![]() ![]() For example, those who are too ill or have more limited social and financial support may find it hard to participate. Recruiting subjects for any clinical research study may be biased by which subjects are willing to enroll (recruitment bias). ![]() General biases include recruitment bias and misclassification bias. 3 4 5 Studies of cognition across the life span are subject to several biases, some of which apply in general and some that are specific to study design. To appreciate how cognition changes with normal aging requires an understanding of some of the limitations that are inherent in studying cognition and aging. Any approaches that could decrease the negative effects of age on cognition or decrease the risk of developing a neurodegenerative dementia would have a tremendous impact on the quality of life of millions of older adults in the United States. 2 Thus, it is vital to understand how age impacts cognition and what preventative or treatment strategies might preserve cognition into advanced age. The Alzheimer's Association estimates that 5.2 million people in the United States had a clinical diagnosis of Alzheimer disease (AD) in 2014, and the number of people with a diagnosis of AD is projected to increase to 13.8 million people in 2050, unless effective preventative or treatment strategies are developed. 1 Because many more people are living longer, the number of people with age-associated neurodegenerative dementias also is increasing rapidly. ![]() The number of Americans over the age of 65 is projected to more than double over the next 40 years, increasing from 40 million in 2010 to 89 million in 2050. In 2010, this has increased to 76 years for men and 81 for women. For example, in 1910 the life expectancy of a man was 48 years and a woman was 52 years. Over the past century, the life span for both men and woman has increased dramatically. It is imperative to understand the effects of age on cognition because of the rapidly increasing number of adults over the age of 65 and the increasing prevalence of age-associated neurodegenerative dementias. It is important to understand what types of changes in cognition are expected as a part of normal aging and what type of changes might suggest the onset of a brain disease. Cognitive abilities often decline with age. ![]() In addition, intact cognition is vital for humans to communicate effectively, including processing and integrating sensory information and responding appropriately to others. Learning Outcomes: As a result of this activity, the participant will be able to (1) describe the type of cognitive abilities that decline with normal aging and those that do not and name several of the structural and functional changes in the brain that correlate with these changes in cognition, and (2) list several age-associated conditions that result in increased neurodegeneration, as measured by hippocampal size, and summarize the lifestyle factors that may improve neuroplasticity and limit this neurodegeneration.Ĭognition is critical for functional independence as people age, including whether someone can live independently, manage finances, take medications correctly, and drive safely. There is emerging evidence that healthy lifestyles may decrease the rate of cognitive decline seen with aging and help delay the onset of cognitive symptoms in the setting of age-associated diseases. Age-related diseases accelerate the rate of neuronal dysfunction, neuronal loss, and cognitive decline, with many persons developing cognitive impairments severe enough to impair their everyday functional abilities. Structural and function changes in the brain correlate with these age-related cognitive changes, including alterations in neuronal structure without neuronal death, loss of synapses, and dysfunction of neuronal networks. Cumulative knowledge and experiential skills are well maintained into advanced age. The most important changes in cognition with normal aging are declines in performance on cognitive tasks that require one to quickly process or transform information to make a decision, including measures of speed of processing, working memory, and executive cognitive function. Understanding these age-related changes in cognition is important given our growing elderly population and the importance of cognition in maintaining functional independence and effective communication with others. This article reviews the cognitive changes that occur with normal aging, the structural and functional correlates of these cognitive changes, and the prevalence and cognitive effects of age-associated diseases. ![]()
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