24.4 New Cognitive Development

You have learned that most older adults maintain adequate intellectual power. Some losses—in rapid reactions, for instance—are quite manageable, and only a minority of elders suffer a major neurocognitive disorder. Beyond that, the lifespan perspective holds that gains as well as losses occur during every period. [Lifespan Link: The multidirectional characteristic of development is discussed in Chapter 1.] Are there cognitive gains in late adulthood? Yes, according to many developmentalists. New depth, enhanced creativity, and even wisdom are possible.

Erikson and Maslow

Long Past Warring Many of the oldest men in Mali, like this Imam, are revered. Unfortunately, Mali has experienced violent civil wars and two national coups in recent years, perhaps because 75 percent of the male population are under age 30 and less than 2 percent are over age 70.

SEAN CAFFREY/LONELY PLANET IMAGES/GETTY IMAGES

Both Erik Erikson and Abraham Maslow were particularly interested in the elderly, interviewing older people to understand their views. Erikson’s final book, Vital Involvement in Old Age (Erikson et al., 1986), written when he was in his 90s, was based on responses from other 90-year-olds—the cohort who had been studied since they were babies in Berkeley, California.

Erikson found that in old age many people gained interest in the arts, in children, and in human experience as a whole. He observed that elders are “social witnesses,” aware of the interdependence of the generations as well as of all of human experience. His eighth stage, integrity versus despair, marks the time when life comes together in a “re-synthesis of all the resilience and strengths already developed” (Erikson et al., 1986, p. 40).

Maslow maintained that older adults are more likely than younger people to reach what he originally thought was the highest stage of development, self-actualization. Remember that Maslow rejected an age-based sequence of life, refusing to confine self-actualization to the old. However, Maslow also believed that life experience helps people move forward, so more of the old reach the final stage.

The stage of self-actualization is characterized by aesthetic, creative, philosophical, and spiritual understanding (Maslow, 1970). A self-actualized person might have a deeper spirituality than ever; might be especially appreciative of nature; or might find life more amusing, laughing often at himself or herself.

This seems characteristic of many of the elderly. As you read in Chapter 23, studies of centenarians find that they often have a deep spiritual grounding and a surprising sense of humor—surprising, that is, if one assumes that people with limited sight, poor hearing, and frequent pain have nothing to laugh about.

Learning Late in Life

Excited Neurons As you see, this nursing home in New Mexico has a large, impersonal assembly room, where some residents sit in isolation. However, that deficit may be offset for others by the energetic Activities Director (Cyndi Bolen, left), who provided Wii Sports bowling on a wide screen. At least one of the oldest-old (Mildred Secrest, right) was thrilled when she got a spare.

© AP PHOTO/LUCAS IAN COSHENET/THE DAILY TIMES

Many people have tried to improve the intellectual abilities of older adults by teaching or training them in various tasks (Lustig et al., 2009; Stine-Morrow & Basak, 2011). Success has been reported in specific abilities. In one part of the Seattle Longitudinal Study, 60-year-olds who had lost some spatial understanding had five sessions of personalized training and practice. As a result, they returned to the skill level of 14 years earlier (Schaie, 2005).

Another group of researchers (Basak et al., 2008) targeted control processes. Volunteers with an average age of 69 and no signs of any cognitive disorder were divided into an experimental group and a control group. Everyone took a battery of cognitive tests to measure executive function. None were video-game players.

The experimental group was taught to play a video game that was preset to begin at the easiest level. After each round, they were told their score, and another round began—more challenging in pace and memory if the earlier one was too easy. The participants seemed to enjoy trying to raise their score. After 20 hours of game playing over several weeks, the cognitive tests were given again. Compared with the control group, the experimental group improved in mental activities that were not exactly the ones required by the video game.

Similar results have been found in many nations in which elders have been taught a specific skill. As a result, almost all researchers have accepted the conclusion that people younger than 80 can advance in cognition if the educational process is carefully targeted to their motivation and ability.

