{"id":1403,"date":"2018-12-20T06:34:40","date_gmt":"2018-12-20T06:34:40","guid":{"rendered":"https:\/\/courses.lumenlearning.com\/wm-lifespandevelopment\/?post_type=chapter&p=1403"},"modified":"2021-04-14T02:24:42","modified_gmt":"2021-04-14T02:24:42","slug":"cognitive-development-in-late-adulthood","status":"publish","type":"chapter","link":"https:\/\/courses.lumenlearning.com\/suny-hvcc-lifespandevelopment4\/chapter\/cognitive-development-in-late-adulthood\/","title":{"raw":"Cognitive Development in Late Adulthood","rendered":"Cognitive Development in Late Adulthood"},"content":{"raw":"There are numerous stereotypes regarding older adults as being forgetful and confused, but what does the research on memory and cognition in late adulthood actually reveal? In this section, we wil<\/span>l focus\u00a0upon the impact of aging on\u00a0memory, how a<\/span>ge impacts cognitive functioning, and a<\/span>bnormal memory loss due to Alzheimer's disease, deliriu<\/span>m, and dementia.<\/span><\/span>\r\n

Cognitive Development and Memory in Late Adulthood<\/h2>\r\n

How does aging affect memory?<\/h3>\r\n[caption id=\"attachment_939\" align=\"alignright\" width=\"461\"]\"Affectionate Figure 1<\/strong>. During late adulthood, memory and attention decline, but continued efforts to learn and engage in cognitive activities can minimize aging effects on cognitive development.[\/caption]\r\n

The Sensory Register<\/h3>\r\nAging may create small decrements in the sensitivity of the senses.<\/span>\u00a0And, to the extent that a person has a more difficult time hearing or seeing,\u00a0<\/span>that information will not be stored in memory.\u00a0This\u00a0is an important point, because many older people assume that if they cannot remember something, it is because their memory is poor.\u00a0In fact, it may be that the information was never seen or heard.\r\n

The Working Memory<\/h3>\r\nOlder people have more difficulty using memory strategies to recall details (Berk, 2007).\u00a0Working memory<\/b>\u00a0is a cognitive system with a limited capacity responsible for temporarily holding information available for processing.\u00a0As we age, the working memory loses some of its capacity.\u00a0This\u00a0makes it more difficult to concentrate on more than one thing at a time or to\u00a0remember details of an event.\u00a0\u00a0However, people\u00a0often compensate for this by writing down information and avoiding situations where there is too much going on at once to focus on a particular cognitive task.\r\n\r\nWhen an elderly person demonstrates difficulty with multi-step verbal information\u00a0presented quickly, the person is exhibiting problems with working memory. Working memory is among the cognitive functions most sensitive to decline in old age. Several explanations have been offered for this decline in memory functioning; one is the processing speed theory of cognitive aging by Tim Salthouse. Drawing on the findings of general slowing of cognitive processes as people grow older, Salthouse argues that slower processing causes working-memory contents to decay, thus reducing effective capacity. For example, if an elderly person is watching a complicated action movie, they may not process the events quickly enough before the scene changes, or they may processing the events of the second scene, which causes them to forget the first scene. The decline of working-memory capacity cannot be entirely attributed to cognitive slowing, however, because capacity declines more in old age than speed.\r\n\r\nAnother proposal is the inhibition hypothesis advanced by Lynn Hasher and Rose Zacks. This theory assumes a general deficit in old age in the ability to inhibit irrelevant, or no-longer relevant, information. Therefore, working memory tends to be cluttered with irrelevant contents\u00a0which\u00a0reduce the effective capacity for relevant content. The assumption of an inhibition deficit in old age has received much empirical support but, so far, it is not clear whether the decline in inhibitory ability fully explains the decline of working-memory capacity.\r\n\r\nAn explanation on the neural level of the decline of working memory and other cognitive functions in old age was been proposed by Robert West. He argued that working memory depends to a large degree on the pre-frontal cortex, which deteriorates more than other brain regions as we grow old. Age related decline in working memory can be briefly reversed using low intensity transcranial stimulation, synchronizing rhythms in bilateral frontal and left temporal lobe areas.\r\n

