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Article

Jack Kuhns and Dayna R. Touron

The study of aging and cognitive skill learning is concerned with age-related changes and differences in how we gather, store, and use information and abilities. As life expectancy continues to rise, resulting in greater numbers and proportions of older individuals in the population, understanding the development and retention of skills across the lifespan is increasingly important. Older adults’ task performance in cognitive skill learning is often equal to that of young adults, albeit not as efficient, where older adults often require more time to complete training. Investigations of age differences in fundamental cognitive processes of attention, memory, or executive functioning generally reveal declines in older adults. These are related to a slowing of cognitive processing. Slowing in cognitive processing results in longer time necessary to complete tasks which can interfere with the fidelity of older adults’ cognitive processes in time-limited scenarios. Despite this, older adults maintain comparable rates of learning with young adults, albeit with some reduced efficiency in more complex tasks. The effectiveness of older adults’ learning is also impacted by a lesser tendency to recognize and adopt efficient learning strategies, as well as less flexibility in strategy use relative to younger adults. In learning tasks that involve a transition from using a complex initial strategy to relying on memory retrieval, older adults show a volitional avoidance of memory that is related to lower memory confidence and an impoverished mental model of the task. Declines in learning are not entirely problematic from a functional perspective, however, as older adults can often rely upon their extensive knowledge to compensate for certain deficiencies, particularly in everyday tasks. Indeed, domains where older adults have maintained expertise are somewhat insulated from other age-related declines.

Article

Joseph A. Mikels and Nathaniel A. Young

The adult life span is characterized as a time of divergent trajectories. It is a time of compounding losses (such as physical, sensory, and cognitive declines) and is also a time of surprising growth (such as improvements in well-being and emotion regulation). These divergent trajectories present theorists with the paradox of aging: in the face of accumulating losses, how is it that as people age, they generally feel good and experience greater well-being? Theorists have grappled with this paradox and have focused on how motivational, cognitive, control, and social factors impact emotional development across the adult life span. These foundational theories have paved the way to a deeper understanding of adult life-span development, but they do not draw as deeply from theories in affective science. Some of the latest perspectives on emotion and aging offer integrative views, such as how older adults may experience different discrete emotion (i.e., anger versus sadness) from an evolutionary functional perspective. Other perspectives consider how an array of appraisal processes may change across adulthood (such as shifts in evaluations of self-control versus other-control for younger versus older adults). These newer approaches dig deeper into mechanistic explanations and underscore the need for greater theoretical integration. Later life is clearly a time of increased well-being, but the field is only on the cusp of understanding the mysteries of emotional experience in later life.

Article

Benjamin T. Mast and Diana DiGasbarro

Clinicians conduct capacity evaluations to determine an older adult’s ability to make and execute a decision within key domains of functioning. Questions of capacity often arise when an older adult experiences a decline in cognitive functioning due to Alzheimer’s disease, stroke, or severe psychiatric illness, for example. Capacity is related to legal competency, and a lack of capacity may be proved by providing evidence that an older adult is unable to understand the act or decision in question; appreciate the context and consequences of the decision or act; reason about the potential harms and benefits; or express a choice. Capacity is domain-specific, time-specific, and decision-specific. Domains include financial capacity, medical treatment and research consent capacity, driving capacity, sexual consent capacity, and voting capacity. Each capacity domain encompasses activities that may vary in complexity or risk, and thus require different levels of capacity. For example, within the medical treatment consent capacity domain, an older adult may lack the capacity to consent to a complicated and risky surgical procedure while retaining the capacity to consent to a routine blood draw. Clinicians determine capacity by using a combination of tools including capacity assessment instruments, task-specific functional evaluations, interviews with the patient and family members, measures of cognitive functioning, and consideration of social, physical, and mental health factors. Extensive research has been conducted to determine the reliability and validity of a variety of capacity assessment instruments for many domains. These instruments generally assess the patient’s responses to vignettes pertaining to the domain in question, information gleaned from structured and semi-structured interviews, functional ability, or a combination of these methods. Although there is still need for more research, especially in emerging domains, capacity assessments help to protect vulnerable older adults from harm while allowing them to retain the highest possible level of autonomy.