Screen to Brain Although elders are least likely to have Internet connection at home, they may be most likely to benefit from it. Video games may improve cognition in late adulthood. Even better may be videoconferencing with a grandchild, as shown here. Mental flexibility and family joy correlate with a long and happy life.

© JOSE LUIS PELAEZ, INC./CORBIS

For instance, in one study in southern Europe people who were cognitively intact but were living in senior residences were taught memory strategies and attended motivational discussions to help them understand why and how memory was important for daily functioning. Their memory improved compared to a control group, and the improvements were still evident 6 months later (Vranica et al., 2013).

What about the oldest-old? Learning is more difficult for them, but it is still possible. The older people are, the harder it is for them to master new skills and then apply what they know (Stine-Morrow & Basak, 2011). Older adults sometimes learn cognitive strategies and skills and maintain that learning if the strategies and skills are frequently used, but they may quickly forget new learning if it is not applied (Park & Bischoff, 2013). They revert back to familiar, and often inferior, cognitive patterns.

Let’s return to the question of cognitive gains in late adulthood. In many nations, education programs have been created for the old, called Universities for the Third Age in Europe and Australia, and Exploritas (formerly Elderhostel) in the United States. Classes for seniors must take into account the range of needs and motivations: Some want intellectually challenging courses and others want practical skills (Villar & Celdrán, 2012). All the research finds that, when motivated, older adults can learn.

Alaska Learning Martha Wroe (right) of Gainesville, Florida is one of 14 seniors who travelled to Alaska on an Elderhostel excursion. “I wanted an adventure,” she said. Adventures in late adulthood expand cognition.

MONICA ALMEIDA/THE NEW YORK TIMES/REDUX

Aesthetic Sense and Creativity

Exercise and the Mind Creative activity may improve the intellect, especially when it involves social activity. Both the woman in a French ceramics class (top), subsidized by the government for residents of Grenoble over age 60, and the man playing the tuba in a band in Cuba (bottom) are gaining much more than the obvious finger or lung exercise.

PIERRE BESSARD/REA/REDUX
© RODRIGO TORRES/GLOWIMAGES/CORBIS

Robert Butler was a geriatrician responsible for popularizing the study of aging in the United States. He coined the word ageism, and wrote a book, Why Survive: Being Old in America, first published in 1975. Partly because his grandparents were crucial in his life, Butler understood that society needs to recognize the potential of the elderly.

Butler explained that “old age can be a time of emotional sensory awareness and enjoyment” (Butler et al., 1998, p. 65). For example, some of the elderly take up gardening, bird watching, sculpting, painting, or making music, even if they have never done so before.

A well-known example of late creative development is Anna Moses, who was a farm wife in rural New York. For most of her life, she expressed her artistic impulses by stitching quilts and embroidering in winter, when farm work was slow. At age 75, arthritis made needlework impossible, so she took to “dabbling in oil.”

Four years later, three of her paintings, displayed in a local drugstore, caught the eye of a New York City art dealer who happened to be driving through town. He bought them, drove to her house, and bought 15 more.

The following year, at age 80, “Grandma Moses” had a one-woman show, receiving international recognition for her unique “primitive” style. She continued to paint, and her work “developed and changed considerably over the course of her twenty-year career” (Cardinal, 2001). Anna Moses died at age 101.

History of My People When they were young they were imprisoned here, in a California internment camp for Japanese-Americans. They wanted to see it again, not only for their own life review, but also to put their experiences in context for the new generation.

MICHAEL S. YAMASHITA/NATIONAL GEOGRAPHIC SOCIETY/GETTY IMAGES

Other well-known artists continue to work in late adulthood, sometimes producing their best work. Michelangelo painted the awe-inspiring frescoes in the Sistine Chapel at age 75; Verdi composed the opera Falstaff when he was 80; Frank Lloyd Wright completed the design of New York City’s Guggenheim Museum when he was 91.

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. The leader of that study observed, “In their seventies, eighties, and nineties, they may lack the fiery ambition of earlier years, but they are just as focused, efficient, and committed as before … perhaps more so” (Csikszentmihalyi, 1996, p. 503). But an older artist does not need to be extraordinarily talented. Some of the elderly learn to play an instrument, and many enjoy singing. In China people gather spontaneously in public parks to sing together. The groups are intergenerational—but a disproportionate number are elderly (Wei, 2013).