The Long-Term Memory<\/h3>\r\nLong-term memory<\/strong> involves the storage of information for long periods of time. Retrieving such information depends on how well it was learned in the first place rather than how long it has been stored. If information is stored effectively, an older person may remember facts, events, names and other types of information stored in long-term memory throughout life. The memory of adults of all ages seems to be similar when they are asked to recall names of teachers or classmates.\u00a0And older adults remember more about their early adulthood and adolescence than about middle adulthood (Berk, 2007). Older adults retain\u00a0semantic memory\u00a0or the ability to remember vocabulary.\r\n\r\nYounger adults rely more on mental rehearsal strategies to store and retrieve information.\u00a0Older adults focus rely more on external cues such as familiarity and context to recall information (Berk, 2007).\u00a0And they are more likely to report the main idea of a story rather than all of the details (Jepson & Labouvie-Vief, in Berk, 2007).\r\n\r\nA positive attitude about being able to learn and remember plays an important role in memory.\u00a0When people are under stress (perhaps feeling stressed about memory loss), they have a more difficult time taking in information because they are preoccupied with anxieties. Many of the laboratory memory tests require\u00a0comparing the performance of older and younger adults on timed memory tests in which older adults do not perform as well.\u00a0However, few real life situations require speedy responses to memory tasks.\u00a0Older adults rely on more meaningful cues to remember facts and events without any impairment to everyday living.\r\n
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Try It<\/h3>\r\nhttps:\/\/assessments.lumenlearning.com\/assessments\/16657\r\n\r\n<\/div>\r\n

New Research on Aging and Cognition<\/h3>\r\nCan the brain be trained in order to build cognitive reserve to reduce the effects of normal aging?\u00a0ACTIVE (Advanced Cognitive Training for Independent and Vital Elderly), a study conducted between 1999 and 2001 in which 2,802 individuals age 65 to 94, suggests that the answer is \"yes.\" These participants received 10 group training sessions and 4 follow up sessions to work on tasks of memory, reasoning, and speed of processing.\u00a0These mental workouts improved cognitive functioning even 5 years later.\u00a0Many of the participants believed that this improvement could be seen in everyday tasks as well (Tennstedt, Morris, et al, 2006).\u00a0Learning new things, engaging in activities that are considered challenging, and being physically active at any age may build a reserve to minimize the effects of primary aging of the brain.\r\n
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WAtch It<\/h3>\r\nWatch this video from SciShow Psych to learn about ways to keep the mind young and active.\r\n\r\nhttps:\/\/www.youtube.com\/watch?v=5DH9lAqNTG0\r\n\r\n<\/div>\r\n

Wisdom<\/h3>\r\nWisdom is the ability to use common sense and good judgment in making decisions.\u00a0A wise person is insightful and has knowledge that can be used to overcome obstacles\u00a0they encounter in their daily lives.\u00a0Does aging bring wisdom?\u00a0While living longer brings experience, it does not always bring wisdom.\u00a0Those who have had experience helping others resolve problems in living and those who have served in leadership positions seem to have more wisdom.\u00a0So\u00a0it is age combined with a certain type of experience that brings wisdom. However, older adults\u00a0generally\u00a0have greater emotional wisdom or the ability to empathize with and understand others.\r\n

Changes in Attention in Late Adulthood<\/h3>\r\nDivided attention has usually been associated with significant age-related declines in performing complex tasks. For example, older adults show significant impairments on attentional tasks such as looking at a visual cue at the same time as listening to an auditory cue because it requires dividing or switching of attention among multiple inputs. Deficits found in many tasks, such as the Stroop task\u00a0which\u00a0measures selective attention, can be largely attributed to a general slowing of information processing in older adults rather than to selective attention deficits per se. They also are able to maintain concentration for an extended period of time. In general, older adults are not<\/em> impaired on tasks that test sustained attention,\u00a0such as watching a screen for an infrequent beep or symbol.\r\n\r\nThe tasks on which older adults show impairments tend to be those that require flexible control of attention, a cognitive function associated with the frontal lobes. Importantly, these types of tasks appear to improve with training and can be strengthened.\r\n\r\nAn important conclusion from research on changes in cognitive function as we age is that attentional deficits can have a significant impact on an older person\u2019s ability to function adequately and independently in everyday life. One important aspect of daily functioning\u00a0impacted by attentional problems is driving.\u00a0This is an activity that, for many older people, is essential to independence. Driving requires a constant switching of attention in response to environmental contingencies. Attention must be divided between driving, monitoring the environment, and sorting out relevant from irrelevant stimuli in a cluttered visual array. Research has shown that divided attention impairments are significantly associated with increased automobile accidents in older adults.\u00a0Therefore, practice and extended training on driving simulators under divided attention conditions may be an important remedial activity for older people.<\/span>\r\n