Article

Emma V. Ward and David R. Shanks

It is well documented that explicit (declarative, conscious) memory declines in normal aging. Studies have shown a progressive reduction in this form of memory with age, and healthy older adults (typically aged 65+ years) usually perform worse than younger adults (typically aged 18–30 years) on laboratory tests of explicit memory such as recall and recognition. In contrast, it is less clear whether implicit (procedural, unconscious) memory declines or remains stable in normal aging. Implicit memory is evident when previous experiences affect (e.g., facilitate) performance on tasks that do not require conscious recollection of those experiences. This can manifest in rehearsed motor skills, such as playing a musical instrument, but is typically indexed in the laboratory by the greater ease with which previously studied information is processed relative to non-studied information (e.g., repetition priming). While a vast amount of research has accumulated to suggest that implicit memory remains relatively stable over the adult lifespan, and is similar in samples of young and older adults, other studies have in contrast revealed that implicit memory is subject to age-related decline. Improving methods for determining whether implicit memory declines or remains stable with age is an important goal for future research, as the issue not only has significant implications for an aging society regarding interventions likely to ameliorate the effects of age-related explicit memory decline, but can also inform our theoretical understanding of human memory systems.

Article

Nancy A. Pachana, Nicola W. Burton, Deirdre McLaughlin, and Colin A. Depp

Research on healthy aging has begun to address mental health issues in later life. Despite the debates about exactly what constitutes healthy aging and which are the most useful or valid determinants of this construct to study, there is substantial evidence for several determinants of successful aging, including physical activity, cognitive stimulation, and social networks. All three of these determinants support mental health, including cognition, in later life. Resilience is another construct that plays an important role in healthy aging, but it has not received as much research attention at the end of life as in earlier periods. Factors that reduce the risk of mental distress or promote resilience with respect to mental health in the face of challenges in later life remain fruitful areas for further investigations.

Article

Michael J. Valenzuela

Cognitive reserve refers to the many ways that neural, cognitive, and psychosocial processes can adapt and change in response to brain aging, damage, or disease, with the overarching effect of preserving cognitive function. Cognitive reserve therefore helps to explain why cognitive abilities in late life vary as dramatically as they do, and why some individuals are brittle to degenerative pathology and others exceptionally resilient. Historically, the term has evolved and at times suffered from vague, circular, and even competing notions. Fortunately, a recent broad consensus process has developed working definitions that resolve many of these issues, and here the evidence is presented in the form of a suggested Framework: Contributors to cognitive reserve, which include environmental exposures that demand new learning and intellectual challenge, genetic factors that remain largely unknown, and putative G × E interactions; mechanisms of cognitive reserve that can be studied at the biological, cognitive, or psychosocial level, with a common theme of plasticity, flexibility, and compensability; and the clinical outcome of (enriched) cognitive reserve that can be summarized as a compression of cognitive morbidity, a relative protection from incident dementia but increased rate of progression and mortality after diagnosis. Cognitive reserve therefore has great potential to address the global challenge of aging societies, yet for this potential to be realized a renewed scientific, clinical, and societal focus will be required.

Article

Li Chu, Yang Fang, Vivian Hiu-Ling Tsang, and Helene H. Fung

Cognitive processing of social and nonsocial information changes with age. These processes range from the ones that serve “mere” cognitive functions, such as recall strategies and reasoning, to those that serve functions that pertain to self-regulation and relating to others. However, aging and the development of social cognition unfold in different cultural contexts, which may assume distinct social norms and values. Thus, the resulting age-related differences in cognitive and social cognitive processes may differ across cultures. On the one hand, biological aging could render age-related differences in social cognition universal; on the other hand, culture may play a role in shaping some age-related differences. Indeed, many aspects of cognition and social cognition showed different age and culture interactions, and this makes the study of these phenomena more complex. Future aging research on social cognition should take cultural influences into consideration.

Article

Intraindividual variability in the present context refers to the moment-to-moment variation in attentional or executive engagement over a given time period. Typically, it is measured using the response latencies collected across the trials of a behavioral neurocognitive task. In aging research, the measure has received a lot of recent interest as it may provide important insights into age-related cognitive decline and neuropathology as well as having potential as a neurocognitive assessment tool in healthcare settings. In the present chapter, we begin by reviewing the key empirical findings relating to age and intraindividual variability. Here, research shows that intraindividual variability increases with age and predicts a range of age-related outcomes including gait impairment, falls and errors more broadly, mild cognitive impairment, dementia, and mortality. Brain imaging research suggests that greater variability is associated with age-related or neuropathological changes to a frontal–cingulate–parietal network and that white matter compromise and dopamine depletion may be key underlying mechanisms. We then consider the cognitive and neurobiological theoretical underpinnings of the construct before providing a description of the various methods and metrics that have been used to compute measures of variability – reaction time cut-offs, raw and residualized intraindividual standard deviations, coefficient of variation, ex-Gaussian curve and fast Fourier transformation. A further section considers the range of neurocognitive tasks that have been used to assess intraindividual variability. Broadly, these tasks can be classified on a continuum of cognitive demands as psychomotor, executive control or higher-order cognitive tasks (e.g., episodic memory). Finally, we provide some pointers concerning the pressing issues that future research needs to address in the area. We conclude that the existing body of theoretical and empirical work underlines the potential of intraindividual reaction time variability measures as additions to the neuropsychological test batteries that are used in the early detection of a range of age-related neurocognitive disorders in healthcare settings.

