years since Spanish was learned Percentage of original vocabulary retained Fig. 19.3

Cognitive functioning in older adults is greatly influenced by: Education: older adults today were more likely to have attended college. Work: as industrial societies evolve into information societies—older adults’ jobs will emphasize intellectual abilities. Health: advances in medical technology and awareness of links between lifestyle and health help older adults live healthier and longer lives.

Use it or lose it: Changes in cognitive activity patterns can cause increase or atrophy of skills. Certain mental activities can maintain current levels of cognitive skills—a critical factor may be amount of time spent in that activity. One longitudinal study linked lack of mental exercise and risk of Alzheimer’s disease.

Cognitive neuroscience of aging is uncovering important links between aging, the brain, and cognitive functioning: Neural circuits in specific regions of the prefontral cortex decline, and this decline is linked to poorer performance by older adults on complex reasoning tasks, working memory, and episodic memory tasks. Functioning of the hippocampus declines less than functioning of the frontal lobes, suggesting the frontal lobes are trying to compensate for declining activity in the hippocampus. Patterns of neural differences with age are larger for retrieval than for encoding.

Attention to distinctions Mean number of pictures recalled 1 2 3 4 5 Control groups Attention to distinctions Mean number of pictures recalled Improving Attention and Memory in Older Adults Fig. 19.4

Language development: Decrements in language may appear in late adulthood due to a decline in memory skills and hearing problems. Aging adults may compensate by using familiar words and speaking with more ambiguity. Language changes among individuals with Alzheimer disease as word-finding/generating difficulties are an early symptom of Alzheimer’s.

Work and Retirement

Work patterns have changed, but people over 65 still find work a very important part of their lives. Men over age 65: From 1900 to 2000, the number who still work full-time decreased by about 70%, probably due to the availability of part-time work. The number of older adults who continue working part-time past age 65 has increased since the 1960s—about 35% now plan to work part-time for interest or enjoyment.

Is is estimated that 78 million “baby boomers” will reach retirement age by 2010, but federal laws will allow many to continue working. 80% say they expect to work during retirement years. Cognitive ability is the best predictor of job performance in older adults. Work provides older workers with opportunities for: Productive activity. Social interactions. A positive identity.

Older adults who adjust best to retirement: Retirement is a process, not an event— flexibility is a key factor in whether one adjusts well. Most research studies on adjustment to retirement have focused on men rather than women. Older adults who adjust best to retirement: Have an adequate income. Are better educated. Are healthy and active. Have extended social networks and family. Were satisfied with their lives before retiring.

Mental Health

The risk of having a mental health disorder is not higher in older adults, but the associated costs are over $40 billion a year. Females show higher rates of depression than males from childhood to early adulthood and between ages 50 and 60. Men show increases in depression between ages 60 and 80, but not women. Common predictors of depression in older adults are poor health, loss events, and low social support.

Alzheimer’s disease: the most common dementia: Dementias are among the most debilitating mental disorders in older adults—more than 70 types exist. Alzheimer’s disease: the most common dementia: Rates could triple within the next 50 years. Onset varies—generally between ages 30 and 60. Brain shrinks as memory ability decreases. There is no known cure yet, and it may be genetic. Healthy lifestyle factors may lower the risk. Antioxidant vitamins may protect brain cells.

Facts about Alzheimer’s disease: Special brain scans, like MRI, can detect brain changes before Alzheimer’s disease symptoms develop. Spinal fluids can also be tested for early signs of disease. Most patients with Alzheimer’s live about 8 years after being diagnosed. Decline is predictable and progressive, and affects physical, cognitive, and social functioning A patient’s important support system is family. 10% to 20% of dementias stem from vascular disease.

Two Brains: Normal Aging and Alzheimer Disease

Caring for people with Alzheimer’s is a major concern for the family. 50% of family caregivers report depression. Female caregivers provide more caregiving hours, higher levels of burden and depression, and lower levels of well-being and physical health than male caregivers. Respite services have been developed to help people who take care of family members with Alzheimer disease. Studies show how stress of caregiving negatively affects immune system of the caregiver.

Comparison of IL-6 Levels in Alzheimer’s Caregivers and a Control Group of Noncaregivers 60 65 70 75 80 85 90 95 55 0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.9 0.1 Age (years) IL-6 Level Control group Alzheimer’s caregivers Fig. 19.6

Perceived Stress Score Comparison of Perceived Stress Levels of Alzheimer’s Caregivers and Control Group of Noncaregivers 2 4 6 8 10 12 14 16 18 Perceived Stress Score 3 1 Assessment Year 5 Control group Alzheimer’s caregivers Fig. 19.7

Multi-infarct dementia is more common in men with a history of high blood pressure. Parkinson’s disease is a chronic, progressive disease characterized by muscle tremors, slowing of movements, and facial paralysis. Drugs have been developed to treat Parkinson’s disease in the early stages, but there is no cure yet—too much drug treatment can lead to schizophrenia.

Fear of crime can prevent older adults from: Older adults can be victimized in many ways as their vulnerability increases with age. Fear of crime can prevent older adults from: Traveling. Attending social events. Pursing an active lifestyle. Older adult crime victimization rates may be higher than reported by victims due to: Fear of retribution from criminals. Belief the criminal justice system can’t help.

Elder maltreatment is primarily committed by family members. Includes neglect and physical abuse. Includes spousal abuse. Is most often suffered by women. Older women were more likely than men to be victims of property damage and robbery—most perpetrators being unrelated young males aged 18 to 29 years.

Older adults receive disproportionately fewer mental health services: Persons age 65 or older make up 11% of the population but receive only 2.7% of all clinical services provided by psychologists. Psychologists prefer to work with young, attractive, verbal, intelligent and successful clients (YAVISes) rather than quiet, ugly, old, institutionalized, and different clients (QUOIDs). Mental health care needs to be more available and affordable for older adults.

Religion

Older adults are spiritual leaders in many societies around the world. Religious patterns of older adults are of interest. Religion is: More significant in older adults’ lives. Related to a sense of meaning in life. Related to higher levels of life satisfaction, optimism, and self-esteem. Associated with better health. Perhaps associated with living longer.

Spirituality and a Sense of Well-Being