Problem Solving<\/h3>\r\nProblem solving tasks that require processing non-meaningful information quickly (a kind of task\u00a0which\u00a0might be part of a laboratory experiment on mental processes) declines with age. However, real life challenges facing older adults do not rely on speed of processing or making choices on one\u2019s own.\u00a0Older adults are able to\u00a0resolve everyday problems by relying on input from others such as family and friends.\u00a0They are\u00a0also less likely than younger adults to delay making decisions on important matters such as medical care (Strough et al., 2003; Meegan & Berg, 2002).\r\n
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Try It<\/h3>\r\nhttps:\/\/assessments.lumenlearning.com\/assessments\/16658\r\n\r\n<\/div>\r\n

Cognitive Function in Late Adulthood<\/h2>\r\n

Abnormal Loss of Cognitive Functioning During Late Adulthood<\/h3>\r\nDementia<\/strong> is the umbrella category use to describe the general\u00a0long-term and often gradual decrease in the ability to think and remember that affects a person's daily functioning.The manual used to help classify and diagnose mental disorders, the Diagnostic and Statistical Manual of Mental Disorders, or\u00a0DSM-V, classifies dementia as \"major neurocognitive disorder, with milder symptoms classified as \"mild cognitive impairment,\" although the term dementia is still in common use. Common symptoms of dementia include emotional problems, difficulties with language, and a decrease in motivation. A person's consciousness is usually not affected.\u00a0<\/span>Globally, dementia affected about 46 million people in 2015.<\/sup>\u00a0About 10% of people develop the disorder at some point in their lives, and it\u00a0becomes more common with age.\u00a0<\/sup>About 3% of people between the ages of 65\u201374 have dementia, 19% between 75 and 84, and nearly half of those over 85 years of age.<\/sup> In 2015, dementia resulted in about 1.9 million deaths, up from 0.8 million in 1990.<\/sup>\u00a0As more people are living longer, dementia is becoming more common in the population as a whole.\r\n\r\nDementia generally refers to severely impaired judgment, memory or problem-solving ability. It can occur before old age and is not an inevitable development even among the very old. Dementia can be caused by numerous diseases and circumstances, all of which result in similar general symptoms of impaired judgment, etc. Alzheimer\u2019s disease is the most common form of dementia and is incurable, but there are also\u00a0nonorganic causes of dementia\u00a0which\u00a0can be prevented.\u00a0Malnutrition, alcoholism, depression, and mixing medications can\u00a0also\u00a0result in symptoms of dementia.\u00a0If these causes are properly identified, they can be treated.\u00a0Cerebral vascular disease can also reduce cognitive functioning.\r\n\r\nDelirium<\/strong>, also known as acute confusional state, is an organically caused decline from a previous baseline level of mental function that develops over a short period of time, typically hours to days. It is more common in older adults, but can easily be confused with a number of psychiatric disorders or chronic organic brain syndromes because of many overlapping signs and symptoms in common with dementia, depression, psychosis, etc. Delirium may manifest from a baseline of existing mental illness, baseline intellectual disability, or dementia, without being due to any of these problems.\r\n\r\nDelirium is a syndrome encompassing disturbances in attention, consciousness, and cognition. It may also involve other neurological deficits, such as psychomotor disturbances (e.g. hyperactive, hypoactive, or mixed), impaired sleep-wake cycle, emotional disturbances, and perceptual disturbances (e.g. hallucinations and delusions), although these features are not required for diagnosis.\u00a0Among older adults, delirium occurs in 15-53% of\u00a0post-surgical\u00a0patients,\u00a070-87% of those in the ICU, and\u00a0up to 60% of those in nursing homes or post-acute care settings. Among those requiring critical care, delirium is a risk for death within the next year.\r\n

