Aging and Cognitive Function

Agingand Cognitive Function

Agingand Cognitive Function

Declinein cognitive function is an issue of concern to near all, if not theentire population of older adults. Cognitive decline that is relatedto aging is exhibited in different ways, including short-term memory,processing speed, long-term memory, and working memory. In addition,a decline in cognitive function among older adults is associated withseveral pathophysiological factors such as, hippocampus damage, lossin brain volume and weight, neuronal shrinking, reduction in synapticdensity, and mitochondrion damage (Myers, 2008). In most cases,decline in cognitive function is associated with minor or significantchanges in the brain function or structure. This reduces the qualityof life (QoL), which is defined as subjective evaluation andexperiences of an individual’s life circumstances (Gessert etal.,20005). This paper addresses the issue of decline in cognitivefunction among older adults, with the main focus on its effect ontheir quality of life and independence.

Corecognitive changes and decline in cognitive function

Althoughold age affects a wide range of cognitive functions, there arecentral deficits that underlay a myriad of changes in functionality.According to Keisinger (2006) the domain general theory proposesthree types of deficit that can be used to explain the occurrence ofthe decline in cognitive function with aging. First, significantchanges in sensation (hearing and vision) can act as the underlyingdeficit that leads to a decline in cognitive function among olderadults. This has been proven by the fact that the performance ofolder adults in a large number of cognitive tasks is stronglyassociated with sensory abilities. This implies that a deficit insensory abilities leads to a decline in cognitive functionality.

Secondly,a deficit in inhibitory control subject older adults to the risk ofdecline in cognitive functionality. According to Keisinger (2006) thedecline in cognitive ability among older adults is closely related tolack of ability to ignore to-be-forgotten information and focus oninformation that is goal relevant. This is because older adults findit hard to inhibit associations that exist between ideas, such asgoing to bed and switching off the stove. In addition, the deficit ininhibitory control may also occur when an older adult has to switchbetween tasks.

Third,a decline in cognitive ability is exhibited in the form of slowdownin the processing speed. Although this type of slowdown in processingspeed becomes apparent at motor level, it is also noted at acognitive level. Cognitive performance is affected because of theslowdown in mental operations that fails to be carried out within theneeded timeframe (Keisinger, 2006). An increase in time betweendifferent mental operations makes it difficult to access informationthat was previously processed. This leads to poor encoding ofinformation as well as reduced ability of an individual to store theprocessed information, which in turn affects the cognitivefunctionality.

Cognitivepreservation and healthy aging

Althoughdecline in cognitive ability is a general occurrence among olderadults, it does not lead to cross-the-board deficit in mentalability. Research shows that there are two aspects of cognitiveability that are either preserved or improved with aging. First,crystallized intelligence, which is the ability of an individual toretrieve and apply information acquired during lifetime, is retainedwith aging (Keisinger, 2006). This gives older adults the capacity toanswer questions that require the use of general knowledge, definewords, applying skills at work, and detecting spelling errors.Secondly, emotional regulation improves with an increase in age,especially starting at the age of 60 years. This means that olderadults who manage to regulate their emotions have reduced chances tosuffer from depression. However, this occurs only in a smallproportion of the population of older adults and enhances theirability to recover from negative moods.

Effectsof cognitive impairment on quality of life and independence

Thequality of life is one of the most reliable ways of determining theburden of a disease on the affected person. Similarly, the burden ofcognitive impairment on older adults can be assessed by determiningits effect on their quality of life. Decline in cognitive abilitydoes not impact the quality of life of the affected persons equally.Consequently, predictors of quality of life can be subdivided intothree categories, namely strong predictors, moderate predictors, andweak predictors. There are two aspects of strong predictors ofquality of life that affect older adults directly. First, decline incognitive function reduces the autonomy of the affected persons bydiminishing their ability to make decisions that relate to issuesaffecting their lives (Mitchell, Kemp, Benito, &amp Reuber, 2010).This occurs because persons with reduced cognitive function tend toforget the past information and events, thus limiting their abilityto make decisions that affect their present and the future. Thisimplies that people suffering from cognitive dysfunction have limitedcontrol over their lives as well as their surroundings.