Article

Simon J. Haines, Jill Talley Shelton, Julie D. Henry, Gill Terrett, Thomas Vorwerk, and Peter G. Rendell

Tasks that involve remembering to carry out future intentions (such as remembering to attend an appointment), and the cognitive processes that enable the completion of such tasks (such as planning), are referred to as prospective memory (PM). PM is important for promoting quality of life across many domains. For instance, failures in remembering to meet social commitments are linked to social isolation, whereas failures in remembering to fulfill occupational goals are linked to poorer vocational outcomes. Declines in PM functioning are of particular concern for older adults because of the strong links between PM and functional capacity. The relationship between age and PM appears to be complex, dependent on many factors. While some aspects of PM appear to hold up relatively well in late adulthood, others appear to show consistent age-related decline. Variability in age differences appears to partially reflect the fact that there are diverse types of PM tasks, which impose demands on a range of cognitive processes that are differentially affected by aging. Specifically, the level and type of environmental support associated with different PM task types appears to be a meaningful determinant of age-related effects. Given the worldwide changing age demographics, the interest in age-related effects on PM will likely intensify, and a primary focus will be how to optimize and maintain PM capacity for this population. This is already reflected in the increasing research on interventions focused on enhancing PM capacity in late adulthood, and points to important future directions in this area of study.

Article

Daniel L. Schacter, Aleea L. Devitt, and Donna Rose Addis

Episodic future thinking refers to the ability to imagine or simulate experiences that might occur in an individual’s personal future. It has been known for decades that cognitive aging is associated with declines in episodic memory, and recent research has documented correlated age-related declines in episodic future thinking. Previous research has considered both cognitive and neural mechanisms that are responsible for age-related changes in episodic future thinking, as well as effects of aging on the functions served by episodic future thinking. Studies concerned with mechanism indicate that multiple cognitive mechanisms contribute to changes in episodic future thinking during aging, including episodic memory retrieval, narrative style, and executive processes. Recent studies using an episodic specificity induction—brief training in recollecting episodic details of a recent experience—have proven useful in separating the contributions of episodic retrieval from other non-episodic processes during future thinking tasks in both old and young adults. Neuroimaging studies provide preliminary evidence of a role for age-related changes in default and executive brain networks in episodic future thinking and autobiographical planning. Studies concerned with function have examined age-related effects on the link between episodic future thinking and a variety of processes, including everyday problem-solving, prospective memory, prosocial intentions, and intertemporal choice/delay discounting. The general finding in these studies is for age-related reductions, consistent with the work on mechanisms that consistently reveals reduced episodic detail in older adults when they imagine future events. However, several studies have revealed that episodic simulation nonetheless confers some benefits for tasks tapping adaptive functions in older adults, such as problem-solving, prospective memory, and prosocial intentions, even though age-related deficits on these tasks are not eliminated or reduced by episodic future thinking.

Article

Karen Z. H. Li, Halina Bruce, and Rachel Downey

Research on the interplay of cognition and mobility in old age is inherently multidisciplinary, informed by findings from life span developmental psychology, kinesiology, cognitive neuroscience, and rehabilitation sciences. Early observational work revealed strong connections between sensory and sensorimotor performance with measures of intellectual functioning. Subsequent work has revealed more specific links between measures of cognitive control and gait quality. Convergent evidence for the interdependence of cognition and mobility is seen in patient studies, wherein cognitive impairment is associated with increased frequency and risk of falling. Even in cross-sectional studies involving healthy young and older adults, the effects of aging on postural control and gait are commonly exacerbated when participants perform a motor task with a concurrent cognitive load. This motor-cognitive dual-task method assumes that cognitive and motor domains compete for common capacity, and that older adults recruit more cognitive capacity than young adults to support gait and posture. Neuroimaging techniques such as magnetic resonance imaging (MRI) have revealed associations between measures of mobility (e.g., gait velocity and postural control) and measures of brain health (e.g., gray matter volumes, cortical thickness, white matter integrity, and functional connectivity). The brain regions most often associated with aging and mobility also appear to subserve high-level cognitive functions such as executive control, attention, and working memory (e.g., dorsolateral prefrontal cortex, anterior cingulate). Portable functional neuroimaging has allowed for the examination of neural functioning during real-time walking, often in conjunction with detailed spatiotemporal measures of gait. A more recent strategy that addresses the interdependence of cognitive and motor processes in old age is cognitive remediation. Cognitive training has yielded promising improvements in balance, walking, and overall mobility status in healthy older adults, and those with age-related neurodegenerative conditions such as Parkinson’s Disease.