Music and singing are often used to reduce anxiety in those who suffer from neurocognitive impairment, because the ability to appreciate music is preserved in the brain when other functions fail (Ueda et al., 2013). Many experts believe that creative activities—poetry and pottery, jewelry making and quilting, music and sculpture—benefit all the elderly (Flood & Phillips, 2007; Malchodi, 2012). Artistic expression may aid social skills, resilience, and even brain health (McFadden & Basting, 2010).

In the life review, elders provide an account of their personal journey by writing or telling their story. They want others to know their history, not only their personal experiences but also those of their family, cohort, or ethnic group. According to Robert Butler:

Hundreds of developmentalists, picking up on Butler’s suggestions, have guided elderly people in self-review. Sometimes the elderly write down their thoughts, and sometimes they simply tell their story, responding to questions from the listener.

The result of the life review is almost always quite positive, especially for the person who tells the story. For instance, of 202 elderly people in the Netherlands, half were randomly assigned to a life review process. For them, depression and anxiety were markedly reduced compared to the control group (Korte et al., 2013).

Wisdom

Wise or Foolish? His family (in the background) is likely to think grandfather is wise, but he probably just enjoys zipping on this home-made wire.

© RICHARD BAKER/IN PICTURES/CORBIS

It is possible that “older adults … understand who they are in a newly emerging stage of life, discovering the wisdom that they have to offer” (Bateson, 2011, p. 9). A massive international survey of 26 nations from every corner of the world found that most people everywhere agree that wisdom is a characteristic of the elderly (Löckenhoff et al., 2009).

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 (Staudinger & Glück, 2011).

An underlying research quandary is that a universal definition of wisdom is elusive: Each culture and each cohort has its own concept, with fools sometimes seeming wise (as happens in some of Shakespeare’s plays) and those who are supposed to be wise sometimes acting foolishly (provide your own examples). Older and younger adults differ in how they make decisions; one interpretation of these differences is that the older adults are wiser, but not every younger adult would agree (Worthy et al., 2011).

One summary describes wisdom as an “expert knowledge system dealing with the conduct and understanding of life” (P. B. Baltes & Smith, 2008, p. 58). Several factors just mentioned, including self-reflective honesty (as in integrity), perspective on past living (the life review), and the ability to put aside one’s personal needs (as in self-actualization), are considered part of wisdom.

If this is true, the elderly may have an advantage in developing wisdom, particularly if they have: (1) dedicated their lives to the “understanding of life,” (2) learned from their experiences, and (3) become more mature and integrated (Ardelt, 2011, p. 283). That may be why popes and Supreme Court judges are usually quite old.

As two psychologists explain:

These researchers posed life dilemmas to adults of various ages and asked others (who had no clue as to how old the participants were) to judge whether the responses were wise. They found that wisdom is rare at any age, but, unlike physical strength and cognitive quickness, wisdom does not fade with maturity. Thus, some people of every age were judged as wise.

Similarly, the author of a detailed longitudinal study of 814 people concludes that wisdom is not reserved for the old, and yet humor, perspective, and altruism increase over the decades, gradually making people wiser. He then wrote:

VISUALIZING DEVELOPMENT

Neurocognitive Disorders in Late Adulthood

While neurocognitive disorders like Alzheimer disease are common in later adulthood, they aren’t an inevitable part of aging. But these diseases are now the biggest cause of disability in developed countries and are growing in prevalence around the world. The different types of neurocognitive disorders differ in their biological origins (some are strongly genetic, like Huntington’s disease; others, like Parkinson’s disease, may have environmental risk factors) and in their underlying brain pathology. Common types of neurocognitive disorder include Alzheimer disease, NCD with Lewy bodies (which may cause up to 30 percent of NCDs in older adults), vascular neurocognitive disorder (cognitive loss caused by a cerebrovascular event such as a stroke, vascular disease), Parkinson’s disease, and Huntington’s disease.