Late Adulthood

Cognitive Development

Cognitive Decline

Begins between 60-80 years of age, with much variability

Small reductions in sensitivity and power of the sensory registry occur naturally with age.

Resulting in some information not reaching the sensory threshold so not even detected, resulting in missing substantial information

Reduced sensory input impairs cognition

Active Memory

Short Term (working) Memory: most likely to decline with age, temporarily stores information and processes information held in the mind

Multitasking is especially difficult because inability to screen out irrelevant material

The brain can not handle as much or a decline in mental energy

Long Term Memory

Knowledge base: information already stored in the memory

Appears to remain unimpaired over age as well as areas of expertise

Research: happy events and emotions remembered better than factual materials

Problem may be more control not capacity of memory

Problem: ability to pay attention, to retrieve information when needed, and to organize thoughts

Older adults can learn better retrieval skills

Explicit memory: facts, definitions, data, and concepts

Implicit memory: unconscious or automatic memory stored via habits, emotional responses, routine procedures

Children, brain damaged people, and older adults are much better at implicit memory

Reasons for Age-Related Changes

Primary Aging: Brain slowdown- reduced production of neurotransmitters (dopamine, glutamate, serotonin, and acetylcholine)

-Speed of thought, transmission of neural impulses, reaction are all slowed

Compensation: memory tricks, reminders, extra time

Terminal decline: overall slow down of cognitive abilities in the days or months before death

Secondary Aging

Hypertension (high blood pressure) in middle age is likely to cause intellectual decline by the age of 60

As well as, Diabetes, arteriosclerosis, and lung diseases

Poor eating habits, smoking and lack of exercise contribute to these diseases and can impair cognition

Ageism

Stereotypes do the most harm when individuals internalize prejudice and react with helplessness

Confidence is eroded

Dementia (senility)

Irreversible loss of intellectual functioning caused by organic brain damage or disease

More common with age

Abnormal and pathological

Signifies cognitive impairment

Diagnosis depends on symptoms

Alzheimer’s Disease

Most common form of dementia

Caused by proliferation plaques and tangles, which are abnormalities in the cerebral cortex that destroy brain functioning

-plaques are formed outside the brain cells from a protein called B-amyloid

-tangles are twisted mass of protein threads within cells

Begins in hippocampus where memory functions

Diagnosis based on report of symptoms because analyzing brain tissue can only be done after death

Risk Factors

Women at greater risk than men

Less common in Japan and China

Less common among Americans of Asian descent

Age is chief risk factor, age 65, risk is 1 in 100 and after 85, 1 in 5

AD in middle age called trisomy-21, is partly genetic, disease progresses quickly and death is within 3-5 years

Alzheimer’s Disease

Most cases begin in late adulthood and take 10 or more years to progress from first symptoms to final stages

AD runs through a progressive course of 5 stages, beginning with forgetfulness and ending with total mindlessness

Alzheimer’s Disease

Stage 1: absentmindedness about recent events or newly acquired information

May forget where place stuff or names of those just introduced to

Most people recognize their problem and write things down to help them remember

Not just normal aging, failure to remember a common word

Alzheimer’s Disease

Stage Two: more generalized confusion, noticeable deficits in concentration and short-term memory

Speech is aimless and repetitious

Vocab limited and words get mixed up

Personality changes are common

People forget that they have a memory problem

Alzheimer’s Disease

Stage 3: memory loss becomes dangerous And can no longer manage their basic needs

Forget to eat, turn away from stove that is on

Forget way home so get lost

Visual recognition becomes a problem

Stage 4: people need full-time care

do not respond normally to others

cannot communicate or recognize others

Stage 5: Alzheimer’s Disease

People no longer talk

Fail to respond with any emotion or action

Death comes within 10-15 years from beginning of stage 1

Treatment: various drugs can halt or slow down the buildup of plaque and tangles associated with memory loss

Dementia of Alzheimer’s TypeDiagnostic Criteria

Development of Multiple cognitive deficits

Gradual onset By memory impairment (inability to learn new

information or recall previously learned information

One or more cognitive disturbances Aphasia (language disturbance)

Apraxia (impaired ability to carry out motor activities

Agnosia (failure to recognize and identify objects)

Disturbance in executive functioning (planning, organizing, sequencing, and abstracting)

Significant impairment in social or occupational functioning

Strokes: Second most common form of dementia

Vascular Dementia (VaD) formerly called Multi-infarct Dementia (MID)

An infarct is a temporary obstruction of the blood vessels that prevents oxygen from reaching a particular area of the brain Resulting in destruction of brain tissue that can

produce immediate symptoms: blurred vision, weak or paralyzed limbs, slurred speech and mental confusion

* In a silent stroke can occur without victim or other’s noticing

Vascular Dementia Diagnostic Criteria

Same as criteria for Alzheimer's diseaseNo gradual onsetPlus,

focal neurological signs and symptoms-exaggeration of deep tendon reflexes-extensor plantar response-gait abnormalities-laboratory evidence of cerebrovascular

disease, multiple infarctions involving the cortex and underlying white matter

Dementia

Alzheimer’s and Vascular Dementia can occur simultaneously

* Accounts for 1/3 of all dementia cases

Cause of Vascular Dementia:

Systemic Arteriosclerosis-hardening of the arteries

Prevention: exercise and control of blood pressure and diet

Subcortical Dementia

Other dementia’s that do not originate in the cortex but below the cortex so do not impact thinking and memory

Parkinson’s, Huntington’s and Multiple Sclerosis: all begin with realization that a chronic illness take over the control of hands, legs, and other body parts

In later stages, dementia appears, STM and ability to learn new information better than LTM

Huntington’s Disease

Inherited progressive degenerative disease of cognition, emotion, and movement

Develops around late 30’s and early 40’s (there is a juvenile form)

Noted by depression, irritability, and anxiety

Memory deficits, problems with executive functioning, and judgment are early symptoms

Parkinson’s Disease

Most common, marked by rigidity or tremor of the muscles

Degeneration of neurons of the brain region that produce Dopamine, necessary for normal brain functioning

Once reaches a threshold, dementia begins

8% of new diagnosis are under age 40

Majority over age 60

Other forms of dementia

AIDS/Syphilis patients develop brain infection that causes dementia

Mad Cow disease leads to dementia

Psychoactive drugs

Chronic Alcohol abuse: Korsakoff’s Syndrome

Reversible Dementia

Overmedication: many forms of anesthesia can trigger dementia in the aged

On-going pain medication

Drug interactions

Insufficient nutrition

Psychological Illness

Mental illness should always be considered and treated when found

Careful diagnosis can differentiate mental illness from dementia