Secondly,old age is associated with the occurrence of dementia, which in turncauses depression and a decline in quality of life. Dementia is asevere neurodegenerative disorder that is characterized byprogressive decline in functional and cognitive abilities. Accordingto Annicchiarico, Federici, Pettenati &amp Caltagirone (2007)prevalence of dementia among increases exponentially with theincrease in age, from 1 % at the age 60 years to 33 % at the age of85 years. This type of neurodegenerative disorder is associated withbehavioral disturbances and total dependency when it reaches achronic stage. At this stage, the affected person becomes depressedand leads an unsatisfactory life that is characterized by totalcognitive impairment, social depression, and inability to participatein social activities. Functional dependency varies with environmentalvariables and occurs in different or the same patient at differenttimes. Therefore, decline in cognitive function subject older adultsto the risk of suffering from more chronic conditions that reducetheir overall quality of life.

Themoderate and weak predictors of quality of life are assessed on thebasis of the underlying neurological conditions (such as the braintumor, stroke, traumatic brain injury, and motor neuron disease) thatcause cognitive dysfunction. The occurrence of brain tumors at oldage prevents the patient from returning to their pre-morbidoccupation and autonomy. Older adults with ongoing complications mayexperience communication difficulties and neuropsychiatric symptomsthat are closely associated with the perceived burden of decline incognitive function (Mitchell, et al., 2010). In addition, prolongedbrain damage reduces the patient’s cognitive capacity, which inturn reduces their ability to carry out the activities of their dairyliving. Traumatic brain injury is another common disease thatincreases the risk of suffering from a decline in cognitive functionamong older adults. The of traumatic injuries in the brain is closelyassociated with reduced physical mobility, difficulties incommunication, work, eating, home management, and reducedintellectual competence. However, reduced competence in occupationalactivities is mainly predicted by memory and physical impairmentwhile issues of interpersonal relationships are associated with thecognitive behavior and processing speed.

Althoughdecline in cognitive function is perceived to be an inevitableoccurrence among older adults, there are several techniques that canbe used to improve memory with aging. According to Foos &amp Clark(2008) memory improvement techniques can focus on improving cognitiveperformance or reducing anxiety about cognitive impairment. In mostcases, techniques that are used to improve memory are rarelyeffective in reducing anxiety about the anticipated decline incognitive functionality. This implies that older adults use differenttechniques to pursue varying goals. Internal techniques are effectivein improving memory with aging. For example, the use of acronyms canhelp older adults in remembering certain things (such as colors andlakes) and improve memory with time. The type of anxiety broughtabout by the expectation of cognitive impairment can be reduced bytraining older adults about cognitive changes that occur with age.This reduces anxiety and improves self efficacy among older adultswho are at the risk of decline in cognitive functionality.

Conclusion

Declinein cognitive function is one of the major factors that reduce qualityof life and independence of older adults. Decline in cognitivefunction in old age is caused by other cognitive deficits that affectthe structure or functions of the human brain. The common types ofdeficits associated with cognitive impairment among older adultsinclude sensory deficit, inhibitory control deficit, and inhibitionof processing speed. Although older adults experience significantdecline in memory, their crystallized intelligence and emotionalregulation either remain intact or improve with time. Decline incognitive ability affect the quality of life of different people invarying ways. Some older adults may suffer from cognitive impairmentand social depression, which reduces their autonomy and ability toparticipate in social activities. In addition, older adults are at ahigher risk of suffering from neurodegenerative disorders that affecttheir cognition and overall quality of life. Internal and externaltechniques can be used to improve cognitive function and reduceanxiety that results from anticipation of cognitive impairment amongolder adults.

References

Annicchiarico,R., Federici, A., Pettenati, C., &amp Caltagirone, C. (2007).Rivastigmine in Alzheimer’s disease: Cognitive function and qualityof life. Therapeuticand Clinical Risk Management,3 (6), 1113-1123.

Foos,P. &amp Clark M. (2008). Humanaging (2nd edition).Boston,MA: Allyn &ampBacon.

Gessert,E., Hyer, K., Kane, L., Rockwood, T., Brassard, B., Desjardins, K.,Kane, A. (2005). Cognitive impairment and quality of life: Views ofproviders of long-term care services. AlzheimerDisease and Association Disorders,19 (2), 85-90.

Keisinger,E. (2006). Cognitionin aging and age-related disease.Chestnut Hill, MA: Boston College.

Mitchell,J., Kemp, S., Benito, J., &amp Reuber, M. (2010). The influence ofcognitive impairment on health-related quality of life inneurological disease. ActaNeuropsychiatrica,22, 2-13. DOI: 10.1111/j.1601-5215.2009.00439.x

Myers,S. (2008). Factors associated with changing cognitive function inolder adults: Implications for nursing rehabilitation. RehabilitationNursing,33 (3), 117-123.