What Have You Learned?

1. Question 24.1

   What aspects of the brain slow down with age?

   Age slows down the production of neurotransmitters. Neural fluid decreases, myelination thins, and cerebral blood circulates more slowly. The result is an overall brain slowdown, evident in reaction time, moving, talking, and thinking.

2. Question 24.2

   Why must the elderly use more parts of their brains simultaneously?

   Compared with younger adults, older adults use more parts of their brains, including both hemispheres, to solve problems. This may be compensation: Using only one brain region may no longer be sufficient if that part has shrunk, so the older brain automatically activates more parts.

3. Question 24.3

   Why is multitasking particularly difficult in late adulthood?

   The brain shrinkage that occurs normally with age interferes with multitasking. No one is intellectually as efficient with two tasks as with one, but older adults are particularly affected when they are given several tasks at once. Recognizing this, many elders are selective, completing one task first then moving on to the next.

4. Question 24.4

   How does sensory loss affect cognition?

   Information must cross the sensory threshold (the divide between what is sensed and what is not) in order to be perceived. A person may not recognize sensory losses because the brain automatically fills in missed sights and sounds. However, a longitudinal study reveals that the average cognitive scores of the adults with hearing loss (who were often unaware of it) were down 7 percent, while those with normal hearing lost 5 percent. Greater hearing losses correlated with greater cognitive declines.

5. Question 24.5

   Which kinds of things are harder to remember with age?

   Explicit memory (the recall of facts and information that has been stored) declines with age. Source amnesia (forgetting where the information came from) becomes more common with age, while prospective memory (ability to remember something that you’ve planned to do, such as a doctor’s appointment) fades with age.

6. Question 24.6

   Why do some elderly people resist learning strategies for memory retrieval?

   Many older adults resist suggested strategies because they believe that declines are “inevitable or irreversible” and that no strategy can help.

7. Question 24.7

   Why is ecological validity especially important for prospective memory?

   The elderly tend to be handicapped by traditional testing. Ecological validity means doing measurements in everyday settings. Such testing conditions ensure that optimal performance is assessed. Awareness of the need for ecological validity has helped scientists restructure research on memory, finding fewer deficits in older adults than was previously believed. Indeed, age differences in prospective memory are readily apparent in laboratory tests but disappear in some naturalistic settings, a phenomenon called the “prospective memory-paradox.” Motivation seems crucial; elders are less likely to forget whatever they believe is important—phoning a child on his or her birthday, for instance.

8. Question 24.8

   What diseases or conditions correlate with loss of cognition?

   Neurocognitive disorders (NCDs) impair intellectual functioning caused by organic brain damage or disease. NCDs may be diagnosed as major or mild, depending on the severity of symptoms. Specific NCDs include Alzheimer disease, vascular NCD, and frontal lobe disorders. Loss of cognition can also be associated with disorders such as Parkinson’s disease.

9. Question 24.9

   In what specific ways does exercise affect the brain?

   Exercise that improves blood circulation not only prevents cognitive loss but also builds capacity and repairs damage.

10. Question 24.10

    How and why does training in cognitive skills help the elderly?

    Through cognitive skills training, older adults sometimes learn cognitive strategies and skills and maintain that learning if the strategies and skills are frequently used.

11. Question 24.11

    Why has the language surrounding neurocognitive disorder changed in recent years?

    Ageism is revealed in the older terminology surrounding neurocognitive disorders. Senile simply means “old,” but senility is used to mean severe mental impairment, which implies that old age always brings intellectual failure—an ageist myth. Dementia was a more precise term than senility for irreversible, pathological loss of brain functioning, but dementia also has inaccurate connotations (e.g., it is related to the Latin word for “mad” or “insane”). The DSM-5 replaces the term dementia with the term neurocognitive disorders (NCDs). Either major NCD or mild NCD, depending on the severity of symptoms, is a better way of capturing the range of cognitive impairment and providing the opportunity for early detection and treatment of cognitive decline.

12. Question 24.12

    What proof is there that Alzheimer disease is partly genetic?

    Alzheimer disease is partly genetic. If it develops in middle age, the affected person either has trisomy-21 (Down syndrome) or has inherited one of three genes: amyloid precursor protein (APP), presenilin 1, or presenilin 2. For these people, the disease progresses quickly, reaching the last phase within three to five years.

13. Question 24.13

    Why are most people unaware of the early stages of vascular NCD?

    People may be unaware of the early stages of vascular dementia because symptoms may vanish quickly and thus go unnoticed.

14. Question 24.14

    In what ways is frontal lobe dementia worse than Alzheimer disease?

    It is particularly likely to occur at relatively young ages (under age 70), unlike Alzheimer or vascular diseases, which typically begin later.

15. Question 24.15

    If a person has Parkinson disease, what effect does that person’s age have on the effects of the disorder?

    Younger adults with Parkinson’s disease usually have sufficient cognitive reserve to avoid major intellectual loss, although about one-third have mild. Older people with Parkinson’s develop cognitive problems sooner.

16. Question 24.16

    Why is Lewy body dementia sometimes mistaken for Parkinson’s disease?

    Lewy bodies are also present in Parkinson’s disease, but in Lewy body disorder they are more numerous and dispersed throughout the brain, interfering with communication between neurons.

17. Question 24.17

    How successful are scientists at preventing dementia?

    Among professionals, hope is replacing despair. Earlier diagnosis seems possible; many drug and lifestyle treatments are under review. Early, accurate diagnosis, years before obvious symptoms appear, leads to more effective treatment.

18. Question 24.18

    How can older people help to improve their own cognitive abilities?

    To boost their control processes, older adults could begin playing video games. To boost general cognitive ability, older adults could begin exercising to improve blood circulation to the brain, which prevents cognitive loss and builds capacity and repairs damage.

19. Question 24.19

    Why might older people become more creative, musical, and spiritual than they previously were?

    In a study of extraordinarily creative people, almost none felt that their ability, their goals, or the quality of their work had been much impaired by age. Old age can be a time of emotional sensory awareness and enjoyment.

20. Question 24.20

    Why do scientists hesitate to say that wisdom comes with age?

    Contrary to these wishes and opinions, most objective research finds that wisdom does not necessarily increase with age. Starting at age 25 or so, some adults of every age are wise, but most, even at age 80, are not. An underlying research quandary is that a universal definition of wisdom is elusive.