17.3 Cognitive Changes and Plasticity in Late Life

As we age, our brains change, affecting how we think and remember. Some mental skills, like using life experience, stay strong. Others, like solving new problems, may slow down. But our brains can adapt, and staying active helps keep our minds sharp.

Older folks might notice changes in memory or decision-making. While some decline is normal, big changes could signal more serious issues. The good news? Healthy habits and mental exercises can help maintain brain function as we grow older.

Cognitive Abilities

Intelligence and Processing

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• Crystallized intelligence refers to the accumulation of knowledge, skills, and experience over a lifetime and tends to remain stable or even improve with age
  • Includes vocabulary, general knowledge, and wisdom gained through life experiences
  • Older adults often perform better on tasks that rely on crystallized intelligence (crossword puzzles, reading comprehension)
• Fluid intelligence involves the ability to think logically, solve problems, and adapt to new situations without relying on acquired knowledge and declines gradually with age
  • Includes skills like pattern recognition, abstract reasoning, and problem-solving
  • Decline in fluid intelligence may be due to age-related changes in the brain, such as decreased processing speed and working memory capacity
• Processing speed, the rate at which an individual can perform mental operations, slows down with age
  • Slower processing speed can affect various cognitive functions, such as attention, memory, and decision-making
  • Age-related changes in the brain, such as reduced white matter integrity and decreased neural efficiency, contribute to slower processing speed

Memory and Executive Function

• Working memory, the ability to hold and manipulate information in the mind for a short period, declines with age
  • Older adults may have difficulty with tasks that require holding multiple pieces of information in mind simultaneously (mental arithmetic, following complex instructions)
  • Age-related changes in the prefrontal cortex, a brain region involved in working memory, may contribute to this decline
• Executive function, a set of cognitive processes that enable goal-directed behavior, planning, and decision-making, can also decline with age
  • Includes skills like attention, inhibition, cognitive flexibility, and problem-solving
  • Decline in executive function may be related to age-related changes in the prefrontal cortex and its connections with other brain regions
  • Older adults may have difficulty with tasks that require mental flexibility, multitasking, and inhibiting irrelevant information (switching between tasks, ignoring distractions)

Brain Plasticity and Reserve

Neuroplasticity and Cognitive Reserve

• Neuroplasticity is the brain's ability to reorganize and adapt its structure and function in response to experiences and challenges throughout life
  • Engaging in mentally stimulating activities, learning new skills, and maintaining social connections can promote neuroplasticity in older age
  • Neuroplasticity allows the brain to compensate for age-related changes and maintain cognitive function
• Cognitive reserve refers to the brain's resilience and ability to cope with age-related changes and brain pathology without showing clinical symptoms of cognitive decline
  • Factors that contribute to cognitive reserve include education, occupational complexity, and engagement in mentally stimulating activities throughout life
  • Higher levels of cognitive reserve may delay the onset of cognitive symptoms in conditions like Alzheimer's disease, as the brain can compensate for the damage more effectively

Brain Reserve

• Brain reserve refers to the brain's structural characteristics, such as brain size, neuron density, and synaptic connections, that provide a buffer against age-related changes and brain pathology
  • Factors that contribute to brain reserve include genetics, nutrition, and overall health throughout life
  • Individuals with higher brain reserve may be better able to withstand age-related changes and maintain cognitive function
  • Engaging in physical exercise, maintaining a healthy diet, and managing cardiovascular risk factors can help maintain brain reserve in older age

Cognitive Decline

Mild Cognitive Impairment and Dementia

• Mild cognitive impairment (MCI) is a condition characterized by cognitive decline that is greater than expected for an individual's age but does not significantly interfere with daily functioning
  • Individuals with MCI may have difficulty with memory, language, thinking, and judgment, but can still perform most daily activities independently
  • MCI is considered a risk factor for dementia, with an estimated 10-15% of individuals with MCI progressing to dementia each year
• Dementia is a syndrome characterized by a significant decline in cognitive function that interferes with daily life and independence
  • Alzheimer's disease is the most common cause of dementia, accounting for 60-80% of cases
  • Other types of dementia include vascular dementia, Lewy body dementia, and frontotemporal dementia
  • Symptoms of dementia may include memory loss, language difficulties, disorientation, changes in mood and behavior, and difficulty with problem-solving and decision-making
  • Early diagnosis and intervention can help manage symptoms and improve quality of life for individuals with dementia and their caregivers