Alzheimer's Disease<\/strong><\/h4>\r\nAlzheimer's disease (AD)<\/strong>, also referred to simply as Alzheimer's, is\u00a0the most common cause of dementia, accounting for 60-70% of its cases. Alzheimer's\u00a0<\/i>is a progressive disease\u00a0causing\u00a0problems with memory, thinking and behavior. Symptoms usually develop slowly and get worse over time, becoming severe enough to interfere with daily tasks.\r\n\r\nhttps:\/\/youtu.be\/7_kO6c2NfmE\r\n\r\nVideo 1.<\/strong> What is Alzheimer's Disease?<\/em>\r\n\r\nThe most common early symptom is difficulty in remembering recent events. As the disease advances, symptoms can include problems w<\/span>ith language, disorientation (including easily getting lost), mood swings, loss of motivation, not managing self care, and behavioral issues. In\u00a0the early stages, memory loss is mild, but with late-stage Alzheimer's, individuals lose the ability to carry on a conversation and respond to their environment. <\/span>\r\n\r\n[caption id=\"attachment_2779\" align=\"aligncenter\" width=\"686\"]\"Brain<\/a> Figure 2<\/strong>. Alzheimer's disease is not simply part of the aging process. It is a disease with physiological\u00a0symptoms and decay in the brain.[\/caption]\r\n\r\nAlzheimer's is the sixth leading cause of death in the United States. On average, a person with Alzheimer's lives four to eight years after diagnosis, but can live as long as 20 years, depending on other factors. Alzheimer's is not a normal part of aging. The greatest known risk factor is increasing age, and the majority of people with Alzheimer's are 65 and older. But Alzheimer's is not just a disease of old age. Approximately 200,000 Americans under the age of 65 have younger-onset Alzheimer\u2019s disease (also known as early-onset Alzheimer\u2019s).<\/span>\r\n\r\nThe cause of Alzheimer's disease is poorly understood. About 70% of the risk is believed to be inherited from a person's parents with many genes usually involved. Other risk factors include a history of head injuries, depression, and hypertension. The disease process is associated with plaques and neurofibrillary tangles in the brain. A probable diagnosis is based on the history of the illness and cognitive testing with medical imaging and blood tests to rule out other possible causes. Initial symptoms are often mistaken for normal aging, but examination of brain tissue, specifically of structures called plaques and tangles, is needed for a definite diagnosis. Though qualified physicians can be up to 90% certain of a correct diagnosis of Alzheimer's, currently, the only way to make a 100% definitive diagnosis is by performing and autopsy of the person and examining the brain tissue. In 2015, there were approximately 29.8 million people worldwide with AD. In developed countries, AD is one of the most financially costly diseases.\r\n
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Watch It<\/h3>\r\nVideo 2.<\/strong> This new report demonstrates an Alzheimer's simulation meant to help families better understand what a person with the disease may experience in their day-to-day lives.\r\n\r\nhttps:\/\/youtu.be\/LL_Gq7Shc-Y\r\n\r\n<\/div>\r\n
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Try It<\/h3>\r\nhttps:\/\/assessments.lumenlearning.com\/assessments\/16659\r\n\r\n<\/div>","rendered":"

There are numerous stereotypes regarding older adults as being forgetful and confused, but what does the research on memory and cognition in late adulthood actually reveal? In this section, we wil<\/span>l focus\u00a0upon the impact of aging on\u00a0memory, how a<\/span>ge impacts cognitive functioning, and a<\/span>bnormal memory loss due to Alzheimer’s disease, deliriu<\/span>m, and dementia.<\/span><\/span><\/p>\n

Cognitive Development and Memory in Late Adulthood<\/h2>\n

How does aging affect memory?<\/h3>\n
\"Affectionate<\/p>\n

Figure 1<\/strong>. During late adulthood, memory and attention decline, but continued efforts to learn and engage in cognitive activities can minimize aging effects on cognitive development.<\/p>\n<\/div>\n

The Sensory Register<\/h3>\n

Aging may create small decrements in the sensitivity of the senses.<\/span>\u00a0And, to the extent that a person has a more difficult time hearing or seeing,\u00a0<\/span>that information will not be stored in memory.\u00a0This\u00a0is an important point, because many older people assume that if they cannot remember something, it is because their memory is poor.\u00a0In fact, it may be that the information was never seen or heard.<\/p>\n

The Working Memory<\/h3>\n

Older people have more difficulty using memory strategies to recall details (Berk, 2007).\u00a0Working memory<\/b>\u00a0is a cognitive system with a limited capacity responsible for temporarily holding information available for processing.\u00a0As we age, the working memory loses some of its capacity.\u00a0This\u00a0makes it more difficult to concentrate on more than one thing at a time or to\u00a0remember details of an event.\u00a0\u00a0However, people\u00a0often compensate for this by writing down information and avoiding situations where there is too much going on at once to focus on a particular cognitive task.<\/p>\n

When an elderly person demonstrates difficulty with multi-step verbal information\u00a0presented quickly, the person is exhibiting problems with working memory. Working memory is among the cognitive functions most sensitive to decline in old age. Several explanations have been offered for this decline in memory functioning; one is the processing speed theory of cognitive aging by Tim Salthouse. Drawing on the findings of general slowing of cognitive processes as people grow older, Salthouse argues that slower processing causes working-memory contents to decay, thus reducing effective capacity. For example, if an elderly person is watching a complicated action movie, they may not process the events quickly enough before the scene changes, or they may processing the events of the second scene, which causes them to forget the first scene. The decline of working-memory capacity cannot be entirely attributed to cognitive slowing, however, because capacity declines more in old age than speed.<\/p>\n

Another proposal is the inhibition hypothesis advanced by Lynn Hasher and Rose Zacks. This theory assumes a general deficit in old age in the ability to inhibit irrelevant, or no-longer relevant, information. Therefore, working memory tends to be cluttered with irrelevant contents\u00a0which\u00a0reduce the effective capacity for relevant content. The assumption of an inhibition deficit in old age has received much empirical support but, so far, it is not clear whether the decline in inhibitory ability fully explains the decline of working-memory capacity.<\/p>\n

An explanation on the neural level of the decline of working memory and other cognitive functions in old age was been proposed by Robert West. He argued that working memory depends to a large degree on the pre-frontal cortex, which deteriorates more than other brain regions as we grow old. Age related decline in working memory can be briefly reversed using low intensity transcranial stimulation, synchronizing rhythms in bilateral frontal and left temporal lobe areas.<\/p>\n

The Long-Term Memory<\/h3>\n

Long-term memory<\/strong> involves the storage of information for long periods of time. Retrieving such information depends on how well it was learned in the first place rather than how long it has been stored. If information is stored effectively, an older person may remember facts, events, names and other types of information stored in long-term memory throughout life. The memory of adults of all ages seems to be similar when they are asked to recall names of teachers or classmates.\u00a0And older adults remember more about their early adulthood and adolescence than about middle adulthood (Berk, 2007). Older adults retain\u00a0semantic memory\u00a0or the ability to remember vocabulary.<\/p>\n

Younger adults rely more on mental rehearsal strategies to store and retrieve information.\u00a0Older adults focus rely more on external cues such as familiarity and context to recall information (Berk, 2007).\u00a0And they are more likely to report the main idea of a story rather than all of the details (Jepson & Labouvie-Vief, in Berk, 2007).<\/p>\n

A positive attitude about being able to learn and remember plays an important role in memory.\u00a0When people are under stress (perhaps feeling stressed about memory loss), they have a more difficult time taking in information because they are preoccupied with anxieties. Many of the laboratory memory tests require\u00a0comparing the performance of older and younger adults on timed memory tests in which older adults do not perform as well.\u00a0However, few real life situations require speedy responses to memory tasks.\u00a0Older adults rely on more meaningful cues to remember facts and events without any impairment to everyday living.<\/p>\n

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Try It<\/h3>\n

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